Curious Incident Podcast Episode 12: Managing Life With ADHD

About This Episode

NYC Special Education Attorney Adam Dayan sits down with husband and wife team, David and Ayla Sitt, both licensed clinical psychologists well-versed in the subject of Attention-Deficit Hyperactivity Disorder (ADHD). Their discussion covers various aspects of ADHD including:

• defining ADHD

• identifying signs of a problem

• assessment and treatment

• supports and interventions

• skills development

• raising a child with ADHD

• the role of pharmaceuticals

• managing life with ADHD from childhood through adulthood

(LISTEN) The Curious Incident Podcast Episode 12: Managing Life With ADHD

Transcript Below

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Do you have questions about your child's education? Call Special Education Attorney Adam Dayan at the Law Offices of Adam Dayan: (646) 866-7157 and request a consultation with our New York attorneys today.

Transcript

Speaker 1: This is Curious Incident, a podcast for special needs families and your window into the world of special education. Special needs parenting can be challenging and we want to make it easier by providing you with the resources you need to help your child. Let's delve deep into the world of learning differently with your host, special education attorney Adam Dion. Adam: I am excited to present my next two guests on this podcast, a husband and wife team, David and Ayla Sitt. Dr. David Sitt is a psychologist in New York with over 20 years experience as a therapist, consultant, and educator. Dr. Sitt is renowned for his engaging and stimulating presentations with professional audiences and educational institutions. He is on faculty at Baruch College, my alma mater, where his passion for teaching has led to many accolades, including being ranked number eight nationwide on ratemyprofessor.com. In the clinical arena, Dr. Sitt specializes in the assessment and treatment of adults with ADHD, anxiety and mood disorders through validated treatment modalities such as cognitive behavioral therapy and mindfulness-based cognitive therapy. He has published multiple scholarly articles on adult ADHD, has been featured on platforms such as Vice Media and the Howard Stern Show. Dr. Sitt's upcoming book, ADHD Refocused, Bringing Clarity to the Chaos is due out Spring 2023. Dr. Ayla Sitt is a licensed clinical psychologist who specializes in using cognitive behavioral therapy and dialectical behavioral therapy to help individuals struggling with anxiety disorders, depression, OCD, low self-esteem and perinatal issues. She works with people across the lifespan and specializes in helping people effectively manage and cope with difficult life transitions. Ayla is the senior psychologist at New York CBT in New York City. Ayla is co-chair of the Mental Health Division of Sephardic [inaudible 00:02:20], and is the co-chair of the Courage to Heal Program, educating communities and schools on how to deal with sexual abuse. Thank you both so much for being here. David Sitt: All right. All right. Thank you so much for having us, Adam. Adam: So David, let's start with you. Tell me a little bit more about yourself. What makes your approach and outlook unique given your particular background skills and experiences? David Sitt: Yeah, so I've been practicing as a clinical psychologist for over 20 years, and when I started actually back in graduate school, I learned fairly quickly that I was struggling with ADHD myself, but having never been diagnosed. In graduate school, the demands far exceeded anything I ever had to face up until then. Learning that the challenges I had were due to in part to ADHD opened up a whole new path of self-understanding. It also directed me towards the area that I would then focus in psychology, which is helping adults with ADHD. So because at the time there wasn't much out there to help adults with ADHD, it was really all child and adolescent focused. I saw an opportunity to fill a vacuum, to fill a void. So over these past 15, 20 years, I've dedicated myself to helping myself with ADHD. And in doing so, learned how to help other people with strength-based approaches using integrations of cognitive therapy, mindfulness therapies, self-compassion, and all sorts of mindsets and methods to help people maximize their probabilities of success. So in that way, I think I've been able to find my unique kind of niche in the field of psychology. Adam: So it's interesting that you were first diagnosed in adulthood, and I'm curious. I'm sure struggled with the kinds of issues that you do now when you were a kid. So when you reflect on your childhood, when you didn't have that diagnosis, how do you put that in perspective? David Sitt: It's interesting because when I look back, when I was diagnosed, a shed of light, the whole big ... the stage lit up. The rest of the stage from my life lit up and I was able to see that. As a child, even as early as 10 or 11 years old, I remember staying up late at night doing my homework assignments with my mother because I couldn't sit down to get it done. I remember when I got a little older, she would sit and type for me while I would speak out my reports because I just couldn't sit down and get the work done. Looking back now, I understand that was all part of my ADHD. Even things like sitting in a classroom, I remember not being able to sit through my class without having to get up to go to the bathroom four times. If the teacher said one was all you can take as a bathroom break, I would take paper and crumple it up just as an excuse to get to the trash bin because I couldn't sit in the chair. So all of that opened up when I realized that's what was going on. But I was fortunate to work hard and to be able to have support around me, my parents and the school in some ways, I guess helped me move along without knowing that I had ADHD. So I pulled through somehow. Adam: All right. Ayla, what about you? Tell us about your approach and outlook given your background skills and experiences. Ayla Sitt: Yeah, so I think while I was in graduate school, what I found myself focusing on was cognitive behavioral therapy. I spent a few years specializing in that area. I think what pulled me towards cognitive behavioral therapy is that it's an evidence-based approach and it's very focused on what are your goals and how can we help you get there? To me, that always felt like what I would want therapy to be, right? There's something I'm struggling with. There's something that I feel is holding me back, and how can somebody guide me in that process so that I can get better and I can feel more confident in a certain area or I can push through a struggle that I'm having. Once I was doing CBT, it's not so far from CBT to become interested in DBT, which is considered a third wave therapy. DBT, some people would say, how I describe it, is like CBT on steroids because CBT is skills-based and DBT is the skills of CBT and so much more. So I found that having the skills of DBT and having the framework of DBT has been so helpful for me to help so many different clients coming in with so many different diagnoses and giving them the ability to have a toolbox that they can feel confident to rely on in almost all types of difficult situations they may face. Adam: Okay, thank you for that example. So what is ADHD? How is it defined and how does it differ from ADD? David Sitt: So ADHD is a neurodevelopmental disorder that typically appears in childhood and can continue into adulthood. The symptoms of ADHD can really vary from person to person. There is a grouping, at least according to the DSM of about 18 symptoms. Clinically, people talk about several more beyond those 18, and not everyone will show the same set of symptoms. So there's a heterogeneous kind of nature to ADHD. To go a little bit further, we categorize ADHD into three presentation types. So the first would be an inattentive presentation where symptoms like difficulty paying attention, sustaining attention over long periods of time, having a hard time being organized, getting out of the way of procrastination. These are some of the inattentive presentations. Then there is a hyperactive impulsive presentation where there's a greater amount of physical activity and hyperactivity, difficulty waiting your turn for things, difficulty in conversations, waiting for the other person to finish, not being able to wait in line for things. For little kids, it's like I described myself running around the room or having a hard time staying seated. Then there's impulsivity as well. So being very impulsive in situations. That's the second presentation. The third is a combination of those two. So we call it the combined presentation. So these are the three types of categories within ADHD. Again, I would say that it's hard to say there's a typical presentation, although in my own practice I would say I do find commonalities among people, but we can get to that later. Adam: Which of these categories do you fall into? David Sitt: I fall into the combined type, yeah. Very clearly I fall into the combined type. I have a lot of the difficulties in being organized unless I'm putting a lot of effort into it. By default, I'm not organized. I'm procrastinating on a regular basis. I run late to things. My kind of conceptualization of time itself is skewed, which is very typical in the ADHD brain. Also, for me to sit and listen to people talk, even sitting here in this podcast, my brain as I'm listening to the two of you speak is running a mile a minute waiting for each of you to get to the next point of your sentence. My mind is already jumping to what's next. So there's an impulsive nature in my mind that I'm kind of always having to reign in at all times. So that's just two of some examples of my combined presentation. Adam: As far as these subcategories go, is any of the three more common than the others? Which category do most people tend to fall into? David Sitt: The combined type is the most common, both in childhood and adolescents, as well as into adulthood. The prevalence of ADHD itself for children is somewhere between low numbers would say 3%. High numbers are up there as close to 10% depending on who's doing the study. The CDC, for example, in I think it was 2018, put out their stat of 9.6% prevalence of ADHD in children and adolescents. Adam: Meaning close to 10% of kids have or are diagnosed with ADHD? David Sitt: Right. Adam: Wow, that sounds pretty high. David Sitt: It seems pretty high. There's a whole question of is there an over diagnosis happening, which I can easily say yes in some regard. There is over diagnosis, but at the same time there is under diagnosis happening. It's one of those interesting phenomenon, and I don't think that research has caught up just yet, but post COVID, I've seen anecdotally a tremendous uptick in ADHD diagnoses. I can't speak to what ... I have theories, but I think the research is still going to be catching up on that one. Adam: I was going to ask you about that point later anyway. Let's just talk about it now. You mentioned it's underdiagnosed and over diagnosed at the same time. How can it be both? David Sitt: So it can be underdiagnosed in the fact that, in schools, not all teachers are trained to spot the kind of nuances of ADHD. Your typical hyperactive kid is easy to spot, but your daydreaming inattentive child who also perhaps may be intelligent enough to pull it off and get the grade done at the last minute, they may not end up on the radar. Maybe I could say I'm an example of that. I was able to do well enough in school, so no one thought to make an issue. They didn't know that behind the scenes I was staying up till one in the morning as a 12 year old. They didn't realize that my going to the trash bin a couple times was because I had this issue. So it's easy for people not to catch it. There are many aspects of the population where maybe there aren't enough clinicians or trained individuals to be able to spot this. So I think that that contributes to some of the under diagnosis. In girls, for example, there's a big push to elevate our awareness of the diagnosis in young girls because again, girls more typically were inattentive, so they're not catching it. They're not seeing it externally. So there's part of the gap. Adam: I want to ask you a follow-up question about boys and girls in a second. I think what you said about flying under the radar is also very much true for OCD. I've talked on recent episodes about struggling myself with OCD when I was a kid. Just one of those things that people either are not trained or don't perceive what might be going on in your head. It's hard to tell if someone's focusing or not. I think it is important for teachers to be trained or clued in to sort of pick out those people in a classroom. David Sitt: Yeah. So we're certainly putting work into that. I think that the field has come a long way in the past 20 years to try to help train people within schools. Even parents are learning way more about ADHD today so that they understand that perhaps their child who's having a hard time at home or having a hard time socially or difficulty, it's not just about, yes, they can focus on their Minecraft or their video games, but when we ask them to sit down and read their books for school or to get to do their homework, the fact that it takes them so long to sit down or ... well, we may get our kids to sit down and have dinner and eat a meal is very challenging. Now parents are more clued in to the fact that that might be due not to misbehaving, but to an underlying diagnosis of ADHD. Ayla Sitt: I think in the classroom, girls generally are less hyperactive though, and many parents who end up going for the neuropsych testing, often it's from the teachers who notice that they're getting out of their seats or they're not able to focus for an extended period of time. While the boys are getting out of their seats and maybe being more disruptive so it's more on the teacher's radar and they want that behavior to stop, girls are not always that way and are probably less so in the hyperactive type of behaviors and more perhaps inattentive or difficulty. Maybe fidgeting in their seat, but it's less disruptive to others and perhaps not being focused on as much as well. So I do think, as David was speaking about being underdiagnosed, perhaps there are a lot more girls or young girls who are not being diagnosed, but do have ADD. Speaker 1: If you like what you are hearing, please let us know by subscribing to the Curious Incident Podcast and letting other special needs parents know about it too. If you have thoughts, questions, comments or would like to suggest ideas for a future episode, we'd love to hear it. So email your feedback to podcast dionlawfirm.com. Adam: ADD is one of those conditions that people tend to throw around pretty casually, and it gets depicted in the movies in a certain way. How would you say the real life experience of dealing with ADHD differs from the way it's portrayed in the movies or on TV? David Sitt: That's an interesting question. I think that when we see ADHD portrayed in media, in TV shows or in movies, you might see them present just a few of the symptoms, and they may make comments, at least from what I see anecdotally, the hyper kid, the one that's running around, they can't sit still. So, oh, there's a ADHD character. Or tuning out, not being able to stay focused on the conversation and they make a joke, oh, what was that? Or I ADD'd on that one. So I don't think that that's a misrepresentation per se. I think they're just kind of highlighting the more overt and typically discussed symptoms of ADHD and not going into the larger aspects of ADHD. So I don't know that it's a misrepresentation as much as they may kind of just highlight, as I said, some of these primary features of ADHD. Adam: Ayla, what's it like to be married to someone with ADHD? Ayla Sitt: It's a lot of fun. I would say that just being married to anybody, there's positives and negatives. I think it's funny because I heard David describe himself as unorganized, and I would actually describe him as very organized, but that is because he's acknowledged and recognized that this is a deficit that he has. So he has coped with that by being overly organized. So he has files of documents of mine from all the way back to college. When I don't know where something is, I know that he has files set aside for me and for every single one of our kids. He has lists and he has systems that I'm sure he's going to talk about more, but I actually find that because he has ADD, he has taken steps to be overly organized to compensate for the fact that otherwise things would probably fall through the cracks. Adam: Sounds like you've made your weakness your strength. David Sitt: I've tried to compensate. I think Ayla's point is true that it's important. That's the game. That's the name of the game is you got to fill in those gaps and it's a daily grind. So I think that that has helped me in. My father was a very organized person, super duper organized. So I had a role model. My mother is poster child of ADHD. I love you, mom. I'm sure she'll listen to this. We talk very candidly about her ADHD. So she's super not organized in that way. She's creative and off the cuff and full of that kind of energy. My dad was super structured and everything was written on a list and everything, to a point where it would bug me out. I used to stress about it, but now as a full-fledged adult these days, I try to emulate some of that. So those are some of the good sides. But Ayla's holding back on the challenges. Ayla Sitt: No, no, I still had more good ones that I wanted to mention first. I would say that ... again, I don't know if this is ... I know in learning about ADD that people with ADD also tend to be more creative. I find David to be an out-of-the-box thinker. He has thought of things that have been created or developed or explored years after he's mentioned to them to me as, wow, wouldn't it be a great idea if I did this or that. I think where he then finds challenges is having that great idea, but then taking the steps to get it to the end game. So I would say as his partner, as someone who supports him, that's hard. That's hard for me in supporting him because I know he's disappointed because I know he has the potential and he has these ideas and he often has them way before they exist. So being that support for him and then selfishly feeling disappointed that he wasn't able to take it to that end game because that would've been great. That would've been great for him, that would've been great for us. Adam: So the end game being what in this example? Taking the idea to the conclusion of fully implementing that idea or something different? David Sitt: So I think we were just talking offline before about we're on this podcast, and I had mentioned that 12 years ago I launched a podcast called The Sit Down. It was way ahead of the podcasting, years ahead of the podcasting craze that's now. I got all my energy together and I got a team, and I had six people and I got funding from the university that I teach at. We recorded 25 episodes and it was great. It was early days of social media, Instagram, Facebook, and I loved it. I was filled with energy about it. But then after the season ended, getting it started again was drudgery and mapping out, like Ayla said, the long-term plan of how to make this podcast live on and get season three going, it just was overwhelming to me. I couldn't plan it and I didn't submit the right paperwork, and all this other minutia came in and I dropped it. That's an example of if anyone started a podcast 12 years ago in their area and stuck with it today, they probably have potentially the big numbers of followers and the big impact and yada yada, and so on. So I think that's a really kind of concrete example of something where I had these ideas and had it all worked out, but just I just couldn't see it through. Adam: And very apropos for this setting. We're sitting in a podcast studio. That definitely helps to make what you were describing, Ayla, more concrete. I think that's a really good example. Ayla Sitt: Yeah. Yeah. I would say other aspects of David's personality that I think probably comes from having some of these symptoms of ADD is he's really, really great at socializing and connecting with people. I know whenever we would go into a new situation, as long as I had him by my side, we were set. He would find something about every person there that he could connect to. By the end, everyone's his best friend, which is really an amazing quality that not your average person has, but there's an energy about him and a way that he can connect to people that I think speaks to more of the higher energy that people with ADD can have. David definitely has that. Adam: I can definitely attest to that too, because we go way back. More than 20 years when I was in your psychology class, probably like 30 years or something, and I remember your event planning where that creativity was full display. I've seen you in charity and networking situations where that comes out in droves. So I can definitely attest to that. David Sitt: I think Adam's leaving out the fact that years ago I was actually his camp counselor. Adam: I was dancing around it. David Sitt: I think that's where it really goes back to. In those days as a camp counselor, I had a lot of energy and creativity and was hired by the camp the year after when I had you as a camper to be their director of special events. I was that guy running color war and jumping on top of buses and stirring up the energy. I have a lot of clients that I work with because that's the work that I do who have that same energy. Now I have clients that don't have that energy. I have clients that are not comfortable socially and that isn't part of what lights up their brain. I think in ADHD, that's part of the magic of it is that, for many of us, there are things that light up our brain and get us super focused and able to be creative and under pressure to produce on high levels in short bursts. For me, one of those things is being social and being out there and creative and stirring the energy of people. So as Ayla is saying, it can come in handy. Ayla Sitt: Yeah. I would say I benefit from having David as my partner because he pushes me to do things that are way outside of my comfort zone and with his energy. He'll be like, "Ayla, come on, we're doing this podcast." And I'm like, "Oh God, okay, here we go." Or we're going to speak on this in front of hundreds of people, or I think you should try this. Or just pushing me to do things that my anxiety would probably say, you know what? Just do what you know, rather than trying to push into areas that aren't necessarily your specialty or areas that don't come naturally to you. David pushes me to do it. He's like, "You can do it." I think his energy has motivated others, his friends, colleagues, students. They really look to him as somebody who can give them confidence through his energy and through his outlook on not being afraid and pushing through whatever anxieties they might have. Adam: So it seems like you guys have nailed down the dynamics of being in a successful relationship. You David, managing your ADHD, and you Ayla being that anchor and that person who can help you stay accountable and bring it to execution. I'm just thinking that there's probably listeners out there, some people in relationships who have been diagnosed, whether in childhood or adulthood, many people out there, adults who suspect that they probably have ADHD, but were never formally diagnosed. So I'm just wondering if you were to give some tips to other couples out there about how to help each other in the relationship, what would you say? Ayla Sitt: I think one thing I would say is to be understanding of the weaknesses that might come up, to also decide how you voice maybe your disappointment of things being forgotten. Or for example, David and I talk about ... we read it somewhere, the idea of an ADD tax and basically it being that often when you have ADD, you might not pay a bill on time or you might not get onto the early bird specials for camp or something like that. So there went a hundred dollars and there went another a hundred dollars. So you call it the ADD tax. I think also part of it for me has been to let certain things go. If it's really not the biggest deal and it's not going to change anything in a really significant way, to let some of those mistakes go or to find humor in it. Now we'll joke around, we'll miss an early bird and I'll go to David, "ADD tax," and then we'll smile. It's not always like ... David Sitt: Sometimes it isn't a smile, like when you book an airline ticket and the price skyrocketed on you. It's not so funny. That happens. Or I know I had a year where I was delayed on renewing one of my type of insurances and it was a problem. The tax can be really painful. To Ayla's point, we want to try to keep supportive of each other and Ayla is very supportive of me and relationships that I counsel. We tried to work on that, having compassion for the other, but also the notion that both parties, especially if you're the one with a diagnosis, it's important to let your partner know, I know that it's hard and I'm working on it and I'm not giving up. I get that today I messed up and I dropped the ball or I wasn't able to get the thing done that we needed to get done and it was a cost to us, but I'm working. I know that I have to do my work. I think that if you have the one partner is supportive and understanding, can bring a little humor. And the other one that says, I'm never going to stop hustling. I'm going to always keep trying to make improvements. If that means, I'm sure we'll talk about it, what are the things you can do to get improvements. Whatever they are, avail yourselves of those as best you can. I think those are some of the ingredients. Ayla Sitt: I think that that really is not only with ADD, but any sort of mental health diagnosis. It might be anxiety, but to just say, oh, I can't do this or I can't do that because I have anxiety, that's not going to always work if it has to do with going to social events. But you say, oh, no, no, no, I have social anxiety. We can't go. Eventually that's going to impact the relationship. So to David's point, you might say, this is something that's really difficult for me right now and I know it's important to you and important for our relationship that this is something that I work on and I'm going to do that work. So I always try to tell my clients that using your diagnosis as an excuse is not effective to say, Hey, this is a reason why it happened and I want to work on it. I think is much more palatable for the other person to hear. Adam: I think that's really important, the distinction of using it as an excuse versus using it as a tool. I think it goes to the power of getting a diagnosis. I think there are people out there who, parents who are nervous about getting their children evaluated because of stigmas or labels or diagnoses. But one thing that a diagnosis helps you do is figure out how to manage whatever you're struggling with. So if you get that evaluation and you figure out what the issue is, it puts you in a position to do something about it. Correct? David Sitt: A hundred percent, a hundred percent. Knowledge is power and knowing what you're dealing with, it empowers you with now learning what tools you can avail yourself to manage that challenge. So meeting with a mental health professional just to say, Hey, I've been struggling or we've been struggling, or my child's been struggling, I don't quite know what's going on. Yeah, I have the social media feed that I follow and I guess maybe it's this, but that's not the same. You've seen someone else describe ADHD or a learning disability or anxiety disorder and saying, oh, that that's exactly like me. It's got to be. Okay, that's the beginning. It's the beginning. But get to that mental health professional. Have someone who day in day out evaluates these conditions to let you know and validate if this is indeed what's going on, because maybe there are other underlying conditions that you're not as savvy in figuring out. Maybe that person that you saw on social media didn't have the other variables that you do have. Or maybe there's medical contributors. So you need to get to professionals and start there. Adam: Absolutely. I want to move from being married to someone with ADHD to parenting someone with ADHD. But before I do, one clarification, we are using ADHD and ADD interchangeably in our conversation. Are they considered the same thing nowadays? I know there's always changes in the DSM, but today are they considered the same? David Sitt: So the whole ADD/ADHD nomenclature has gone through many different iterations over the years, as guided by the Diagnostic and Statistical Manual of Mental Disorders, the DSM. Today, ADHD is the technical kind of full term that we use followed by an attentive presentation or hyperactive impulsive presentation. But when we're talking to normal parlance, for me personally, I just wrote a book. It's coming out soon, and I battled with this. Should I call it ADHD throughout the book or ADD? I like ADD because it flows easier. It's just easier to say ADD, right? It just comes off the tongue easier. Some other people will say ADHD if they know there is hyperactivity involved, so they'll say the H, but if there's not hyperactivity, they'll say just ADD. But these days you cannot assume that because a person said one of those acronyms versus another that it really means something. So I use them interchangeably at this point. Adam: Thank you for clarifying that. All right, so let's move on to parenting A child with ADHD. What's it been like to raise a child with ADHD? Ayla Sitt: Would say it's a learning process. I think that it's been interesting to see the ways in which our son struggles and the ways in which he excels, recognizing, we've been talking about, that ADD looks different for every person. Our son is super intelligent and he actually doesn't struggle academically because of how interested he is in the topics and how much he loves to learn. So it's been a learning process, I would say. David Sitt: So just to give a quick background, we have four children, which is a handful and can create a person to have ADHD, just having that many kids running around you. So we have nine-year-old, a seven year old, a four-year-old, and a two-year-old. So our oldest was our first to hit our radar. Being that I'm in the field and I have ADHD and we've seen it so much, I think we smelled it early, we sensed it early. Our spidey senses were tingling when it came to our oldest son. He's since been formally diagnosed more recently over the past ... I think we solidified the diagnosis I'd say in the past six months, right before the summer. Then our second child, again, we suspect. He's too young I think for us to formally lock it in, but seems like the signs are there, but our oldest two are very different it seems than our younger two in this way. So again, parenting ADHD, it has been interesting to watch and see these differences and how each kid kind of manifests in different ways. Adam: What is it like for you specifically having ADHD yourself and now seeing it through your kids? David Sitt: It's funny, actually. I was just thinking as we're talking that where he's third generation ADHD at least, because my mom and me and my son. So there's certain aspects that I'm very grateful for having the knowledge about ADHD. I'm grateful that I have the knowledge because I try my best to help my son manage his ADHD, and I have language that I can use with him. So I'm grateful in some respects. For example, one of his things that he academically, while he's smart and he can perform well thus far, and that could change by the way. As the demands, that's what happens with ADHD. It seems like everything's good and you don't notice it, but if the demands flip and the demands exceed his capacity to focus his attention or if he isn't interested, he may struggle academically. That's what happened with me. But one of the things that we work on is him double checking because he tends to skip over instructions because he's so quick to think impulsively, I got this. So especially with math where he loves math, so he jumps into things, but he missed that this was a subtraction problem, but you use addition, or it was multiplication and you did division, or it's a three step problem and you didn't do the middle step. So we're working on a system where he puts a dot next to each problem that he works on. So the first thought is, I did it. After the test, he's to go back over it and put a second dot when he checked it a second time and maybe even a third dot. So that's something that I don't know that might pop into everyone's mind, but I'm aware of it and so I'm grateful for that. But in other ways, it's really hard because I feel bad. I see myself and I know that I struggled in certain ways, and I worry how is he going to be able to handle this? Will he be able to manage his impulsivity? Or if it plays out in social ways, what will that do? So I think I have both sides of that. Adam: Yeah, it's interesting. I see some behavior in one of my kids that reminds me of how I used to behave when I was a young kid and it kind of stops me in my tracks because, as many skills as I have, and as much as I have learned and mastered managing my issues, I don't think I'm equipped to help him with his when he's like that. It's just too close to home. I imagine that for some people who are managing issues that their kids have as well, there's some of that going on. Ayla Sitt: Yeah, I think that makes a lot of sense. At the same time, I feel grateful that we're both in this field and that we both have enough knowledge to, in the moment, try to give him some skills that he can use and tools that he can implement to make things a little bit easier for him. At the same time, it's a learning process for us too. So the perfect example that David just shared where he came up with this three tiered dot system and checking and rechecking his test, he came home and he made a careless mistake. I recognized that what he did was he reviewed the second and the third time the work he had done that first time. So he rechecked his math, but what he didn't do is redo the problem completely or reread the problem completely. So then we had to change it because he misread it the first time and his math was correct based on how he misread it. Now we have to say, okay, don't look at all at what you did that first time, and when you check it over the second time, do the problem as if you've never seen it before. So it's also continuing to work with what happens, what works, what doesn't work, and then being flexible. Adam: So I was going to ask you to clarify this three-tier system, David, because I know that you use it as well for yourself. So if I'm understanding correctly, it's do the problem or do the task, then do it again from scratch as if you never saw it before, and then the third time is just recheck your math or recheck your work or whatever it might be. David Sitt: Yeah, yeah, exactly. That's correct. In this instance, just triple checks. The triple check, right? It's the triple check method if you can. So I use that with emails. I write an email and then I double check it. Then I use Google as the backdrop of my server and I set it up that, when you send an email, it has a 30 second ... there's a feature that you can turn on that after you send the email, there's a 30 second window where you can cancel the sending of that email. If you do nothing, the email goes. But then if you press send, a window pops up that says cancel? and there's a timer. Now in that 30 seconds I do a third check, and that's actually when I'm super focused because the pressure is on and the deadline's about to hit. That's like my triple check that I do. Adam: Not to make light of what you're saying, but that's a great feature to have everywhere in life. David Sitt: Yeah. Adam: Are you sure you want to send this angry text message? David Sitt: Yes. Adam: 30 seconds to cancel. That would be brilliant. David Sitt: It is. It is a great feature. Ayla Sitt: But meanwhile, while you're saying that, I'm thinking if anyone has OCD, do not do what he is telling you to do. We do not want you triple checking. We want you to send it out after you've read it once and be okay with the fact that you might have made a mistake. Adam: Yeah, so I'll raise my hand. I'm in that boat right there and I've spent a long time learning how not to be a perfectionist and how not to triple check things. So I think that is very well said. David Sitt: There's one thing I would've just ... I'm going to go back to one of the point you brought up earlier when you talked about parenting someone with ADHD when you have ADHD. My hardest thing in that is my emotional management. Interestingly in the DSM, emotion regulation is not mentioned at all. Yet it is probably in the top three challenges that ADHD individuals face is the ability to manage their emotions, direct their emotions, because typically the impulsivity of things, not being able to control the gates of things, the things just flood out. So that's one that I know is harder with my son. When he gets emotional, I sometimes ... when they get into a fight with each other, some of the boys, I get emotional and I might even raise my voice or I might kind of get frustrated. That's one of the hardest things for me, knowing that I have ADHD, knowing that I'm modeling that behavior for my kids is really hard for me because I really try. I want to do better at all times, but it's hard. It's not easy. So that's one of the examples where I really struggle in having ADHD and seeing how it manifests and how it's modeling and it's reinforcing what he might do. I literally see him do the clenched teeth thing that I do the same exact way. It's a work in progress, but I can definitely call myself out on that. Adam: How do you do it then? How do you hit reset or keep yourself in that zone where you're able to regulate your emotions successfully and be the way you want to be? David Sitt: I say, "Ayla, I need your help. Switch. Tag out." No, but sometimes- Ayla Sitt: I was going to say, we're laughing, but that will happen sometimes. He'll say, "Ayla, I'm tapping out." And that's okay. So knowing when you have to take a step back. I had mentioned DBT, and one of the skills that we talk in about in DBT in is something we call the stop skill, which is a skill for how to not make a situation worse. The first step is stop, don't do anything. T is take a deep breath or take a step back. O is observe your surroundings, observe what's going on inside of yourself, outside of yourself. And the P is proceed mindfully. That's what do I want to do? What's my goal here? Is my urge that I was about to do going to make things worse? If so, let me get out of this situation. So I also think that mindfulness is really helpful and I know David has been practicing mindfulness for years and includes mindfulness in his treatment of ADD. We've been teaching mindfulness to our son from the age of two to three years old. We have pictures of him meditating on vacations and practicing mindfulness and having him listen to sounds and focus on his breath. He loves it. He likes ... and maybe this is unique to him, but he really likes being able to take control of things that feel out of control for him. So he really enjoys learning skills, like taking deep breaths or focusing on his breath or removing himself from a situation. He feels success in knowing that he handled a situation well. Speaker 1: If you like what you are hearing, please let us know by subscribing to our podcast and letting others know about it too. If you have thoughts, questions, comments, or would like to suggest ideas for a future episode, we'd love to hear it. So email your feedback to podcast dionlawfirm.com. Adam: I think that's probably true for many people, myself included. I do meditation from time to time as well. Those exercises of being present, taking deep breaths can be very helpful for tackling the day. All right, so as parents of a child with ADHD, what would you say is "normal" behavior for very young children, and what might be a sign of a problem? David Sitt: I think we're going to attempt to speak to that question, but I want to just put a little disclaimer that, professionally, Ayla and I are both adult focused clinicians. So we're not in the trenches day in and day out with large populations of children and adolescents with ADHD. So normal behavior for children is what we all know, children being curious, children having high bouts of energy where they get excited for things and they really want to exert their excitement into something, where you as the adult may not want them to be as excited. May be normal for children to space out when you're trying to get them to focus. Every aspect of what we know about ADHD, when taken by itself, is highly normal. It happens in all children. Every single one of the symptoms of ADHD, every child, most children will exhibit either occasionally or very often. The art of understanding the difference is the context, the intensity by which these symptoms or behaviors occur, the settings at which they occur and the impact on their overall levels of functioning. That's where I think parents need to be able to start putting those lenses on. Again, settings, intensities, impact on functioning and the combination of. Not just two, three, four five. To have the diagnosis technically for a child, they need to show six symptoms of the nine in any one of those domains. Six out of nine in inattentive or six out of nine in the hyperactive impulsive. If it's at the combined type, then it would be six plus six is 12 of the 18 symptoms. Adam: How do you tell when it's just a little bit distracting versus significantly interfering with functioning? Ayla Sitt: I think as it relates to school, often those reports are coming from the teachers. During parent teachers conferences, they might say something or hopefully in touch with you even before that, but they'll notice a difference between your child and the other children around. So not just they couldn't sit down for 45 minutes where most kids can't sit down for 45 minutes without getting up, but they're continuously unable to sit for extended periods of time. So it's often, like David was saying, a continuous behavior that they're seeing. Not one bad day or a few bad days over a couple of months, but the behavior is constant and seems difficult to manage even with intervention from the teachers in some ways. Adam: Okay. In your case, when did you first discover that your child was struggling with ADHD, and how did it manifest in his case? Ayla Sitt: I think like David was saying, I think we were first tuned into him being unique in some ways from other children from a pretty early age, I would say he was in- David Sitt: Nursery or early childhood. Ayla Sitt: Early childhood. He was about two, three years old. They would tell us that he would often have difficulty following instructions or sitting for extended periods of time. Again, most two-year-olds can't sit for an extended period of time, but they're comparing him to other two-year olds. So if it was five minutes, he could sit for 30 seconds or something along those lines. But obviously that age is too young to diagnose with ADD. But there were other things we would see where, as your average two-year-old is mainly running, he was climbing. He was going from our couch to our counter to our cabinets when most kids- David Sitt: Walking on the windows sills, teetering- Ayla Sitt: Scaling buildings. But he was definitely more hyperactive, higher energy than most of the kids we would see him with that were his age. So there was that we noticed from a young age. David Sitt: Right, and also there was a degree of that impulsivity that was there early and we can see that. We couldn't get him ... some of our other children, they have this in common, they won't sit to eat. To get our kids to sit down and have a meal. When we look at our friends, when we go out with our friends, their kids sit and they eat. There's no effort that goes into it, but our children will not sit. They have to run around. With him in particular, I remember we were pulled into television early on because that was the only thing, literally the only way that he would stay seated is if the television was on. We knew the risks of having media, but we had to balance that. We had to make choice in that. So those were some of what the signs that we had. I just remember early on just watching his eyes. I just remember very distinctly, even I would say as a clock when he was months old and I had said to Ayla, "I see the way his attention moves around so rapidly and how he doesn't fixate for very long periods of time on some things. He's constantly searching for stimulation and goes with it and then searching for the next." Adam: So we've talked about some of the benefits to having ADHD. You've discussed the creativity aspect. Are there any other benefits to having ADHD? David Sitt: It's a great question. You hear a lot of the talk of the superpower of ADHD. People, especially those of us with ADHD, like to feel good about positive qualities. But it's important to know that even though I'm going to speak for a moment about some of these kind of advantages, that we shouldn't take them just in isolation. We have to understand that we have to take the whole person into account with the challenges as well. But some of the advantages, or at least commonly I hear from people there is this, as Ayla talked about, creativity and energy levels. The ability to think well under pressure and to turn things around when there's a deadline in front of you, it really is almost unlike anything that I see in my neuro typical clientele or friends. Adam: Wow. David Sitt: That can be a great thing because ideas can come up and pulling a lot together in a short period of time without feeling the weight of that. It's not crushing, it's liberating. The downside is that people need that pressure to execute. So even here, you sent me a list of questions how long? Two weeks ago maybe, because you are prepared and you're on top of things. When did I turn them around? Maybe this morning. That's typical. That is typical is working under pressure. But I think I did a decent job pulling together these questions. I pulled it off. So the ability to work on the pressure, be creative, have this kind of high energy, are definitely some of the upsides of ADHD. Adam: Yeah, and I joked off the record earlier, but I think that the preparation for this recording was really insightful. I told you that when we got off our call, my wife who is sitting close by said, oh my God, this is OCD meets ADD. What suggestions do you have for parents whose children are exhibiting ADHD? And what would you say is their first step or should be their first step for getting help? Ayla Sitt: I think the first step for when you think that your child might have ADD is gathering information, gathering information from their teachers, from caregivers, from whatever you've noticed or your spouse has noticed. Just trying to get a comprehensive picture of the ways in which you think they're struggling because it might not be ADD, right? So just getting a sense of where are their challenges. Then I would seek evaluation from a professional, a neuropsychologist or a psychologist to get an evaluation first before you go the route of neuropsychology. Cause that could be quite expensive if not necessary, and see what they suggest. What I would also say is there are times where I'll meet parents and they'll get a diagnosis of ADD, and again, we know what it means. So in some ways that brings up, like David said, difficult emotions. In other ways, we see it as a diagnosis, just like other diagnoses, that people have, like anxiety, and that there are tools and skills and ways to manage it. So oftentimes, I'll have parents who feel so afraid, so scared for their kids. What does this mean? What are they going to be capable of? What are they going to be able to do? So I think it's also educating yourselves, reading up on it, better understanding ADD, because you can be so successful and have ADD, and ADD does not mean you're not intelligent. My son's so bright. I have family members who are diagnosed with ADD who have ranked so high on IQ testing. So just recognizing that it doesn't necessarily mean what you think it means, and your children can still be very successful. They're just going to have to learn ways to manage their challenges just like everybody does. Adam: Yeah, I think that there's a lot of that fear going on out there for parents who are first starting out in the process or not yet informed about what ADHD means and how someone can manage it. So I think you're absolutely right. Gathering information, reading up on it and understanding the landscape better is super important. Speaker 1: If you like what you are hearing, please let us know by subscribing to the Curious Incident Podcast and letting other special needs parents know about it too. If you have thoughts, questions, comments or would like to suggest ideas for a future episode, we'd love to hear it. So email your feedback to podcast dionlawfirm.com. Adam: We talked a little bit about this, but let's paint a clear picture. What kinds of supports and interventions are available for individuals with ADHD? David Sitt: So once you've gone through the evaluation and you have a clearer sense and confidence in your diagnosis, and I will also say about that going to a general MD, meaning your primary care physician might be a where you start, but I really do think it's important to seek a second opinion or confirm that with a mental health professional, especially someone that you can confirm has experience with ADHD. So I'll put that out there. Once you've gone past that stage, there are multiple avenues of support. So many people talk about medication, as it's very common for that to be the first line or at least part of the front line of treatment. There are many, many medications out there. I will very often get the question of, do you think we should medicate? Is there a problem with that? My advice in terms of medication is medication for ADHD is typically one that are types that you can try out for a few days and see how they go. If it's not a good fit for you, you can go off of it the next day with the guidance of your prescriber obviously and move on. There's no long-term detriment of trying out medications for ADHD. There are other disorders out there where the medications have to be in your system for weeks before you see the effects, and getting off of them is a big challenge and have to be titrated. It's a lot more effort that goes in, but that's not the case with the typical ADHD medications, the stimulant class. So if you're open-minded to it, try it out, see what it does. It can really be life changing. It can be akin to someone who has blurry vision and they don't even realize how blurry their vision was until they put on the glasses and then, whoa, wow, whoa, this is so clear now. I can get so much done. The anxiety that I had about procrastinating cuts off. I feel like I can transition between tasks easier. I'm less impulsive, so on and so forth. So medication is a valuable tool. That being said, it's not for everybody. In fact, I forgot the stat exactly, but I think it's less than 20% of adults that have ADHD that actually take medication regularly, and they avail themselves of other tools like therapy. So it could be something that is geared towards ADHD that keeps the executive functioning in mind. So coaching and therapy, it's a whole nother conversation of what the difference is, but a therapy that keeps in mind the challenges of ADHD and the ability to manage time and manage tasks and deal with these issues of procrastination and address the emotional kind of baggage that comes along with ADHD, that can be really important and helpful. For children and adolescents and maybe anyone in the school setting, getting accommodations is an important resource and way to help support your efforts in maximizing your life with ADHD. Then for parents, getting parent training, it's not just about the child. It's about the parents as well. Learning like we learn about how to help our son, and it goes a long way. So those are some of the resources that are available. Ayla Sitt: I would also add that it's not medication or therapy. You can do medication and therapy. You can have your children learn skills while giving them medication. Perhaps over time, they might find that these skills are really helpful for them and they're able to implement them and maybe they need the medication not every day. It could be different for everybody. So I don't think you ever lose out by learning skills. Medication can be a helpful bonus too. David Sitt: Yeah, a hundred percent. I agree with Ayla. The skills are crucial. To just do medication, I would really caution against that because you need to learn how to live differently with ADHD. And mindfulness we mentioned, and meditation, to me those are crucial top skills for anyone, adult, adolescent, to childhood to learn. Adam: So do you want to talk a little bit more about what the therapy session or therapy program looks like, what skills it helps somebody develop? And then you mentioned mindfulness and meditation. Where does that fit in? David Sitt: So I think that it depends what age we're talking about in terms of what the therapy might look like. For children and adolescents, there's going to be much more structure involved, a lot more behavioral interventions, learning how to set up a calendar for themselves, learning how to manage their homework and set themselves up for success. Maybe things like controlling their environment, sitting in a room with less distraction. Therapy might include elements of emotion management like we talked about. Ayla Sitt: Emotion regulation, learning how to not act on impulsive urges, how to take that stop, how to breathe, and not necessarily though the urge feels so strong to sort of extend between the urge and the action and maybe pick something else. David Sitt: Using breathing, breath work to help someone, an adolescent or a child is really important for managing ADHD. Then there's the whole psycho education about ADHD, knowing what it is, teaching them about what it is, giving them language to use to destigmatize ADHD is crucial. I think that's something very new [inaudible 01:00:20]. There's stigmatization. 15 years ago we talked about it in the academic circles, but I don't think people were so tuned in as they are today. I will say for adults, the work that I do, I introduce this executive function coaching where I do a lot of training on time and task management. Earlier you mentioned this three tier system that I utilize, which is a kind of funnel down way of seeing your life. So I give people a spreadsheet or even there's a notebook called the planter pad. That's the similar system where on top of this kind of single page outlook, I write my life's requirements in categories or my tasks that I got to do this week and next week in category. So I have my private practice as one category. My finances for my private practice is another category. My teaching at Baruch College, my home life, my finances in my home life, a miscellaneous category and maybe my book was a project that needed a lot of attention, so that got a category on the top of a piece of paper. Let's say if you're holding it horizontally and you fold it in, you draw a line in half. The top half are these seven, eight categories. On the bottom is the days of the week, Monday through Sunday. So now I have this dashboard view where I externalize everything and that's key, getting it out of your head and getting it so I can see it. Now I can see my whole list of goals for the next couple weeks. Then I can say, okay, tomorrow, Friday morning, what am I going to do on Friday? It's based on what I see on top. On Saturday, Sunday, Monday, I'm going to jot down my list of goals for that day and narrow my expectations. So that's a big part of the skills that I teach people as well as the emotion management, the cognitive restructuring, understanding that I'm going to feel guilty and shame and depressed and anxious, and so many other feelings that are byproducts of the wake of having ADHD. That needs tools and skills. So I'll pull in cognitive therapy skills for that. Then I'll add in a lot of mindfulness training as we talked about already, and meditation for ADD specifically because expecting someone to do a 25 minute meditation is unrealistic. So kind of an ADD friendly toolkit for mindfulness with a heavy dose of self-compassion. So that's like my ingredients for success. Adam: Yeah, I think that's a really great example. It's that duality of the skills training and the emotional regulation piece. David Sitt: Exactly right. Adam: So you've talked about some of the strategies and techniques that have worked for you. Are there any others that you want to mention? David Sitt: I think it's important to highlight, I think I just said it very quickly, but the self-compassion is really important because dealing with ADHD, it's a daily grind. If you didn't shed it out of childhood, which happens for some children, about 50% of children "shed" or the symptoms really kind of fall into check and they're able to kind of manage without as much attention to their symptoms. But if that's not the case, then you're dealing with a lifelong brain style and this is your brain. So it's a daily grind. You need self-compassion every day. Adam: Cutting yourselves in slack. David Sitt: Oh my God, it is so important. If you have a partner that can cut you slack or if you have colleagues that you can... If you're comfortable to let them in on the fact that you're struggling or that you have this disability that you have to work through and they know about it, that can help you. That's a whole nother conversation about the workplace of ADHD. But bringing yourself self-compassion and hoping others around you can bring it as well really can't be emphasized enough. Adam: So we're on the subject of self-compassion. Do you have any tips on how to be accommodating and compassionate toward both children and adults who have or showing signs of ADHD? Ayla Sitt: I think one thing you can do is once you've better understood what ADHD is like, I would say imagine yourself in their shoes. Imagine what it must be like for them in that situation. I believe that most people want to do good and most people want to succeed. So if they are falling short of that or if they're really struggling in some way, imagine how much of that sucks for them. So trying to imagine from their perspective of what it must feel like. I think just doing that in itself will decrease the intensity of any negative emotion you'll feel towards that person because you'll simultaneously feel compassion for them and the struggle that they're going through. Adam: I got to be honest. As a parent, I definitely struggle with that. Sometimes your kid is on the floor having a tantrum and you want to be compassionate, but the screaming is loud and there's flailing and stuff needs to happen for the bedtime routine or whatever it may be. So how do you accomplish that in that type of moment? Ayla Sitt: Yeah. Well, I wish I can tell you a magic skill for that, but I think it's a combination of different things. I think each tantrum sometimes might call for something else, but sometimes it might be a hug. I found that sometimes when my children's emotions are really big and the thing that they're crying about I know is not even what they're actually upset about. I might say something along the lines of, it sounds like something feels really hard for you right now. You're really upset. I'm sad to see that you're so upset. Would it help if I gave you a hug? Sometimes they'll say no, and other times they'll come up to me and grab me. That in itself will be comforting. Other times it might be giving them the space to allow them to ride that wave of the emotion that they're feeling. It's okay for kids to get upset. We all do. It's an emotion. It's one of the emotions we were created with. So every emotion is there for a reason and their emotion is telling them something. So we don't always have to make negative emotions disappear immediately. So I would say that's something. David Sitt: And there are some times where ... I have my own example of just this week where one of my children was having a tantrum of his own and started to walk around the house ripping things off the walls and artwork that his brother worked hard on and crashing, really causing destruction. That was a tough one because I knew that I had to figure out ... Again, my own impulsive came up and I said, that's not okay. That was something that to me warranted the timeout space. So we kind of used a one minute or two minute timeout chair or an area on the steps that we learned when we worked on something called PCIT therapy. Ayla Sitt: Parent Child Interactive Therapy. David Sitt: Right. We signed up for that kind of a therapy for our children and we learned a lot. That was one of the things where you have to place him in that timeout spot. He wouldn't sit there because I don't care what you tell me, I'm going to do what I want to do now. I, in that moment then, went to Ayla's suggestion of there's nothing I can do to change the fact that he did the damage. I attempted to do my separation. At that point, I walked away and I said, this is too much right now. I'm going to come back after you've calmed down. He continued to rage and I just did my best to ignore it. That was hard. But in reality, what was so big? Yes, so he ripped a paper. Yes, he threw something on the floor he shouldn't have. He caused damage that I'll clean up, but I needed to separate. Ayla Sitt: Or he'll clean up. David Sitt: Well or I'll end up exacerbating the situation. Then there are other times where I'm a complete utter disaster myself and I do nothing right. That's normal and that's okay. So that's the other thing I would add to this conversation is self-compassion. We're not always going to be perfectly amazing. People joke with us all the time. We're two psychologists. Our kids are like, the shoemaker doesn't have shoes. That's us. We try our best, but there are many times where, despite our best efforts, it doesn't go perfectly. But it's okay, we have the long game here and we have to be compassionate. Adam: Certainly. Ayla Sitt: I think to that end, being able to model behavior for your children. So if you did react in a way that you felt wasn't effective to say, "[inaudible 01:09:03] I'm sorry I raised my voice. I wish I didn't. I got really upset and I shouldn't have raised my voice. And at the same time, we can't rip things off the walls, not your artwork. You ruin something that your brother worked really hard on." You can also apologize for something that you wish you would've done differently, because we also don't want our kids to grow up with the impression that perfection is the goal, because then everyone's failing and everyone's feeling sad about where they are and how much more they can do. Adam: Sure. Yeah, that certainly resonates with me personally. I just wanted to say, we're talking about parent training and I think it's such an important piece of this in DOE world, in the legal matters that we litigate. Usually, the only parent training that's available within the DOE system is for families who have a kid with autism. Even when they recommended it there, it's not recommended frequently. The parent training component is such an important piece, whether you are raising a kid with ADHD or some other challenge, for the parents to understand the proper and effective ways of intervening and providing support and doing the things that you guys just articulately described, that requires professional guidance. There are programs that do that, but I think it's just really important to be on parents' radars that this is an important component and there are professionals out there who do provide parent counseling and training. Are there any emotional or behavioral issues that you typically see alongside ADHD? This is usually referred to as comorbidity. David Sitt: So it's very common, again, for people to have byproducts as I call them. So it's typical that you're going to go through bouts of depression when you miss your deadlines or when you struggle to organize your house or you haven't done laundry in two weeks. You'll feel anxious, you'll feel depressed. So there are these byproducts that are very typical. At times when I have people come to my office who don't know they have ADHD, they present with these anxieties, these depressions, these guilt and the shame. Then in further delving into it, I learned that underneath those emotions is this undiagnosed ADHD. So sometimes that's how things present and they need to be addressed. Sometimes addressing the ADHD can help alleviate the emotions, but sometimes the emotions need to be dealt with separate and apart.

There are other times where people might present with a bonafide comorbidity, otherwise known as a co-diagnosis. So they may have ... typically you might have major depression or an anxiety disorder. These can present together with ADHD. We also very often see sleep disorders, that people have difficulties with sleeping because they're maybe staying up so late, they're procrastinating late into the night. Substance abuse is a huge issue in the ADHD community. They're prone to impulsive behaviors seeking out stimulation in different ways, trying to medicate and self-medicate is typical in the ADHD community. Learning disabilities will come up often as well. The last area I would say comes up very often is just there's a strong drive for people that have ADHD towards perfectionism, which there is no diagnosis of perfectionism, but it is a big challenge that kind of very often presents with adults, at least with ADHD. Adam: David, you have a forthcoming book, again, that's ADHD Refocused, Bringing Clarity to the Chaos. Before we talk about the contents of the book, talk a bit about the writing process. What's it like for someone with ADHD to embark on writing a book? David Sitt: Oh boy. It's interesting because this has been a labor of love and procrastination. That's how I think I wrote it in the forward. I started wanting to write a book many, many, many years ago, 10, 12, 15 years ago. I started taking notes and I had all this big ideas, like we talked about earlier. I have a big vision about how I want to make this happen and what it's going to be like and et cetera. I struggled to get organized enough to be able to sustain that excitement. It took me a very long time until I finally decided I had to take a different approach and I kind of had to hack it into existence, as they say. I ended up hiring a company whose purpose is to help authors bring their book to life, and the company is called Scribe. They helped me by, they assigned me a scribe, someone who basically interviewed me, and I shared all those writings that I had done in the previous 10 years but couldn't get them all together. I sent them over. Every podcast I did, every recording, anything that I had put out, I sent it over. Then they interviewed me for maybe 12 or 14 weeks, and I came prepared with my material on the deadline. I knew I would meet with them at 10:00 AM, so obviously the night before I was crunching, getting all my information together. Ayla Sitt: So at 9:59, he was ready. David Sitt: That's right. By 9:59 I was ready, or at 10:07 actually, because I always ran late. I would download all my information to them through a conversation and they were able to take all my words and organize it into a text for me. Then I went through an editing process. This took me, I think four ... I don't even know if it's four or five years, and I've just now hit the finish line. It's been really invigorating, exciting, depressing, anxiety provoking, disheartening and invigorating again, all at the same time. Adam: A lot of emotions. David Sitt: A lot of emotions went into it, and I think Ayla knows, been watching me go through this. She's been pretty patient with me. I tried everything. I tried everything. Locking myself in a cabin. I was using my medication to try to help me get into good focus zones, and I just ultimately needed to be patient. I'm really excited about it. I'm really proud of the work, and I think it's going to be an effective tool for people to help improve their probabilities of succeeding in their lives with ADHD. I talk a lot about technology also in that book, about how technology these days, it's just a whole other conversation about how technology, these days, for all of us, it's creating something like ADD in us, and maybe that is what's leading to this kind of excessive diagnosis or the explosion of diagnosis lately, is that we've been so tech dependent. So I cover all of that along with all my tools and tips, from my own experiences and my client experiences and my marriage. All that stuff is kind of laid bare in there, so hopefully it'll be great. Adam: Sounds like it's been a long time coming. I'm sure you put a lot of blood, sweat and tears into that project, and I'm really excited to read it. I'm sure it's going to be amazing. David Sitt: Yeah. I'm going to give a shout-out to someone in your life, your dad, who was a very integral in encouraging me. I'll never forget in my early days, because I've known Adam's dad for a long time, he was a staunch supporter and encourager of me never to give up. Just keep going. So he'll be getting one of those free copies for sure. Adam: That's amazing. I'm sure he's going to be touched when he listens to this. Before we conclude, I have to ask, what fuels your passion? Why do you do what you do? What drives you to get out of bed and go into work every day? David Sitt: I'm a stimulus junkie, as many ADHD adults out there are, and I really thrive. The stimulus of interacting with people is my number one stimulus experience. So whether it be I've been teaching since 2001, I think. So how many years? That's 20, what? 20 something years. The connection with people and my students over these years, Adam being one of them, keeps me every day feeling alive, and working one-on-one with my clients or speaking in public settings with corporations or educational institutions. That gets me jived, that gets me excited, and I feel very blessed and fortunate that that is what excites me. So I'm just going to keep at it. Adam: Amazing. Ayla? Ayla Sitt: Yeah. I think similar to David, I love connecting with people. I think the moments that I have in session where I can see a burden lift off of my clients or I can see them sort of seeing something that they may have thought in one way for their whole lives, and all of a sudden they're like, wait a minute. Now that I say it out loud, it kind of feels silly. You just have these moments where you see that you've released some of the negativity, some of the anxiety or painful emotions they've been carrying with them, and they're seeing things a little differently and they're approaching their lives a little bit differently and being more compassionate with themselves. Those are the moments that really impact me and really make me feel excited about the work that I do and motivate me to keep on doing it. Adam: So as far as contact information, so our listeners can get more information about you, David, for your website, you said www.drsitt.com. Dr. Sitt with two ts.com or by email info@drsitt.com. Ayla, do you want to give your contact information? Ayla Sitt: Sure. It's www.newyork, spelled out, cbt.com or my email is ayla@newyorkcbt.com. Adam: All right. Excellent. I want to thank you both for being here with me today. David, you've always been a mentor to me over the years, whether you know it or not. Studying psychology has been a huge part of my life and career, and you definitely helped spark that interest when I was a student in your classroom over 20 years ago. You even influenced my decision to go into law, and it's been great to stay connected with you over the years. Ayla, I don't know you quite as long as I know David, but we've had some overlap in the field of special education. I respect the wonderful work you've been doing in your clinical practice, and I look forward to keeping in touch with you in the future. Again, thank you both for giving so generously of yourselves to our listeners. This has been deeply meaningful to me on a personal level, and I'm sure it'll be incredibly valuable to our listeners. David Sitt: Thank you so much for having us, Adam. Ayla Sitt: Thanks for having us. David Sitt: This has been great. Good luck with the rest of this podcast. It's incredible. Thank you. Adam: Thank you. Speaker 1: Thanks for listening to Curious Incident, a podcast for special needs families. Don't forget to subscribe for a new episode every month. For more resources and helpful information, check out our website and blog at dayanlawfirm.com. This podcast provides general information which is not intended to and does not constitute legal advice. You should not rely on this information for any purpose. 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