This is a Global Player original podcast. We'll move on. I think I'll be all right. We're going to talk about a very important subject today, medication and how the drugs work.
They didn't work for me. They don't work for everybody, but they did for you, Katie. Tell me a bit about when you take your medication, what it does and how you know it's working. It's a funny one, really, because I know some people describe it as the noise stops and suddenly everything comes into focus.
And I sort of have that experience. But actually, what I find happens is that I look back a couple of hours later and I realise that I'm a functioning human being. It's much more about the practicalities of how I lead my life. There's a really good example, actually.
I sit on a committee here at Global for Make Some Noise. And I have to look through a bunch of paperwork and it can be incredibly time-consuming and overwhelming. I love doing it. Part of the job I really love.
And it can take me weeks and weeks and weeks. And last year, for the first time, I did that job with my meds. And my husband went off on a talk walk and he came back later that afternoon and he said, oh my God, have you finished? And I said to him, no, no, no, I found a new system.
And he said, no, that's your meds. And of course, now that you and I have been talking about this as long as we have, and now I've had time to sort of mull what's going on in my head, I realise it's largely to do with that working memory issue that I have. I find it hard to hold information and that's what my meds fix for me. So it's not necessarily motivation, it's more clarity of thinking then?
It's clarity of thinking. And maybe also the motivation because, yeah, I get more housework done when I take them and I'm quicker and I get down to the job so much more easily when I've taken those meds. And honestly, if you were to ask me if I can tell the difference between me on meds and me off them, I'm not sure I can. Could you have them?
Yes, and so do my kids. Really? Yeah, absolutely. I think when I'm off them, I'm just so busy and so scatty and so unable to function that I am so busy wrapped up in trying to cope that I don't see the difference that they make and I'm just a human being when I want them.
See, that's a really interesting phrase because I was going to say to you, I think one of the big concerns Absolutely. So do you think it changes your personality? Does it change who you are? Does it change your characteristic, your personality traits?
I would say no, but I know there have been days. I think it depends on the day, actually, and that's probably to do with my body chemistry. But I know there have been moments when I'm thinking of a brunch. I was out having brunch with my family, with my boys and my husband.
And I got chatting to the waiter and I had taken meds an hour before and I'm full of them and vagrant energy. It gives me energy. So the meds give me energy and volition. Perhaps sometimes a little bit too much.
And apparently I got chatting to the waiter and I was asking loads and loads of questions about which bed of Spain he was from. Eventually the waiter had taken our order, left, went back to the kitchen. And Robbie turned to me and said, enough with the questions. You just calm down a little bit.
So clearly sometimes it gives me a bit too much energy. That's interesting. So rather than slowing you down, actually you find it speeds you up? It speeds up the body.
That's what I understood it. Yeah, it speeds up the body, which of course speeds everything else up. It speeds up the brain. It speeds up your ability to make those connections and possibly speeds up the speed at which I speak.
I don't know. All I know is that my life is better when I'm on them because I can get more done and I have to get a lot done every day. So does it change my personality? I don't think so.
I certainly don't feel like I can't do my job on them. That was a big worry for me before I talked to them. You know, we as radio presenters, we rely on something you can't quite put your finger on when you're sitting in front of a microphone. You just want to come up with stuff.
It's smart. It's smart. It's silly ideas and little jokes that you tell and new ways of telling stories. And I was really worried about that to begin with.
Would I still be able to do that? Well, actually, probably up to the people who listen to me to this side. But certainly I go into the studio and I feel the same. I just feel better.
So you don't seem any different to me, but you feel better. And surely that's the combination. That's all you described about the weight of me. That's you.
That's you. That's not for me. I would say that. But apparently I was talking at 100 miles an hour and asking lots of questions.
But then... That's what you do. That's what I do. And I've always done that, haven't I?
So maybe my masking has slipped slightly since I got my diagnosis. I don't know. There are so many more elements to this than just the meds, aren't there? Of course, yes.
I think, you know, that's the thing. And trying to focus in on whether or not that was fixed by the meds or fixed by the fact that you knew that it was a challenge. So you fixed the environment. It's really hard.
But I do know that when I couldn't get the meds in December, that is when I knew how much easier they had made life for me. So what was life like without them? Oh, slow. It was slow and lacking in energy and I felt like a zombie.
And isn't that ironic considering everyone is worried about taking the meds because they think it's going to turn into a zombie? The opposite happened. I couldn't get out of bed in the morning. So then how many...
What was I losing? An hour to a lion every morning. And so that's maybe a whole working day by the time you get to the end of the week that I'm not up an atom. And all of the other stuff came rushing back.
The emotional dysregulation. I mean, dare I say it. It's a sort of mild paranoia, actually, about how people are relating to you and what they're thinking. And that all came back too.
And that then affects every other aspect of your life. Because if you're not getting stuff done, then the anxiety comes back. And all of that stuff. And it was just before Christmas.
It was a really rubbish time for that to happen. And when I finally managed to get hold of my meds from a wonderful pharmacist in central London, my husband identified somewhere where I could get them from. And I ran to the pharmacist from work to get them. And I fell on her.
And clearly, because she was in this kind of golden place of having some medication in her shop, she had a number of people like me falling on her that day. And she was expecting me to be emotional. And I was. Because it felt like I was taking from her the key to getting me back, I suppose.
Does that make sense? It does make sense. And also, you found the thing that made things clearer, that made you work better. Another thing that comes to mind, though, I think it's another question that people have about drugs is you're taking quite strong medication for potentially the rest of your life.
Did you ever fear taking the drugs? Was there ever a point of you where you thought, hang on a minute, what about this? What's this going to do to me? Neatically or physically speaking?
Absolutely. And I still have it, actually. I'm really looking forward to the chat we're going to have today. Because for exactly that reason, there are questions I have about, A, taking them at all, but also, as you say, the long-term use of them.
I have a friend who was diagnosed some years ago now with ADHD. He is now at the stage where he has left the meds behind. His view is that the meds gave him the ability, essentially, to learn life strategies. They sorted his brain out for long enough for him to be his own parent and his own grown-up.
He's now post-meds, and with those strategies, he reckons that he's able to cope without them. And I find that an interesting question. That's really interesting. Yeah, is that something that maybe we could work towards?
Is it something we should work towards? Or actually, should we just accept that we're so lucky to be living at a time when this miracle has been invented that makes us feel better? The guy, one of the psychiatrists who did one half of my diagnosis, said to me that it's one of the most rewarding areas of psychiatry to work in. Because if you get your diagnosis and then go on to be treated with that work, it's a lot of drug.
You don't have to take them every day. They are out of your system. By the end of the day, you can have a whole week off, and you wouldn't necessarily have withdrawal symptoms. You know, my life doesn't work as well, but what I'm not suffering from is physical withdrawal symptoms.
And so, should we actually be as obsessed as some people are with this question of, oh, should we take them? Well, if they're working. But, you know, you're absolutely right. It's a concern.
I have definitely. That's a question to ask. I mean, you know, the drugs didn't work for me, and I... Yeah, how do you feel about that, first of all?
I wish they did. I think, if I'm really honest. When, you know, we talked before, I was at a crisis point. I had been diagnosed.
I tried all of the medication. How many is that? How many are there? So I tried L-bands first, and I remember being completely wired.
You know, they don't work for everybody, and they didn't work for me. I had this piece of Beethoven's Fifth Symphony, part of the finale, in my head, and it was just going round in my head for two days. I was tapping it on the table and chewing it on my teeth and bouncing off the walls. I do that anyway.
But this was, like, at double speed. I mean, you know. Yeah, yeah, yeah. So I then tried...
That's what I take. I'm going to take L-bands. Yeah, yeah. So I then tried Concerta, and didn't do anything on a low dose, had a higher dose out of the same thing.
Then I took Ritalin. Now, while I was taking Ritalin, my pulse dropped. I ended up going to an hospital for some checks, and the doctor's view was that was not caused by the Ritalin, but he was very much of a view that, you know, stopped taking that. And then I tried non-stimulant medication, because there's also non-stimulant alternatives called athermoxetine, and they tend to build that up quite slowly.
So I had that for a number of months building up the dosage, and I found that it didn't really do anything for me. Did you feel any change at all? I had. I mean, one of the things is you have to monitor your pulse.
And I found that, and I think it can be quite stressful. They call it titration. They can be quite stressful for people. You are trying this new drug that you want to work, that you sort of feel like you need to work.
And honestly, it was a bit of me panicking about whether it was going to work. I'm at home checking my own... You needed it to work. I needed it to work.
I'm checking my own blood pressure, and I'm checking in with the doctor, and I'm thinking, if this doesn't work, what's going to happen? And, you know, I've talked on other episodes about what happened after that, but ultimately, they didn't work. And I think it was a lot of hard work to then go through all of the counseling and the therapy and coming up with other strategies. I suppose there's a bit of me that feels like, well, if I could just have a drug, you might have just solved it.
However, my rational view of that is I'm not sure that it's as simple as that. I think, actually, even if you're taking medication, you still have to come to terms with your ADHD. Absolutely. And also, also, they don't fix everything.
Anyone who's in that place where they've got the diagnosis and they're waiting to see if the meds work, I think it's really important to say that I still have bad days, even on the days when I'm taking my meds. I still have days where it's crap, and I don't know quite why it's not going according to plan, but I'm tired and I'm ratty because we're human beings. And so even, you know, basically, the drugs don't touch the sides on certain days, and I imagine without the drugs are being worse, but they're not a fix-all. I think some people think they are going to fix everything, and they don't necessarily.
You know, I did wonder whether or not I ought to up my dose for a while for a bit, and a bit like you, I kind of haven't because I thought I don't want to necessarily push it. I don't know. I think, as a society, we have a fairly complex relationship with drugs, don't we, because you know, we've got memories of drugs doing damage in the past, in the 60s, 70s, and these days, I think, you know, we kind of have to accept that actually some drugs can really help us. That is your experience.
Yeah, absolutely. There's lots of questions there, aren't there? Lots of questions about how they work and the effect they have on you. Yeah, what side effects are.
Absolutely. Well, Dr. Max Davey, consultant, paediatrician, and co-founder of ADHD UK, seems like the person to answer those questions. We'll speak to him in a moment.
Hello, Max. Hello. It's very nice to be on. So, my first question to you, I suppose, is, can you take us through the different forms of medication and how they all work?
Yeah, of course. Broadly speaking, there are two forms of medication most often used for ADHD. Those are stimulants and non-stimulants. Now, in order to understand how they work, it's a bit difficult in a purely audio format, but if you imagine, you've got to sort of think back about what ADHD is, and I'm sure we've had lots of discussions and lots of episodes about what it actually is, because it's such a difficult question, but one way of thinking of it, a mental model I find really helpful, is that ADHD is a chronically under-stimulated brain.
So, you have, imagine a level of stimulation at which your brain would be comfortable, and every brain has a level of stimulation at which it is comfortable. That's a universal, that's a human universal. But people with ADHD, that level is much higher than the level of stimulation that the world typically provides to us. I say us, because I have ADHD myself.
Now, the medication acts to close that gap between how much stimulation you're receiving and how much your brain is comfortable with. So, the stimulant medications, which are best thought of as a little bit like a cup of coffee that lasts all day, that's got that kind of feel to them, those increase the level of stimulation that you are experiencing so that that gap becomes lower, so that the behaviours that you might be kind of driven to do, the fidgeting, moving around, getting distracted, may well be reduced. The non-stimulants somewhat act in the same way by increasing the level of stimulation that you are experiencing, but also act over a longer period of time, talking six, eight weeks, to reduce the amount of stimulation that your brain seems to require in a way that is actually, if I'm honest, slightly mysterious quite how they do it, and they don't do it quite as reliably as the stimulants. So, that's broadly the two sorts and how they work.
That's a fantastic explanation, thank you. Is there, are there any side effects that come along with these drugs? Yeah, I mean, they definitely are, and I think we need to be absolutely clear that the decision to go onto medication like this is not to be taken lightly in any way. What I tend to say to people, and I'm a paediatrician, but actually there isn't a magical difference between a 17-year-old and a 19-year-old who's suddenly an adult, as we know, so I think what I say is relevant, and it's what I say to my teenage patients, definitely.
The first few weeks can be a bit rough. Your brain feels different, and sometimes it's a bit hard to sort of explain or describe, but I mean, I have taken medication and no longer take it, and the experience of going onto medication was odd. It almost felt a little bit like jet lag that just went on for a longer period, you didn't feel quite in your own brain, and it was hard to explain what was wrong. Sometimes this can manifest itself with agitation or irritability, and so it's just not a fantastic experience to start these medications, you can feel a bit weird.
I've mentioned that it feels a bit like coffee, the stimulants anyway. That's how it feels for me, actually. It gives me that energy throughout the day. Yeah, but equally, if you have a bit too much coffee, if you overdo it for your body, you can get that kind of tightness in your chest and the palpitations, and that can be really unpleasant.
I'm interested in the fact that you no longer take them. Now, that's really interesting, because Sam's sitting here as somebody who tried all of them, and they didn't work for him, so did you stop taking them because you felt you no longer needed them, or because you didn't enjoy the experience being on them? Well, I think it was a bit of both. I think when I first was diagnosed, I definitely felt like I needed them, because I hadn't quite come to grips with my own ADHD, hadn't quite kind of worked out what works for me, what my limits were, hadn't really adjusted to it, and so for that period, it was really vital for me.
I tried Lisdex and Fesamine, also known as L-Vans, and just didn't get on with it, and I spent about a year on misalphenidate, which is also known as various things, such as Concercer or Equusim, so I spent about a year on that, and I also was going through some stress, just non-ADHD related, and I just felt that when I was stressed otherwise, that feeling of tightness in my chest felt like, it's a bit dramatic, but almost felt like a sense of impending doom, and that would happen for most of the middle of the day when I was on that feeling, but actually, I was on such a low dose, I wasn't actually helping my ADHD, so by which time, I'd also made some adjustments, and mainly just sort of knowing what my limits were, what I could and couldn't manage, and so I decided to come off at that point. That makes me to ask the question, why don't the drugs work for everybody? You know, it's something like 20% of people it doesn't work for, so what's the reason for that? I just, I think we don't know.
I was talking on our podcast, the ADHD Science Podcast, to somebody who's trying to find out how we can predict who the medication is going to work for, and who it's not, and which medication is going to work for whom, and at the moment, her conclusion is that we really don't know. We're very, very early in the process of being able to predict who this stuff is going to work for. I mean, in my clinical experience, the people for whom the ADHD medication works are often people for whom ADHD is kind of the only real problem holding them back. If there are lots of other complications, there's trauma, there's anxiety, there's family difficulties, there's school difficulties or police difficulties in some of the patients I look after, then you're only actually altering one variable of a very complex situation, and therefore you're maybe not going to make a huge difference to this person's life.
If the ADHD is the only thing that's really holding them back from fulfilling their, you know, what they want to set out to do, then you've got very likely to have an impact on that. That really speaks to me, actually. I mean, that certainly seems to be my, I think that was my situation. There was, you know, I was diagnosed with traits, borderline personality disorder, there were other things going on for me, there was mental health and comorbidities, I suppose is the phrase.
It does, as you're speaking, and Katie and I talked about this before about coping strategies, it does make me think that what you're looking at with ADHD, correct me if I'm wrong, is a sort of package of treatment. So yeah, okay, there's medication, but it's also about being aware of yourself and all the other things that go along with it. Would you agree with that? I would, and while I like all good NHS...
acolytes i subscribe to the nice guidance and i follow the nice guidance one of the things that i would like to be different is there to be more emphasis in adults on treatment other than medication the very much the guidance suggests that if you're an adult as soon as you get a diagnosis of hd medication is what we would call the first line and i think that's the unfortunate side effect in a cash-strapped system that people get the diagnosis get their prescription and off you go um good luck and which is not really how it should be certainly at the same time katie's certainly seen that the medication works in the last situations and there are lots of situations for lots of people whereby medication they take it and it does is a magic bullet in a way absolutely one of the um i was telling sam earlier one of the psychiatrists who treated me said he's found an enormously rewarding area to work in for that reason because you know they can be a wonder drug for the right people if the meds work for you and they seem to work for me i can't tell you really why actually because it's not like some people describe everything something coming into focus there is clarity definitely but it's about energy i think for me and volition and it definitely enables me to get more done which means all that other stuff that comes rushing in with hd the emotional dysregulation and the anxiety they are held at bay because the meds are working for me is there is there an issue do you think with taking them long term you know should we should we all be working even if you're somebody like me for whom they work that's great take them every day should i be working towards not taking them one day i don't think so i mean it's very difficult we talk about evidence-based in medicine and the reason why the medicine is our first line is because the evidence base is the strongest for them let's be clear about that the evidence for long-term use is very difficult because you can't put people in a randomized control trial for three years they just won't stay doesn't work so all you've got is observational data but if you look at the very large cohorts from scandinavia for instance the outcomes for people who stay on their medication long term are very much better for people who don't stay on medication who are not treated so i think overall that is a population who tends to do better now there's all sorts of confounders and there's also criticisms you can make of that data but certainly there doesn't seem to be any harm in long-term use and there does appear to be some evidence that there is benefit to your long-term outcomes to continue providing it works for you so i am very relaxed about people continuing as long as it works for them that's absolutely fine what are the side effects because you know i know that i'm i definitely get more thirsty that's the thing i need a lot more water i've got a family member who gets very sweaty gets very very hot so are there any other side effects that you're aware of that i've talked about that initial period that initial phase of it being a bit tricky and talked about the kind of palpitations and so forth the big thing after that first initial phase that we talk about a lot is appetite particularly in children but to an extent in adults and of course if you have already an unusual or a problematic relationship with food before you start this medication you're very likely when you're on stimulants particularly not to want to have that much for lunch and you definitely snack less on medication that's the thing i really i've seen that i've seen that but you know maybe that's because i was definitely overweight before we identified the adhd and i now recognize that the adhd meant that i was massively addicted to sugar basically got me through the day and it would be something that i would rely on at night and that's all gone and i don't see that as a drawback for obvious reasons because it means i'm now choosing healthy snacks if i choose a snack at all because i just don't tend to need them as much anymore i don't see that as a downside really and it connects it connects in with this idea of stimulation sort of being starved stimulation because eating is stimulation arguably sugar is stimulation i think there's an argument about whether that kind of buzz of sugar is a real thing or not and i think it's really important to note that giving particularly children sugar does not give them adhd that's a really important point to make yeah but yeah but definitely having said that if you are somebody who struggles to gain weight um i mean this is perhaps more relevant for children but also some adults that appetite suppression can be difficult and there are as i mentioned cardiac side effects so you need to be cautious at times for some people about starting these medications because they do stimulate the heart right and that sounds like a sort of a sensible warning for anyone who's taking medication you know the sort of things that doctors will be checking up on and one of the things i wanted to address i suppose it's another of those big fears out there that you hear people say it certainly is i think prevalent in the old view of adhd about you know naughty sore boys who are turned into zombies to what extent should people be afraid that these drugs are going to change your personality what should be on that i don't think i've ever seen a patient of mine i treat adhd in my clinic i treat a lot of kids i treat hundreds of kids with this medication and these medications more broadly i've never had somebody who has said my child is different now my child is a different child you certainly see people for whom they behave differently so if it's really worked this medication somebody who is kind of all over the place kind of you know in your face all the time really kind of always on kind of and once they slow down sometimes there's some aspects of their personality that become obvious but it's not that it wasn't there before it's just that you're seeing things differently because you're just working through things a bit more slowly i have seen kids for whom treating effectively their adhd has made their anxiety more or their trauma or their mood problems more obvious simply because they've had the time to reflect and to think i don't see that as a bad well i'm not sure i see that as a bad thing because in order to get through this stuff you have to reflect you have to stop and think they're processing for the first time exactly that's a good thing because at some point they were always going to get there if being treated correctly they were coming to a point where there was under face stuff yeah that's really interesting and on that it's probably helpful to sort of talk about the benefits i mean you know you're talking about treating patients what are you seeing in them and the changes in them that are really positive changes to their lives i think the thing that the medication does is reduce the symptoms the core symptoms of adhd so by bringing that gap between how much stimulation you're getting how much you need down you will on average in most patients reduce their hyperactivity their impulsivity and improve their concentration now for some people there's a very straightforward link between that and making their life better which is ultimately what it's for you can decrease the symptoms but if the person's life has not improved then you're not actually doing medicine you're just experimenting around you're just experimenting yeah so um you know so so where that connection is very clear you can actually make a big difference though we have people who you know have been gone from school to school to school not really settling and have gotten to the medication and have been able to settle into school it's gone from being somebody who all the other children and obviously very mandatory adults but all the other children don't want to play with them and don't want to be their friends to someone who is well liked and who is accepted so all those sorts of things that just make a good life a kind of positive life can come with time if you just tackle the core symptoms which and the response to the core symptoms is often very rapid it's that life changes they can take months and years of course yeah of course can i ask about taking meds and their relationship with alcohol because i know that if you are someone going off to university for instance and you're newly diagnosed with adhd that is a big question isn't it about how and when you're allowed to drink because that's the way you meet new people and go out and have a bit of a laugh also i'm a 52 year old middle-aged woman i still want to have a drink now and then yeah how and when should that happen it's a really good question and i have to admit um i've got to be honest i'm not an expert on all aspects of adhd and all aspects of medication i don't drink so i've actually come across this personally um i mean there is no recommendation that you avoid alcohol while on these medications there's no particular problem there there's no cardiac reason why you can't mix these medications and alcohol i mean i think untreated adhd mixed with alcohol can be quite a difficult potent cocktail can't it the impossibility of adhd and the lack of reserve produced by an excess of alcohol can lead to some pretty sticky situations treated adhd and alcohol i suspect would probably actually probably be safer in the longer term obviously as a doctor i don't you know please drink possibly etc but if you but you know there isn't any reason why you can't have a healthy relationship with alcohol while you're on these medications great okay um what does it say about us as a society that we have to take these drugs in order to be part of it do you think yeah i think there's people push back against that argument but i think there's some force to it so it is always and i go back to childhood but i think it's true in adulthood as well when people say to me well why can't we just accept these people why can't we just accept them for who they are and make allowances for them and then we don't need to do this medication and i really i can have a lot of sympathy for that view and i work very hard not just giving medication but also working with schools working families trying to make the lives of the people with adhd as accommodating as possible and that's one of the big missions we have at the charity adhd uk that i co-founded and run with my friend henry shelter i've been on a podcast before so that's definitely true but on the other hand everybody not everybody but lots and lots of people need adjustments to their world there is no world which is well adjusted for everyone let's take the sort of sibling conditions autism and adhd if you have what an autistic person needs in a classroom versus what an adhd person needs in a classroom they can be directly opposed an autistic person might need a very quiet slow pace whereas an adhd person will need something quite bright and lively so even even in this perfect world where everyone gets accommodations and adjustments it isn't possible for everyone to have a perfectly adjusted world it just doesn't logically make sense and of course we live in the real world where we have to get through the education system we want to change the education system but it is what it is now and it's not going to radically alter any time soon i'll tell you what i'll tell you what i'll come over work i was just gonna say katie's trying the big question down you there i think you did an incredible job answering that i think about it recently frequently and then yeah another one which is it's kind of related to that sort of societal pushback that we adhds are hearing a lot of at the moment of oh overdidagnosis blah and uh you know oh why does everyone have to be on all these meds and obviously you know we have that conversation a lot my question is if someone were to inexplicably present at one of these clinics looking for an adhd diagnosis who doesn't have adhd and then took these meds what would it do to them how would their body react to these meds we've got a reasonable amount of data on that because the medication has been trialed on people without adhd just to see if it improves their performance and you can understand the situation where somebody thinks that this might be essentially a performance enhancing drug for them for whatever it is that they want to achieve but it doesn't work that's the thing it doesn't actually improve school performance in people who don't have adhd because they don't have this gap so it doesn't help i mean the evidence is that it doesn't really help so yes i'm sure i mean we know over diagnosis happens we know under diagnosis happens and people get very upset about it on the internet but i don't because all we can do is try and make sure that we have as much over and under diagnosis if that makes sense you know we have as little as possible of both and we try and get it as right as possible but the fact that some people might have something else and be convinced themselves about adhd and get through all the assessments and end up with a prescription doesn't upset me that much because if they don't have adhd it's probably not going to work and then the thing that everyone needs to do is take a step back and go huh have we got this right rather than worry too much about you know the kind of broader societal scandal of adhd treatment or whatever it is people want to write about today yeah i agree and you know for me i think we haven't yet reached all the adhd years and the three of us know that having undiagnosed adhd can be extremely problematic and can give you a really sort twisted sense of self and so until we've reached that stage until we've you know we've shone the light in all the corners then then we need to keep going we need to keep chatting about it thank you so much for joining us today and explaining so much about the science of it that's a great deal it was brilliant thank you absolutely and speak to you again soon thank you so much so interesting really interesting not as straightforward as i thought it would be really absolutely i what am i taking away from that do you know what i suppose i am so evangelical i'm so evangelical about my lives because they're so helpful to me that perhaps i become a bit blinkered about that as a treatment and what i got from that conversation was the need to be a bit more conscious about my treatment and to stay conscious and to keep thinking that that's the treatment that i need and to think about all the other stuff as well yeah and i think that was for me a really interesting part of the conversation is medication is part of the treatment and there are other things and there are other things that need to go alongside medication and there are alternatives to medication which is what we're going to talk about next week we're going to talk about how you manage your adhd without medication and we want to hear from you we want your thoughts your opinions on this question should you tell people you have adhd it has a number of implications for an employer for a potential partner for an insurance company there are all sorts of ramifications we want to hear your thoughts your opinions your experiences email us at adhdpodcast at global.com that's all important question again should you tell people you have adhd you can listen to you're wrong about adhd for free on global player download it from the app store or go to globalplayer.com see you next time this is a global player original podcast you