Everything Is Connected to Everything with Dr. Mel Houser

0:01 Welcome to Hacking Your ADHD. I'm your host, William Curb, and I have ADHD. On this podcast, I dig into the tools, tactics, and best practices to help you work with your ADHD brain. Hey, team. This week, I'm talking with Dr. Mel Houser, a family physician and founder of All Brains Belong, a nonprofit that brings together healthcare and community to support for neurodivergent people.

0:24 Dr. Houser is also autistic and ADHD herself, and the author of A Failure of Imagination: How the Healthcare System Fails Neurodivergent People and What We're Doing Instead. in our conversation today, we get into some topics I don't normally cover on the show, including how physical health conditions can overlap for neurodivergent people and what gets missed when we treat each issue as its own separate problem.

0:49 We also talk about a resource you can bring to your doctor to help you get that conversation started. From there, we get into understanding our capacity, setting boundaries around what we can actually manage, and why rest doesn't always have to mean lying down and doing nothing. And Dr. Hauser shares a way of thinking about those moments when we can't stop scrolling.

1:08 If your foot is already on the gas, what could it look like to steer somewhere else? If you'd like to follow along on the show notes page, you can find that at hackingyouradhd.com/321. All right, keep on listening to find out what to do when you're feeling beyond capacity but have to keep going on all right.

1:34 I am so excited to have you here today because, we're gonna be talking about some topics that I don't normally cover that often because not that many people know about it, with a lot of these chronic conditions that are more physically, show up with people with autism and ADHD and other neurodivergents.

1:54 everything is connected to everything. Can you tell me a little bit about that? Yeah, for sure. So I would say that concept really applies to lots of different things that we do here. here at All Brains Belong, our nonprofit organization, we support neurodivergent folks who have struggled to get their needs met in lots of different broken systems.

2:15 And so it's healthcare, it's school, it's workplaces, it's community at large. And I'm a family physician, mostly caring for neurodivergent kids and adults, of all ages. And when I worked in traditional primary care, I was finding that I was spending almost all of my time problem-solving life outside the exam room.

2:38 that's how I'd spend my time in the exam room. Because everything's connected to everything, right? So it's m- the idea that the healthcare system treats medical care so separate from the rest of life never really made any sense to me. And so for the past five years, we've been, together with our community, really thinking intentionally about how we want healthcare to look.

3:01 And so it's healthcare for neurodivergent people by neurodivergent people, really co-created with our community. and so some of the things that have come up, folks wanting support for employment, folks wanting help and support making friends, folks wanting us to train employers about how to create workplaces where all people can do their best work.

3:25 And so it, it's, that foundation of everything's being connected, meaning, healthcare is more than medical care. and then what we have seen in our medical practice as folks who come here are generally those who have medical problems that they were unable to get the care they needed from traditional healthcare.

3:44 That's generally why they come here. And so what we were seeing is a pattern, a constellation of intertwined medical conditions, that there is research that links all of these conditions to autism and to ADHD and links these conditions to each other. But we did not anticipate that this would be the overwhelming majority of the patients who would seek care here.

4:09 So some examples of that cluster of intertwined medical conditions: hypermobility, mast cell dysfunction, irritable bowel syndrome, pain syndromes like fibromyalgia migraine, endometriosis, post-infectious chronic illness, for example long COVID, dysautonomia or a subtype called POTS. the list goes on and on.

4:34 That's not an exhaustive list by any means, but it's the idea that these are conditions that impact the nervous system and the immune system, the neuroimmune systems, which are our first line of defense, to threat. And living in a world that's not designed for you is threatening. And and yet on top of that, having physiology that is different from the general population, in such a way that is not really well understood or even known, by medical education Yeah, and it's just kinda like shocking when you hear about all the physiological conditions that can come along with ADHD and autism and all these things, because that's not what you think about typically or it… that's, you're never, like, seeing that be the thing that pops up in, pop culture or something.

5:30 Right. And so what we see here is that, some patients come because they either know they're neurodivergent or they wonder whether they're neurodivergent. and sometimes it's because, let's say, their children get diagnoses and they start thinking and learning about brains, and they wanna know about their brain.

5:46 That is one pathway. it may be that someone is deep in neurodivergent burnout, and they're just struggling to access anything in their environment, and so they come. They don't necessarily, they're not thinking about neurodivergence, but they're just deep in struggle, and so that's their pathway to understanding.

6:03 But then a third pathway is I have all of these medical conditions and, there's something really wrong with me, and I keep being told that my tests are normal and that I, there's, that, it's in my head. It's actually, no, it's not. It's in your neuroimmune systems. And so that's the pattern that we see here Yeah, and it's so often that you wouldn't even, associate them with yourself.

6:29 I've dislocated my shoulder so many times because I was-- And I was just like, "Oh, that's just how this is." And I'm like, it didn't really occur to me that yeah, not everyone Not everybody dislocates their shoulder ever, let alone multiple times. And I think that a lot of these things, ju- just as, autism and ADHD run in families, so do these medical conditions, and so a lot of this gets normalized intergenerationally.

6:54 So I'm the six-year-old who needed allergy shots. Not all six-year-olds need allergy shots, but, s- so did my mother, right? So it's just "Oh, that's what happens. allergies, they're bad." It's like, actually my mast cells have not been, working appropriately for almost, 40 years Yeah. We, my son was at a doctor appointment and they were having him, do the stupid human tricks with, like, how bendy he is.

7:20 And he's way more bendy than I am, because I… There's only a couple places where I have the, hypermobility, but I was like, "Oh, wow, you can really bend your fingers in way-- That is unpleasant to look at now." No, and totally. And so, being bendy, and so like I, I have a nine-year-old who is also bendy, and so like just the way we talk about this with kids is just "Yeah, you have a bendy body." And so we think about, how are you able to do the activities in your life that you wanna be doing with some extra support?

7:49 So when we go hiking, maybe we wanna make sure that we're wearing shoes with ankle supports as opposed to hiking in flip-flops and stuff. Just like we wanna… We don't, wanna limit our activities per se, just because we're bendy. We just maybe need some supports. Yeah, and it's, comes in all sorts of things.

8:07 my daughter has really bad interoception and just does not get a th- thirst thing, signal. So we're like, "Oh, we have to get water bottles that blink every half hour," and then she g- remembers to drink or, or just more fun to use. Yeah. But, and I find there's so many things where you can do like little… yeah, it's like we don't need to be like, " Oh, you can't do things." It's just "Okay, how do we modify things so that we can?"

8:30 Right. Exactly and so I see a lot of people though being like, yeah, they do have these things that they don't know that they have. A- and I think related to that is to not know what one's risks are. So for example, we know that autistic and ADHD people have higher rates of long COVID. We also know that among all comers, the more times you get COVID, the higher your chances of long COVID.

9:05 If you're hypermobile, you have an increased risk of long COVID. So if you are all these things and you don't know that, you don't know that you're actually at increased risk. And so what happens, in 2026 we're having people having to choose between their health and safety and, what, their full and meaningful participation in their life looks like.

9:27 And so that's, that, that is a real problem to have. it's one thing for, informed risk-taking, but we don't have informed risk-taking. We just have risk-taking Yeah, it does not help with the, and the tendency for risk-taking already, where you're just like, "Oh yeah, impulsivity." I'm like, "Yeah, that's just-- I'm gonna do that.

9:47 I'm gonna do that thing. And I do trust that the air that I'm breathing is safe to breathe. And if I can't actually trust that, that's gonna impact everything Yeah. and I could definitely see that leading to other mental conditions that are like, OCD things where you're like, "Oh yeah, this is-- I'm training myself to be un- to not trust everything around me."

10:14 I'm hypervigilant because I can't trust the systems to take care of me and keep me safe. Mhm. And the stakes are really high when people have this constellation of neuroimmune conditions. they, even if their, their case of whether it's COVID or any acute infection, that case might be mild, but the long-term consequences of the neuroimmune system can be profound.

10:40 a third of my medical practice has long COVID actually, and, cases were generally mild for the actual COVID, but now we have people who they can't go to work, and they can't play with their kids, and they're homebound or even bedbound, and they had no idea they were at risk Yeah, I guess I've I don't really know what you do with long COVID at this point.

11:04 I've, heard so how exactly do Yeah. so I would think about, actually, I'd, refer your listeners, we have a project, and this is what you were starting to ask about before. We have a project that we co-created with 100 of our autistic and ADHD patients, in 2023. It's called Everything's Connected to Everything: Improving the Healthcare of Autistic and ADHD Adults.

11:26 And so it's a toolkit that patients and their primary care clinicians can work through these medical problems together. So long COVID belongs to that constellation. And so there's a 16-page evidence-based clinician guide where it talks about, like, how do we support long COVID and related conditions?

11:43 And, there, there's also, on the patient page, there's a letter that folks can print out and bring in to their next primary care appointment. It introduces the project. It's written in language that doctors are used to speaking in. And so this way the people don't have to contort themselves to get the attention that they need.

12:03 They don't have to use the right words or, conform themselves in the 15-minute visit. Just print out the letter, hand it over, and it's written in such a way that invites the clinician to check out the clinician guide. Especially if someone knows that they are ADHD and/or autistic, it's oh yeah, I think a lot of primary care clinicians would acknowledge that they didn't get a lot of training in the health conditions of autistic and ADHD adults.

12:29 That wasn't really part of a lot of people's training, and so they're open, "Oh, there's a resource that I can learn from? yeah, we can look at that during an appointment, sure." And so we've gotten feedback, from, the, the, general public that, that letter actually ends up being helpful to them during their appointments in a way that they didn't, they weren't able to have an effective conversation before.

12:49 Yeah. I know often when I go to the doctor, I am very aware of, I wanna be very specific in what I'm saying and being like, describing my problem accurately to make sure that I actually get the care I need. And I know as a white male, I'm much more likely to be able to have that conversation. so I can imagine that's just an incredible tool for people.

13:13 And so just let the letter speak for you, just, as a, it takes the pressure off of saying the just 'Cause what we are finding actually is that the language that doctors are used to hearing to match the patterns that they have in their brains, those are not the words that patients use. And someone might describe like a tingling or a buzzing, but the doctor's looking to hear that there's pain or something.

13:41 so th- that's just one small example. But these, this, and, why this becomes important actually is that, these, this constellation of intertwined medical problems, they actually interact. And so for example, let's say somebody, goes to the doctor. They have chronic pain, and so let's say the doctor s- sees that maybe their muscles are tight, so they prescribe a muscle relaxant.

14:04 But actually they're hypermobile, or maybe they're hypermobile enough to meet criteria for hypermobile Ehlers-Danlos syndrome, which is a systemic connective tissue condition. So let's say somebody's hypermobile, including in their airway, where their unrecognized sleep apnea, now on the muscle relaxant, the connect- the floppy connective tissue got floppier, including in the airway, makes their unrecognized sleep disorder worse, and which makes their dysautonomia worse, their, dysregulated autonomic nervous system, which they didn't know they had either, which actually makes their pain worse.

14:38 And so now the very thing that the doctor thought they were treating is actually making the whole constellation worse. So what this, what this tool walks folks through is ways of thinking about how, what are some supports in place, medicine, supplements, strategies that can make the salient parts of the cluster better without making the other parts worse.

14:57 And, we screen for the whole cluster in our practice because we almost always find that it's not j- it's never just one thing in this population. As someone that has been prescribed muscle relaxants and finds that they're just murder on my sleep, I was had my mind blown there for a minute. Yep. I was like, "Oh, that makes so much sense.

15:18 Okay. Yeah, Yeah. But like nobody knows, so it's just "Oh, do, we do the thing." And this is what goes on in the healthcare system, especially because, it's… I don't think that it's the fault of any individual clinicians. I think that the healthcare system is the villain here, and I think thwarts patients and clinicians alike.

15:37 And so the idea that in a, if you get 10 minutes with a patient, the idea that you would zoom out and think about the whole body, like the, like holistically, that's just really hard to do in 10 minutes Yeah. and there's just so much to know too. It's the, I'm like, I think, see my primary and I'm like, I find he's fairly knowledgeable on ADHD stuff, but I'm like, there is so many fields of medicine now that like it really is hard to be like, "Oh yeah, you wouldn't, expect everyone to know everything."

16:07 And I think it's, it, is a, should be expected and normalized for someone to say, "I don't know," as opposed to, "That's not a thing just because I, don't, know it." and I think that happens a lot too, and patients have, uncomfortable experiences when that happens, and it feels really bad Yeah, it's a very strange power dynamic with doctors where, 'cause it really shouldn't exist that way 'cause it's not like they're, like, above you in a way.

16:33 You're just like, they're technically working for you Yeah, no, totally. And our model here at All Brains Belong, which is really about community-based healthcare, it's the idea that patients come, they connect with other patients, and it's really this community model of learning and healing together.

16:51 And, we have endeavored to, shift that power dynamic and, redistribute power, to the community because solutions come from those closest to the problem Yeah, absolutely. And it's Yeah, I, just love being able to get more of this information out because it is one of those things where j- just knowing gives you s- a leg up Totally.

17:20 Absolutely. And I think that, so it- it's like different levels of knowing or different domains of knowing. So you can know about your brain and your access needs, what you need for full and meaningful participation in your life. Then there's also this l- this level of knowing, like we've been talking about, about, "Oh, actually I have…

17:39 There's, It's more likely that I have these medical problems, and maybe when something new arises, I maybe have a different lens to be able to have conversations about this and get the care that I need." Then there's also this level of, I think for a lot of particularly late identified neurodivergent adults, there's a lot of internalized ableism, that has to be unpacked and, shifting the shame narratives.

18:01 And so for us, this happens best in community. It's the idea that when you hear your own story reflected back to you through the stories of other people, that is so health promoting, right? So it's, certainly not a fast track to unlearning internalized ableism, but it's a faster track than trying to do it alone, of just "Yeah, I'm not the only one.

18:21 I'm not the only one who struggles in the, in, in this way and these ways, and it's okay and I'm okay." Yeah. Yeah, I've sometimes will find myself in that trap of being like, I should just be able to do this anyways." And it's yeah, okay, but maybe if we step back and go like, "Okay, I sh- maybe I should.

18:41 Who cares if that's true or not? What can I do?" No, totally. And, for, me, I received my ADHD, autism, dyslexia, dyspraxia, and dyscalculia diagnoses, a little over five years ago. And I think that for me, I, haven't actually tried to do the unpacking alone. Like, All Brains Belong started shortly after my diagnoses.

19:07 So it's really just being part of this community, has been so helpful for me also as someone not only providing services, but just, being part of a community of people who get it Yeah, absolutely. I find community aspect for ADHD, and any mental health condi- any condition, any community is fantastic.

19:26 It's, one of those things where I'm just, every time I think about the, individualism idea, I'm like, "That's… No, it doesn't work." It doesn't work. Yes. Yeah, and so like having to unlearn like the myths of independence. Like there's nothing wrong with being connected to and relying on other humans.

19:48 and in, this new book, A Failure of Imagination: How the Healthcare System Fails Neurodivergent People and What We're Doing Instead, we spend a lot of time talking about, those kinds of shifts, like the community care, the interdependence, and then of course like i- if you are in a position of, shifting environments and paradigms in whatever spaces that you travel in, how to replicate some of the things that we're doing here.

20:13 And if you're not, what are some things that you can demand and expect from your environment? What can you ask for? Like one of the big things that we do here in all of our programs, because in addition to medical care, we have free community and education programs that are open to everyone, located everywhere, that are virtual, that people can participate in wherever they are.

20:34 one of the big things for everything that we do is universal design, which is offering everything we do in multiple, flexible, different ways, and giving people freedom and choice to pick what works for them. And so you can have universal design for healthcare, universal design for a community event, universal design for workplaces.

20:52 And so the book also talks about how do you actually implement that, or how do you ask for some of these things if you're not being offered that in your own life? Yeah, and I love the ideas of universal design too, because when I've, talked about, how accommodations, can help people, I've had, neurotypical people being like, "Oh, I would love that too." And I'm like, "Yeah, that's, this is great for everybody."

21:14 this is great for everyone. It's like the curb cuts that, were developed for folks with mobility-related disabilities, but think about how many other people benefit from curb cuts in terms of, if you're pushing a baby stroller or a shopping cart or whatever. So it's just the idea of multiple paths of participation really do benefit everyone.

21:31 And I do, neurodiversity trainings, for workplaces, and what we hear, or sometimes people will ask us, isn't that like giving special, treatment?" It's like, no, actually, you should be building cultures and environments where everyone can have their needs met. There is no resentment from someone who's getting their needs met Yeah, and yeah, it's definitely one of those things where the more I've learned about it, the more I've been like, "Yes, this is something we need to apply more," And 'cause I'm like, examples like having, show transcripts for my podcast where it's oh yeah, this is great not just for people that are, hearing impaired, but for people that just "I want to be able to search the thing with a text thing."

22:20 Like that makes, it makes everything better Absolutely. one thing that your listeners might be interested in a couple of weeks we are releasing a free universal design toolkit. There's a version for healthcare, a version for community events, and a version for workplaces. And so whether someone is, let's say, an employer who's maybe thinking about how to structure onboarding for all new employees, or an employee who's like, "I'm struggling at work and I don't really know how to talk about this," like it'll also give you ideas of what, how to have these conversations.

22:50 and so it is in those other, domains too. So that'll be, that'll be available on September 22nd Awesome. Yeah. And we'll see if this comes. I probably won't be up before that, but Perfect. Perfect. So that would mean that by the time it comes out, it'll be live and people can access it Yeah, it's always the funny thing with podcasting where I'm like, "Oh, yeah, I'm doing this then," and okay, dates are imaginary.

23:16 Yeah. Yeah, especially like I, don't personally experience time in a linear way. It's like, "Oh, all the things will get done." Yeah, in… I'll remember I have a finite capacity and of time and energy and all the things. I think, that capacity piece is such an interesting piece to think about too, because often we have this thing where we're just building and building, and we're not considering that "Oh, I'm borrowing from tomorrow to make sure that today goes really well."

23:48 Yes. Yes. Absolutely. And in the chronic illness space, sometimes the spoons metaphor gets used. So it's a term coined by Christine Miserandino, and it's the idea that you start off your day with a certain amount of spoons, and you spend them on different things. And so you can think about it that way, you can think about it as a bandwidth budget, you can think about, what- whatever, analogy works for you.

24:10 But it's the idea of yeah, at some point I will spend all of my energy, and I won't have any more, and I will have to charge my battery before I'm able to spend it. And what happens if you chronically have, first off you're in environments that don't meet your needs, you're having to mask your innate ways of doing things in the world.

24:29 You are not feeling, emotionally or psychologically or even physically safe in some of the environments that you're in. chronically, this takes its toll. And so if you are draining your battery more than you're charging it, that's neurodivergent burnout, right? And that's, in, in our medical practice, that's probably the most common pathway that, neurodivergent adults come in with and start learning about their brains for the first time, and that's certainly how I got my diagnoses also, of just like it has to be so bad that I start losing skills, before, a clinician's able to match the pattern to the stereotypes that they were trained in.

25:10 Although I'll also say that, my professional opinion as a doctor is that self-identification of neurodivergence is completely valid. I think people are the experts in their own lives, for sure Yeah. Like I find it's like helpful to be like the self-identification is often the first step to being able to be everything else.

25:28 and one of the interesting things with, spoons theory that I found too that I saw someone expand on is, adding knives to it. And so I don't know that one. What's that? So once you're done with spoons, you can start using knives where you're either hurting yourself or you're hurting someone else Ooh, that is so true.

25:46 As someone who regularly reaches for knives to eat pudding and yogurt. Yeah, totally. When they're, when the dishes aren't clean. Yep, for sure and I'm just like, "Oh, yeah, that…" 'Cause that makes so sense, much sense when I'm like, "Oh, yeah," like I'm gonna get through this by being angry or, just using all of tomorrow's energy today, and I'm like, "Yeah, I'm hurt, just hurting myself with, by reaching past the spoon drawer."

26:11 Yes, for sure and I think that's just one of those places where it's hard for people to, imagine that they're-- how the, that capacity and thing just sits as a, continuum. They, they often with, especially with ADHD, we think so much in the now that it's hard to picture how we're, our f- Totally. And s- and capacity fluctuates for all of us, and the cumulative impact of, like, how was your sleep and did you have enough protein or enough water, and, like, how… If you have a chronic medical condition like ME/CFS or long COVID, an energy disorder, you're just not going to have the same capacity day to day.

26:55 And so I think that's the other thing that community really does for each other, is, normalizing that. When you are around other people who talk about capacity and use, language like, "I am beyond capacity to do that. I need to cancel that. I cannot show up to that thing even though I said I would do that thing, because actually I am beyond capacity to do that thing."

27:19 And in, in the book, I talk about, the difference between, preference-based boundaries and capacity-based boundaries. preference is like I don't want to answer the phone because I don't like the phone. A capacity-based boundary is like I am beyond capacity to answer the phone because I have the kind of brain that if I'm in a room with you, let's say I'm seeing patients, like I can't have the phone ringing.

27:48 I can't do it or I wouldn't be able to do my job. and so we don't have a phone that rings here. That's a capacity-based boundary. And yeah, we are gonna have conflicting access needs, what, anyone needs for full and meaningful participation, because we all have different brains and different brains have different needs.

28:04 We are gonna conflict. Like when my nine-year-old comes home from school shortly, they're gonna have an access need to make a lot of noise and run through the house to discharge energy. I have an access need for complete and utter silence at all times of my life. And so I… but and also, conflicting access needs can be within a, person.

28:23 So as an autistic ADHD peop- person, I often find that I am l- I am seeking sameness and novelty at the exact same time, right? And just this is reality. It just is. it's morally neutral Yeah. I have, annoyed myself with vocal stimming and I'm like, "I should really stop this because this is breaking my brain," and I cannot get myself to stop that And foot on the gas.

28:49 I can't stop doing the thing Yeah. yeah, and I think, yeah, having that, the, yeah, kids coming home and having the, the restraint collapse and being like, "Okay, they need to, let this out because they've been holding that in." And also being like, "Yeah, that's gonna happen to me too 'cause I'm, if I'm doing that at work or in any of these-" Really, it's the same thing.

29:09 you have an excess need to discharge energy and you're gonna, you're gonna find a way to do that. I think nervous systems find a way to regulate Yeah, or we tamp them down so much that then we hit the burnout. which is one of those, places I've been playing around with, oh, how much am I, training myself to not meet my own needs through masking and stuff?

29:35 Yes, absolutely. and I, think also that… I forgot my thought. no, but the idea of h- habitual, like over-rehearsed neural pathways. Like I do this thing because this is always the way I do it. Like I always will, stay up till 3:00 AM to do the things that I didn't do during the day when I got distracted doing other things.

29:57 yeah, I don't have to do that. I could say I am beyond capacity to do that today. And it's very hard as an individual to make those choices. But if you're surrounded by other people who are also collectively deciding, "Hey, I'm gonna work on figuring out my access needs, endeavoring to meet them, learning about yours, and also helping you support yours in in a culture of interdependence," like that feels very different to me Yeah.

30:25 it's kinda like a mental health body doubling. I love that. Yes Yeah. I've also found it's very funny with, I'm like very good about getting my wife and myself to go to bed when it's time because it's "Okay, we gotta get-- we're gonna have to get, My wife's not home. I don't do that aspect, and then I'm like, now I'm just staying up even though I'm the one that usually leads us to going to bed."

30:48 Totally. Yeah, but like the, that co-regulation of experience of having another safe nervous system around and, we can… It's another form of body doubling Yeah. And, it, again, that goes back to community and you don't have to do it alone Yes. Yes, and you're not the only one Yeah. It's one of those things that I know I have to keep reminding myself with.

31:12 And always when I'm doing writing and talking to people, just being like, "Hey, even if this doesn't come naturally right off the, first try, it's worth keep-- to like being like reminding yourself like, 'Yeah, it's okay. Give yourself grace and you can try again.'" yeah. And especially with chronic conditions where, yeah, you have the days where it doesn't, you're like, "Yeah, I just can't."

31:33 Yeah. Finding the, your capacity and then really building in what can I do if I-- and what… 'Cause I think that's one of the harder things, is that people don't want to set those limits on themselves. Yeah. Yeah, and I think that also, autistic and ADHD brains, like we've figured out that we need dopamine for everything.

31:57 We need it for starting and stopping an activity, for starting and stopping an idea. Like inertia, dopamine deficiency feels terrible. So sometimes the things that we find ourselves repeating and gravitating to, like we are seeking dopamine. and so we need it, but we also need sleep. or, another example of conflicting access needs, like sometimes there are medications that increase dopamine but that also constrict blood flow, and if somebody has a chronic illness that impacts blood flow, we've given co- long COVID as an example.

32:33 if I have to choose… Like I, I do need dopamine, but I also need blood flow, and if I have to choose, I should pick blood flow to my brain and my organs, right? So sometimes that gets tricky, too, but just acknowledging these things in, again, like a morally neutral way. I need dopamine and I need blood flow.

32:51 Or like the sa- the same thing would be like, the language of like I'm avoiding or I'm procrastinating. It's like I'm not initiating or I have not done that thing, like neutral language Yeah. And I find a lot of the time it's also an aspect of letting yourself pause and checking in, being like, "Okay, why-- what's the feeling here?

33:12 What do I actually need to address?" Yeah, I love that and so I was wondering, do you have good way… I was just trying to figure this out, on my own with some stuff I was doing. building that pause is so hard though, 'cause often we're just one step after the next. No, totally. And for, me personally, like I have breaks on my calendar.

33:36 do I sometimes overbook them? Yes. but like sometimes I actually see them and I plan the day around them, like great. but I'm also, I have the, like of all my many layers of privilege, one of my layers of privilege is that I'm surrounded by other people who get it and who navigate these kinds of things, and so these are conversations that I'm having.

33:56 one program that your listeners might be interested in, we have a free, virtual community education program called Brain Club. It's most Tuesday nights, and so we talk about a lot of the topics that, that we've talked about today so far. And so like there's the idea of you'll hear from guest speakers and community panels talking about things like rest and barriers to rest and navigating workplaces and navigating relationships and how do you talk about your access needs with other people and these kind of everyday brain life things.

34:25 So it's like the building those new neural pathways of oh, these are things that I- are important. Here are some things I've learned from other people about how they're, navigating this. So not only do I feel less alone, but I also have some like practical, tangible things that I might wanna try in my own life Yeah.

34:45 I think the thing with rest too is so interesting because I know personally, just rest is the idea of "Oh, I'm just gonna lie down and rest." That is nightmare fuel where I'm just like, I'll be out of bed in three minutes where it's like, that was, good enough," and I'll be like, "That was not restful in any way."

35:03 Totally. So it's like figuring out what rest can look like. Like rest could be just not talking. Like rest, like, so s- sometimes, for, my neur- all neurodivergent staff, like sometimes we'll have no talking meetings. Like we'll be on Zoom, but we'll just start using the chat exclusively. Like no auditory processing, no speaking, and that is rest even though we didn't stop doing the thing.

35:29 we also stopped doing the thing, but it's like layers of that, of what, how can I reduce demands on my system? Yeah. And remove demands and then, yeah, like what can I do to, find something that works for me that's, helps bring back some of that, energy that I was feeling the lack of? Totally. Yeah, I, don't know if you are familiar with the tools of Autism Level Up.

35:56 Even for people who are not autistic, it's a great set. It's basically universal design for nervous system regulation. They have all these, brilliant free resources, there, that, that, are just freely available on their website, autismlevelup.com, and, like, all these ideas for what are some things that I can try for rest, for regulation, how can I explore some of my access needs and figure out what works for me Yeah.

36:22 It's-- I haven't been to it myself, definitely check that out. and I do think it's one of those things where You get, just caught up in what you're doing and don't… It's hard to stop because you're just not doing the pause to check in Yeah, and you me- you mentioned your child with the interoception differences.

36:44 a lot of us, we don't feel tired until we crash, right? we're not getting short incremental cues of "I'm slowing down. It's time to take a break," or it's just, "Oh, now I can't move." "Oh, it's been 12 hours since I've eaten 'cause I didn't feel hungry until I'm ferociously hangry and now have difficulty accessing food."

37:08 it's all that stuff too. So I think that, if we can acknowledge that we can't always rely on intuitive physiologic cues, so like, your child with the water bottle that makes the noises and does the whale spout. I eat lunch because it's this time, not because I'm hungry Yeah. And I guess one of the things is, so when you do have all those troubles listening to your body cues, like what's a process to… So like for some things it's very easy to be like, "Yes, I know I need to eat every day and I know I need to drink water throughout the day." Like that's very easy, Yeah, and I think that like for a lot of people who stay up late, they're seeking dopamine that they weren't able to get during the day.

37:57 And so that might be a clue of "Oh, maybe if I shift how I'm spending my time during the day, to charge my battery like throughout the day, and I'm not waiting till 2:00 AM when everyone goes to sleep and I finally get quiet time to do the thing I'm trying to do or that gives me joy or gives me dopamine."

38:17 like shifting around to get some of those things throughout the day may make it be that you don't need to stay up so late Yeah. That and I find when I'm staying up late and doing phone stuff, I'm like, I'm not even really enjoying it. It's just it's on the gas, I can't stop doing the thing. C- can we talk about that actually?

38:33 Because what comes up for me about that is the idea of inertia, dopamine deficiency having two flavors. I think maybe if folks have ever heard that term, sometimes they're thinking about, the foot on the brake variety. I can't initiate the thing. I don't have enough dopamine, so I don't go initiate a shower.

38:53 I don't, go do my laundry. I don't initiate a hard project at work. I don't initiate. But there's another flavor of dopamine deficiency, and that's like foot on the gas. I start doing the thing, and I can't stop doing the thing. It is still dopamine deficiency. It just looks the opposite. And if I wake up and I… it's hard for me to get out of bed in the morning, so I reach for my phone, and I start scrolling ' cause I'm seeking dopamine, and I think that I'm gonna get it, but it's junk dopamine.

39:21 It's not good dopamine, and I'm just scrolling, and I'm scrolling. Now, all of a sudden, I have foot on the gas. I'm scrolling, and I can't stop scrolling. I still did not get out of bed, but I, went from foot on the brake to foot on the gas. I'm still dopamine deficient, so it's really also about, brainstorming when you have the dopamine.

39:39 Brainstorming, what are the things that actually give me real dopamine in my life? And so maybe it's reading something new, learning something new, listening to a podcast, watching a, some kind of informative or engaging YouTube video. that's gonna probably be better than scrolling on social media, for most people.

39:59 But, everyone's gonna be different in terms of what it is, but there's gonna be something for most people that's better than the scrolling on social media thing Yeah, I find there's so many things where I'm just like, it's just this little drip of dopamine and it's enough to keep me like, "I need to try and get more from this," and it's not helping.

40:15 Not helping. Still dopamine deficient and yeah, it's frustrating 'cause I'm like knowing in my head like, "This is not what I wanna be doing." I know. so f- for me, like knowing that concept of the foot on the gas, like sometimes if it's early enough, I can catch the pattern. "Oh, there I go again. I have foot on the gas." And much like in your car, if you had your foot on the gas, you wouldn't also slam on the brake.

40:43 So if you're like scrolling on social media, you being like, "I gotta stop, I've gotta stop scrolling," like that doesn't work. Like I think we all know that doesn't work. But think about the car thing, like you would not do that. What would you do if you have foot on the gas and you don't like where you're driving?

40:56 You drive somewhere else. So that might be like, "I'm still scrolling, but like I'm gonna get up with my scroll." And as soon as I get up, like I stop scrolling Yeah. I've also done, just toss my phone to the other side of the bed, and then I'm like, now I gotta move to get it, and I don't wanna do that."

41:15 Love that Yeah. Sometimes it's just finding a small thing to get me to that next you move, you get real dopamine and it, just, yeah, I love the… Yeah, that, yeah, you don't have to take your foot off the gas, just go another way. That's a, a great metaphor. we're kinda coming up on time here, so I was wondering if there were any, other thoughts you wanted to leave the listeners with?

41:40 Yeah, we'd love for folks to connect with All Brains Belong and check out our resources. Probably the best website to access is allbrainsbelong.org/get-connected, and that lists all of our programs and resources all in one place, and you can check out what interests you whether that relates to healthcare or workplaces or looking to connect with community through Brain Club or a program for kids called Kid Connections.

42:05 and if folks are interested in, learning more about, our new book, A Failure of Imagination: How the Healthcare System Fails Neurodivergent People and What We're Doing Instead, you can go to allbrainsbelong.org/book. Pre-orders are available now, and the book will be released on print, e-book, and audiobook on November 6th Awesome.

42:26 I'm sure a lot of people enjoy looking at those, and thank you so much for, taking the time. Thank you so much for having me Thanks for sticking with us all the way to the end, and thanks again to Dr. Hauser for coming on the show. If you want to learn more about Dr. Hauser, be sure to check out her book, A Failure of Imagination: How Healthcare Systems Failed Neurodivergent People and What We're Doing Instead.

42:52 But before you go, let's go over this episode's top tips. One, our boundaries need to account for our capacity. There's a difference between not wanting to do something and not having the capacity to do it, even if those can look the same from the outside. We can still want to answer the phone, go to an event, or help someone, and still need to say, "I just can't do that right now."

43:16 Two, it's important to pay attention to what drains you and what helps you recharge. Whether you think about that in terms of spoons or a battery, the point is to recognize that your energy has limits, and those limits can change. Being able to push through something doesn't necessarily mean you have the capacity to, to keep doing it forever, Especially if you're borrowing from what you'll need later.

43:39 Three, when you're having trouble stopping, try changing direction. Dr. Houser describes this as having your foot stuck on the gas. Instead of trying to slam on the brakes while the gas is still going, see if you can steer somewhere else. If you're stuck scrolling, getting up while you're still holding your phone might be a first step towards a transition.

43:57 You don't have to make the entire change at once Four, rest can mean reducing demands, not just stopping everything. A meeting where you can use chat instead of speaking is one example where you're making participation less demanding. When you're looking for ways to rest, consider which demands you can remove or reduce, even if you can't step away from everything altogether All right.

44:22 That's it. Thanks for listening. I'd love to hear what you thought of this episode. Feel free to connect with me over at hackingyouradhd.com/contact. And if you'd like links or to read this episode's transcript, you can go to the show notes page at hackingyouradhd.com/321 And if you'd like even more Hacking Your ADHD, be sure to sign up for my newsletter, Any and All Distractions, which comes out every other week.

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