Episode 435: Women's Mental Health and Peak Performance

Hello everyone, this is Rebecca Green for the Winey Palooza podcast, and I am very excited to speak with my wonderful guest today, Dr. Charlene Ruan. Dr. Charlene, thank you for being here with us today.

Yes, thank you for having me. I'm looking forward to it.

This is going to be a great conversation. She is a fabulous lady who has so much to talk to us about, but let me tell you a little bit about her first. She is a clinical psychologist, founder and CEO of Thrive Psychology Group, a large group practice specializing in women's mental health. With extensive experience working with female founders and CEOs, she is an expert in trauma recovery, post-traumatic growth, and peak performance. She's certified by EMDRIA in EMDR and attachment-focused EMDR. That was a mouthful. Dr. Ruan provides advanced treatments for PTSD, anxiety, ADHD, insomnia, and more. She is a sought-after speaker and media expert featured in Shape, Reader's Digest, Vogue, and Dame magazine, offering insights on self-talk, stress management, personal growth, and the unique mental health challenges women face throughout life's transition. I mean, this is such good stuff. I just love all of this. I love what you do for women. I definitely want to dive in and talk about as much as we can in the time allotted. But let's start with— I know you work extensively with female founders and CEOs, and I'm just curious what unique mental health challenges that you're seeing with these high-achieving women?

Yeah, yeah. And you know, it's interesting how I got into that space. I, you know, I— and now I would say probably maybe half to maybe 75% of my clients are female founders, or at least like high-functioning executives. And partially because there's not a lot of people that can do that or have experience with it. So once you start seeing one, then they refer their other founder friends.

And of course, I'm the person—

and I actually do see some—

love it.

Now too, because again, so few people seeing Founders and they have some similarities. But again, there's some specific things for women. And so I would say a couple of things that people don't realize. There's a lot of female founders that have an enormous amount of trauma. And so, you know, it's interesting how, like, when you read my bio, you can see it almost seems like these things are at odds, but they're not, where it's like really in-depth, really hardcore trauma and what I call peak performance, because there's not— we don't talk about that for women or like thriving. We're always just like, be functional. You know, and, and we don't talk about like, okay, how do I not just be okay? How do I like become my best self? How do I like become my most authentic, most empowered self? All of that. And there's not like a great word for it. And very little out there. If you think about like just in your mind, all of the influencers, all the people talking about biohacking and peak performance, they're all aimed at men. And, you know, and again, like what women need and most thrive in is a lot different than what a man needs, just downright to our biology.

Very true.

Nothing out there, which really says something about the expectations we have for women. You know, we can see it trickle down even to like what, like what insurance covers for like medical stuff, right? Like, you know, there's so little around perimenopause and menopause. And if you go in and say something like, you know, my sex drive is off, they're gonna be like, okay, right? If you're a woman, if you're a guy, they're gonna be like, Here, have some Viagra and we're going to cover it with insurance. And with women, they're like, meh, you know, nothing, nothing, just crickets, you know. And so, but what's— it's such a cool period of time to be living in right now because women are not shutting up the way that they have. Partially podcasts, like what you're doing. Like most of my clients get a lot of their information through podcasts, through other women going awesome, sharing knowledge, not being silenced, not like giving in to the stigma of I can't talk about these things and really coming together. So it's such a fun time because women are just, you know, we're just embracing our everything in a way that we haven't. Again, unprecedented pressures as always, but at the same time, like where we're speaking out. So the two, that's something that goes together, like with founders. And I would say even, I think all women want that, right? To be their best and to have their peak performance.

Yes. Yes.

And not to be discounted because of their trauma. Right. Post-traumatic growth is a really powerful thing. But a lot of people think if they've been through something traumatic that it counts them out of being—

Explain to everyone what post-traumatic growth is, because I guarantee you that people probably don't know.

Yeah. I mean, a lot of my clients didn't until I— until I—

Yeah.

So it's a whole newer— there's a whole area of research around it. So basically, what psychologists notice— a lot of stuff is like we just kind of stumbled across it and then studied it. But what they noticed was like, okay, a bunch of people go through something really traumatic. How come a percentage of those people have like low functioning, just they're low functioning the rest of their lives? They'll have like intractable PTSD. They will like never really, like it seems like there's just an injury they'll never recover from. And then a percentage of those people become wiser, faster, smarter, you know, they go out in the world and do incredible things. And if you just cast upon your mind of like anyone who's done incredible things, like, I don't know, Nelson Mandela, right? Or like even Oprah, right? Of like, and they talk about how their trauma made them partially who they are. And so then psychologists are like, we should study this, right? Maybe we should study what goes right to figure out helping people to figure out what goes right and how to make things go right instead of just having— how to be a symptom-based way of looking at things, to just be like, oh, let's just get rid of your PTSD. And what we found was that depending on what you do when the hard thing happens, and if you use it for growth it actually is a huge catalyst for change, and it can just— it's a powerful factor in your life. But everything is about the choice you have in a circumstance where usually you didn't have choice. So that's a big, a big thing is a mindset shift. And, and, and as much as I love people talking about mental health out in the world, there is sometimes still a way of looking at things like trauma is— I always say it's an injury, not an illness. It's healable. You can grow.

Love that.

Yeah. And people will say things like, I have anxiety, like it's, it's a life sentence, right? It's like, there's treatment. Like, diagnosis is only step one, right? And, and, you know, we're not going to flatten the world around us. We, we have to like seek the treatment. And same with trauma. Like, and so a lot of the clients I've worked with, it's like you would never know the amount of trauma they went through, and they're doing incredible things in the world.

So You know, yeah, I'm always floored when I hear people's stories. We don't know the backstory. We really don't. We see the success, but we don't know what brought them there.

Yeah, absolutely. So yeah, so that's that, you know, for me, the, the powerful work I love to do is like working with people who have really hard things in their past but who are really, really committed to like using that for their own good and the good of others. And those are so clients that I work with.

I love it. I love what you're doing. I've told you that since I met you. I think what you're doing is amazing work for women and men. It sounds like you're working with men too now. But I want to back up to someone who is successful, has PTSD, maybe doesn't feel like they're healing. What advice do you have for them to start going on the right path?

Yeah, I mean, I really think, yes, it's interesting because when you have PTSD, often you're very high functioning in some areas. And then it's like you'll just be walking along and the floor will drop out and you will feel like, you know, what, what just happened, right? It's a very feeling of being fractured where you can function. It's not like a lot of different things where it's like, okay, this person's low functioning across the board. They will be super high functioning in certain areas. But then like, say for example, they're very professionally successful, but then they get really, really triggered in relationships because maybe their trauma is related to attachment, right? So, and that's where I see a lot of people, you know, because of our good founders, it's like, okay, I'm great in my company, but then we'll find areas where like The things they use to get a certain level of success, because they still operate in a survival mode, they will tear down their own success. They will self-sabotage to get back to what they think they deserve. And if they're comfortable in chaos, they'll make chaos. And so, you know, it's healing that. So it's— I look at it as like, look, it's, it's like you get superpowers from your trauma, but you have these pockets of kryptonite where like you will just be like Superman, right? Where it's like you can do all the things and then you just hit an area of kryptonite, you just fall right over, and it's really destabilizing. And frightening for them. But I do a lot of work with like helping them in their nervous system, helping them to understand their brain, you know. And you'd mentioned EMDR and all the acronyms that go with that. Like, that's a great— yes, hey, it's an incredible technique to process trauma that's trapped in the body and then that's trapped in their amygdala, which, you know, puts them in a fight or flight freeze state. And, and they're triggered into this other state. I say it's like, you know, you have trauma if you feel like sometimes you lose your free will. You know, you're walking along in the world, you see something, and then all of a sudden, you know, you interact with somebody and then you feel like a child, right? As opposed to the powerful woman that you are. And I'm like, that means that something got such a good—

that's a great explanation. That, that is super good.

Yeah. And that's a way of like, because it's so— again, trauma is an injury, not an illness, very healable, and also makes you just feel crazy pants, you know, because you're like, I don't—

I can't—

why am I responding this way? Why does this thing put me in bed for 2 days, but then I'm out here crushing it in other areas. So it's really tough. And, and again, because women tend to pathologize themselves, they tend to think they're the only ones. I mean, men do it too, but like women will say, it's my fault, what did I do wrong? And, and so it's like, no, no, no, this is your brain's defenses using old defenses for an old situation, and it's trying to protect you, it's trying to help you. That worked for you at one point, but we have to help your brain evolve and grow and heal so that it can use defenses that work for your current life.

100%. That is so true. And you mentioned EMDR. So I want to tell everybody, can you explain to people what that is and how you use it?

Yeah. So it's been around, gosh, now probably 40 years. But for when it first came out, the inventor, who was a woman, she was thought of as quite of a quack about it. Right. But then she was like, no, this is so powerful for processing trauma. So then she dove in and did an enormous amount of research to prove this is now what we call an evidence-based practice. So in, in any area of medicine and in psychology, we have things that are backed up by research, ones that are promising, but we don't have the research to prove them yet. And ones that are like, we got no research on this, you know? So any, any gains are anecdotal. So this is a very strong evidence. They use it in the Veterans Administration, the VA, they use it in the Department of Defense. It's like a well-proven technique. So basically how, what it does, and I'll try to like, well, I have to explain a little bit what happens with trauma first.

So yeah.

When something— well, our memory is split up in different ways. Our hippocampus would be like our file cabinet of memories, right? It's like our picture book, our yearbook, our thing of like, you know, this happened when I was 6 and this when I was 7 and 8. And it's like the story we tell of our lives. It's in order. It's like nice files by year, by date, by circumstance. And then we have our amygdala. So the amygdala is an older part of our brain. It's the fight, flight, freeze area. It's the part that's very instinctual. It's the part where the trauma lives. So when something traumatic happens, our memory puts that memory in our amygdala and keeps it there and doesn't put it in our hippocampus. So that's where when we have a trigger for something traumatic, like, so for example, you know, and our brains are evolved, think of it like a cave person, right? So we saw a bear one day, the bear chased us, right? And, and we escaped barely, you know, um, but that lives in our amygdala so that next time we see fur, that time of day, right? We're going to be hypervigilant. Um, yeah, smell any person we were with when it happened. The whole goal of it keeping it in our amygdala is to make it reactive, and so that it happens, our reaction is faster than our cognitive thought can say, oh, look, a bear, right? So it keeps us alive, but it also keeps us hypervigilant. So, you know, and, and normally how that happens is in your sleep when you dream, it'll process your memories, will go over to your hippocampus, but your brain's not going to release this trauma memory into your hippocampus in your filing cabinet until it knows you're safe. So what EMDR does is I use buzzers, but you can use eye movements, you can use auditory, but it basically uses bilateral movement between the areas of the brain. So it kind of moves the energy between the lobes of the brain the same way that like REM does, REM sleep, you know how your eyes go back and forth in REM.

Yeah.

So it'll use that in a safe setting to help you go into the memory when you're using the buzzers with someone who's safe, when your body and your nervous system are saying, I'm safe. I can let this go. And so we go through that memory in session and it moves over to the hippocampus. And you can see it in a brain scan, like when someone gets triggered, like what part lights up versus afterwards. It's like, yeah, this thing happened.

Amazing. That is amazing.

Yeah, it's super powerful because it really— we get stuck sometimes in talk therapy and we can't talk to our nervous system. So this really is one of the ways that you can bypass the bottleneck that is our talking and get to what the— what's actually going on in our brain.

Well, and what's interesting, I don't want to generalize, but most people have some sort of trauma that is holding them back. So it's almost like every single one of us needs EMDR.

Yeah. I mean, especially attachment trauma, right? And that's like challenging because one of the weird things about biology that I would say are like, I'm like, why are we designed this way? Like most of our attachment networks are developed before age 6, but we don't actually have conscious memories till after 3. It's called infantile amnesia. So whatever happens before 3, most people don't remember. So we develop most of our beliefs about who we are, our place in the world, our safety prior to us even having a memory of what happened. Wow.

That's crazy.

Yeah. So again, EMDR, you don't necessarily need the memory. You can just go into the feeling. You know, and that's where attachment-focused EMDR could go into, like, I feel unsafe, but I don't know why. And we can process that in your nervous system without even remembering, like, when I was 1, my parents forgot me in a store, and now I have, you know, abandonment issues. Like, you don't have to remember it. You can just process it by keeping your nervous system feeling safe.

Amazing.

It's so—

I love, I love talking about this stuff. This is such good stuff that you're doing. Well, and I know that so many women that I talk to are having trouble sleeping. I feel like I feel like when you talk to a woman— and I'm sorry, women, I'm not generalizing— but most women tell me that they're anxious or they're not sleeping. I feel like, I feel like those are two huge issues. Can we help them? Can we give them some pointers for anxiety and insomnia?

Oh boy. Yes. And that is like, understand— and you're right, though, you can generalize. That's a fair generalization. The research backs that up, that women do struggle with sleep a lot more than men. And there's a range of reasons. For that. And so then there's a range of ways to approach it because each woman has to look at why. So what I usually do when someone comes to me with sleep, especially if it's like, you know what you're saying, if there's anxiety with the sleep, I ask them like a series of questions and kind of explain to them why. I also love explaining to people, you know, the plants, how they have their little care and feeding instructions. Like, I love— like, we don't have a care and feeding instruction. We're just given a human body to care for.

Yeah.

We're trying to figure it out without actually understanding how we even manage it. And somehow that's okay, right? And then we, well, whatever we don't understand, we turn into shame. And, and that's why I love explaining that because they'll be like, why can't I sleep? And I'm like, okay, well, let's figure out there's a reason. And then if we know why, so, so I'll go over the, the, the usual suspects of why women struggle to sleep.

Okay. So, okay.

First of all, we're biologically designed not to sleep as deeply because we, you know, historically have had the role of the baby and the caregiving.

Yes.

So we're just kind of doomed at birth a bit.

Makes sense.

Yeah. And then on top of that, when we have kids, it gets worse. So if you have a baby, that's worse and it continues to be worse for the rest of your life. One would hope that this was like a little biological gift that got removed at menopause when they're like, okay, you're probably done. But no, because we still again usually care for babies in some capacity historically, right? Like over the human history, we would be caring for babies or other people. In the village or whatever. So we just keep that gift. And also, this is fun. Whenever you are pregnant or even if you don't carry your baby, when you start caring for a baby, the part of your brain that sees risk grows by 12%. So that's what I call like— I said, that's the reason for what we call like mommy snuff films where it's like your child trips on the, you know, on the playground and you're like, oh my God, they're going to fall on a stick and roll down a hill and then a beast is going to eat them. And like you see 30 horrible outcomes in 20 seconds where you're like, like, that's, that's why, that's that part of your brain, and it never goes back to normal after.

Oh, interesting.

Where were you when I had babies to tell me this?

It's so tough.

And, and again, it's like where women don't understand that they shame themselves, because a lot of new moms, they will see bad things happening to their baby in their mind. They'll be like, what if I kill my baby? What if I sit on my baby? What if I do all this? And they think, oh my God, I want to hurt my baby. But when they get— it's so sad. And they a lot of times don't share it because they're going to take my baby. I'm going to— I'm a bad mom. I'm a bad person. But they did brain scans on women who are having those thoughts. And what they found was it wasn't the part of the brain that plans action. It was the part that was doing risk analysis. So what it means is their brain is saying, I have to protect my baby from everything, including me. So I'm going to run through every possible bad thing I could do to my baby so that I won't do it. And like, they don't know it, so they feel terrible.

Makes so much sense. I remember walking down the stairs with my new babies and going so slow because I was so nervous.

Yeah. And I mean, historically speaking, anxious moms are more likely to keep their babies alive. And nature is more interested in us being alive than happy. We are not designed to be happy. We are designed to stay alive, which is why we have to work so hard. At peace and happiness. That practice, you know, so go back to the sleep. Like, again, you might in the middle of the night wake up running your risk analysis. That part of your brain, when you finally have silence, might do that. So that's also a part of it. And the anxiety that women tend to have, um, also, and this is something they very rarely talk about, is that during perimenopause, which, P.S., starts around 40 possibly earlier. Your hormones are a mess. I would say post-menopause is actually smoother sailing, and perimenopause is the roller coaster, and that can start as early as your late 30s. It's really, really a crime that we— like, so few OB-GYNs are trained in this. I was just reading like a study that said like 1 in 5 don't even hear about it in medical school. And those who do hear about it only get like half of a lecture on it. Yet they are literally the people that we go to to talk about hormones and they know nothing. And I've talked to OB-GYNs that don't know anything. Psychologists don't know anything, which is why, like, for me, as part of my work, it's been my mission to like learn. But I had to step outside of psychology completely and deep dive on hormones because I would see women come to me and they would be like, I'm not sleeping. I'm, I'm like having rage. I don't wanna have sex even though I love my partner. What the heck is going on? And I will say like, I can help you with the, you know, figuring out what's going on psychologically. You gotta go to your doctor and get your hormones tested. And half of the time, if not more, they had imbalances and that they, you know, well, there's reasons why some women can't or don't wanna do hormone replacement, but it is definitely highly preferable if you can. At least from a mental health perspective. I don't want to speak about something outside of my area, but from a mental health perspective, because women who don't have their hormones balanced, you know, again, rage, fighting with their partner, you know, mood swings, guilt, shame, and like, it's literally the middle of our lives. Women live much longer than men. We're having this go on right smack in the middle where we've got— now a lot of people have babies, you know, or they've got teenagers in the home even. They are right in the middle of their professional peak, right, when they really should be crushing it and getting to levels of leadership. And yet they're having hot flashes in the boardroom, having rage. And when I say rage, I don't just mean anger. I mean, like, if you've been through that, right, it's a level of just like, I will kill you all that women usually don't experience. But it causes sleep disturbances. And so low testosterone can cause middle of the night waking, you know, progesterone can impact it and estrogen. So I would say if a woman is after 38, 39, especially if her mother had early menopause, because menopause typically happens now. Menopause is a year without periods. That's what that word means. So typically 51, earlier for women who are not white, like it's earlier for Asian women and it's earlier for Black women, is earlier for Latino women.

So, oh, interesting.

Yeah. And the problem is, is most women suffer through their 40s, causing chaos throughout their lives, you know, or what's terrible, they'll put them on an SSRI, which hurts bone density, and they're not giving them the hormones that also protect their bone density. So then they can be set up for osteoporosis and— yeah, and limited mobility and health later. So again, it's really important that we understand. I always recommend get a full scan of your hormones. If you have been a decent sleeper and all of a sudden you're in your 40s and not sleeping, get your hormones checked. It is probably the thing that's causing it. So, you know, those are the things. Then from like a sleep perspective, don't scroll in your bed. Like, that's blue light. And when it's funny, we all know the thing. Like, we all know not to scroll, we all know to have dark, we all know to have a cold room, to, you know, and then we don't do it. So, but I would say like, you know, don't scroll for an hour before bed. Don't scroll news or things that are going to get you triggered in your bed. You're— again, our bodies still think like cave people. If you're looking at a war while laying in your bed, part of your body is going to be like, my God, there's a war in my room. It's going to be stressed out because it doesn't understand that it's just in your phone. So yeah, so all of that. I don't know if that— but at least if you're listening, super helpful. Yeah, they can run down that checklist that I give to my clients when they come in and say, I'm not sleeping. I'm like, okay, when is it you're waking? What is it you're thinking? Have you had your hormones checked? And I just run through that checklist. And then that's— then they'll know how to actually treat it appropriately. And because usually what they end up being given is sleep aids, but that, that has its own negative impact. So, you know, you want to treat the root causes.

Well, and we have to check in with ourselves too, because my husband and I realized that we had to stop watching a certain show before bed.

Oh yeah, that's true. Was it crime drama? Was it something that was getting you—

Oh my gosh, it's Yellowjackets. I don't know if you've seen it on Netflix, but we love it, but we cannot watch it before bed. And then last night, you know, you think reading is so good for you, but I don't think I can read my Kindle before bed. I think I have to have like a real book. Yes. Yeah.

All of that. Like, really? So, like, this is like the best treatments and the things for insomnia. Always, always, always what we say, your bed is for nothing other than sleep, sex, cuddling. That's it. You know, even I would say reading. You'd be better to have a reading chair, you know, because what can happen is you may have a cause of insomnia that then is resolved. So say it is hormone-based, but if your brain starts to associate bed with not sleeping, you don't want that, right?

So that's interesting.

Yeah. So if you wake up, if someone has really bad insomnia, what we always recommend, like part of the sleep hygiene and the treatment, um, is we say like, do not stay in bed awake more than 15 minutes. So if you wake up in the middle of the night, get up, go to your chair, read the most boring book in low lighting that you possibly can until you're sleepy, then go back to bed. If you're awake for more than 15 minutes, get up, go over, like, because unfortunately smartphones like really have increased, uh, sleep problems and they decrease sex, the amount of sex people have by a lot.

I believe it.

It's like, I want— Yeah, you're both sitting next to each other, sending each other reels back and forth and not having sex. I love it. Yeah, not good. Not good. No, we all do it, but it's like, you have to put— now we know more. We didn't know, you know, it made sense, but that we would just do this and we didn't have, we didn't have any kind of precautions or things around it. Now we know the impact, we have the research, and we could say it's fine to scroll your phone. Don't do it in bed right before bed, right? Yes.

Such good advice.

We love a good crime drama or an action. Don't do it before bed because your brain is like, I gotta be geared up, especially if that thing is happening in your room.

Yes, do not, do not. That is very good advice, avoiding the high crime shows. So I wanna talk about ADHD because it looks very different in women is what I'm learning. So can you tell everyone the signs of it? In a woman?

Yeah, so, oh my goodness. And that's a— again, this is like a specialty that I ended up getting into by just the fact of who I worked with. A lot of— yes, also have ADHD. A lot of founders in general have ADHD.

So cool. So interesting.

Yeah. And, and so the issue is though, and what has been the problem in society, is there's certain diagnoses that get put together with a gender. We always classically, for example, thought of narcissism as a male thing. We always think of your classic blowhard, you know, brag about himself narcissist male.

Yes.

There's just as many narcissistic females, but they look different. So now there's awareness, thank God, and starting to be, especially narcissistic mothers. Oh my gosh, that is probably the worst thing that you can be born into if you're a woman. So, um, but ADHD, most of those, because with little girls, they're not hyper and moving around. And so they weren't getting diagnosed. They were just thought of as like messy or not, you know, not paying attention, or they tended to get pathologized or not pathologized, but like judged as like it was if it was their personality. And so they didn't get diagnosed, which they could have been if they were ever sent for testing. By the way, it's not that the testing is skewed, it's that the observation of the adults to send them for testing was wrong. And now, and people are like, why is there so much ADHD in women? It's like, it's always been there. It just, and I, it breaks my heart when I see adult women who aren't diagnosed because they have all these shame messages. I'm lazy, I'm messy, I can't finish things, you know, I'm scattered. Like they have all this shame again, right? Women pathologizing themselves.

Yes.

Whatever is not understood, we turn into shame. So, you know, it's really talking to them about— so the signs that you're asking, the signs for women, and are you mean like an adult or a child?

Um, I mean, let's talk about an adult because I think women do not know when they have it.

No, they don't. So I'll ask different things. Now there's a few fun ones that I can give them. Um, and these are just kind of like anecdotal ones. If they're an adult, I'm like, so did you do cocaine in college? How'd that go for you? Like, you know, that's like such a funny one, but it's true where they're like, oh boy, I wrote my term paper. You know, they're like, everyone else is sweating and running around and I was so productive. I'm like, yeah, because that's a stimulant. You know, I'm like, how do you do with coffee? How do you like, you know what I mean? Like that kind of stuff. That's a funny one that a lot of people, I can't say that there's a research base, but I would say anecdotally it's a stimulant. And the way that ADHD brain responds to a stimulant is different than the way that like a neurotypical brain responds. So that's something I will ask. I will say, you know, how many projects do you have that you have started and not finished? You know, um, and, and also like, do you lose things? Like some of that, you know, uh, that one's a little bit less common in women. Um, oh, this is such a sad fact too. I just read a research study on this. So women with ADHD have a shorter lifespan than other women. I know, isn't that sad? Um, men with ADHD also have a shorter lifespan. But this is a very sad thing. If they're married to a non-ADHD partner, a male with ADHD will get his lifespan back. A woman won't. And that's in part, I think, because of the gender dynamics, right? Women, like a married man just lives longer. A married woman does not. Right. And so it's because women are like, you got to go to the doctor. Part of our risk analysis. I also say it's not just because we're better people. It's because we're also better long-term investors. And this man is our investment. You know, or this woman is our, like, this is our life partner. We don't wanna take care of them sick when they're old. So we're like, take vitamins, go to the doctor. Right? So a woman who is with a non-ADHD partner, if he is having that classic male role of not taking care of those things for her, you know, then I, I would be curious actually with the research on same-sex couples, cuz I suspect that like a lesbian partnership where one has ADHD, probably the one with ADHD probably lives longer because again, that's with you might care, and I don't know how to— so anyways, it just, you know, do you struggle to follow through? You know, do you feel like you start something, you can't finish it? All of those like classic symptoms. Are you, are you, um, really sensitive to rejection? Are you really sensitive to criticism? You know, do you struggle like when, when you feel like— because that's something, it's, um, called rejection sensitivity dysphoria. So that's a long word for basically saying people with ADHD tend to be more sensitive to criticism.

Um, I didn't know that.

Yeah, it's not in the DSM, but it's just something that we— which is our diagnostic manual, but it is something that has been noticed, you know, in the research. So, you know, you might be more sensitive to criticism. Um, and so it's just looking at those things, like, do you struggle with, like, keeping things clean? Do you describe yourself as someone who's, like, lazy? Do you scroll for way longer than other people or have a hard time staying off of your phone? So a lot of these types of things. Also genetics. Do you have a parent that you think maybe didn't have— has undiagnosed ADHD? So these are the things to look at in women that I will ask them. If I hear a lot of I'm lazy, I can't follow through, really high functioning maybe in their work where it's a stable environment and they have set expectations. But again, the ADHD brain, the non-ADHD brain is motivated by consequences. If I do this, I'll be rewarded. If I don't do this, I'll be punished. The ADHD brain is motivated by interest and urgency. And so if they're not interested and it's not immediately due, they're going to be hard pressed to get motivated to do the thing. Oh, another one I ask, are you the person who puts off something until the night before and then crushes it? And then you're like, stress and all that. So a lot of times they could do compensatory strategies is what we call it. Like they could do that when they're in college and just live without sleep, but by the time they get in their forties, they're like, I can't do this. I'm tired. Like I, you know, and so we work on strategies of how to work with their brain to be able to accomplish what they want.

So, so to the ADHD woman listening, what is your advice to her to start to head in a better direction with her ADHD?

I mean, I would definitely say if you suspect it but don't know, get evaluated by a good evaluator. You know, you're probably going to need to go in someone's office and actually sit down and do the tests. There's a lot of not very effective evaluations out there, right, where someone will just ask you questions. But anxiety can look like ADHD. PTSD can look like ADHD. You don't want to be misdiagnosed and then medicated if it's not the actual—

Yeah.

So get a really good evaluation, usually going in-office. And so that, you know, and then once you know, it's figuring out what you want to do with it. And so some women do want to do medication. There's better medications than there is in the past. Some women who are diagnosed when they're young, they're like, I don't want to do Ritalin. It was horrible. I don't want to do Adderall. It's very buzzy. There's a lot of new medications that aren't buzzy like that. Vyvanse is better. There's even non-stimulant medications. There's different treatments that are now coming out. Like neurofeedback is something that's used. Again, it's still kind of research pending to see how effective it is for ADHD, but there's all these other treatments you can do. There's supplements, there's all kinds of stuff. So what I would say is get a good diagnosis, look at it from that part. What can I do either with supplements or medication? Get educated, get your partner on board, because there is an enormous amount of marital stress that happens when you have an undiagnosed ADHD, and a lot of it is just knowing. So if your partner knows, then they can be a part of it because for them, they're probably just frustrated, right? They're like, how come sometimes she pays so much attention to me and other times she ignores me? How come she's so reactive? But usually the people who end up in a relationship with someone— I mean, an ADHD partner is incredible if You both know what's going on. They tend to be super loyal. When they focus on their partner, like, they are hardcore in for life. They adore their partners. They're very exciting and fun usually. They're really up for new things. Like, they are great. And they tend to attract partners who are a lot more like, you know, take it like step by step by step because they're looking for the excitement and then they're looking for like stability in the two get-togethers and they make each other's lives better. So I would say you definitely want your partner to be educated for sure so that they know, and then they can be like, oh, she's not just reactive, or she's not ignoring me. Or you can work together to come up with strategies in your household. Also, by the way, having kids, oh my gosh, if you're going to enter something into your life that makes ADHD so much harder, Children. It's like having, yeah, little gremlins that run around your house and move your things, right? So it's like you, if you've built all these strategies around like, okay, I don't lose my keys cuz they're always in my bowl, right? Until your toddler grabs it out, putting it up their nose and sticking it in their purse. Like, you know what I mean? A little tiny purse. Like, it's so maddening. A lot of my clients don't realize they have it until they have kids and it just, it's the breaking point of like, all the things I used to do don't work anymore, you know. And so, yeah, so it's also, you have to get really educated. I would say a lot of education, trial and error on what works. It's so— that's such tiny things you can do to make all the difference. Like, if you're saying something to your partner with ADHD, like, don't say it across the room while they're looking at something else. They're not going to hear you, and then you're going to get frustrated. Go over, touch their arm, make eye contact, and say this, this, this, right? Have a deadline for what the thing is if you need them to do something because of the urgency, you know, and you want them— like, that's the way to do it. Or, or come up with— you can come up with the funnest hacks for yourself. You can gamify stuff, you know, you could do all kinds of things where it's like, I have to do this, you know, before the timer goes off, you know what I mean? Like, and then that creates the urgency. I have to fold my laundry, but I'm gonna do it in 10, you know, minutes instead of— I'm gonna beat my own thing. That's how you love it, you make it fun for your brain and you make it work.

I love that you're figuring everybody out. I love listening to this. It's like somebody had said to me once that I'm like a private investigator. It was some school situation and I was like, no, this is like therapy. I feel like we're like investigators.

Yes, therapists are the most— I used to read mystery novels, but then I would try to figure out the author's tells. To figure out if I read the same person more than once.

Because how different is that from therapy?

You listen to somebody talking and you learn how they tell their own story.

Yes, yes, yes. 100%.

Yes.

Yes. Well, and I know that our time is running out, and I also know that you work with very successful people. So I want to ask you before I let you go. So to the women who want to be at their peak performance, every day. Tell us what advice you have for them, because I know this is your specialty.

So this is the thing that I tell them, because a lot of women— and this is where the society is not necessarily built for women— they'll say if they come to somebody and they're like, this is really hard, I'm really tired, usually the advice they get is, well, why are you doing that? You don't need to be CEO. You could just take a break. And then they're like, wait, wait, no, but I want to.

I just know how to do it.

So I say, look, You're a race car. You are a race car. You enjoy— and that's same, right, for, again, the ADHD brain. You want excitement, novelty. Same for the person who is like high functioning. They're a race car. And what do we know about race cars? They have to have a pit crew. They got to have their bolts tightened, their tires pumped. They have to have really, really dialed-in self-care. They usually need a team that's like working on, you know, like a psychologist who knows how to work with them, who's not going to, again, tell them just to quit their job because it's hard, you know, but to understand they want to do hard. Just because it's hard doesn't mean you should stop, you know, you just need help to do it. So, you know, I think a lot of women are taught like if it's hard you shouldn't do that. Like what? Like that's never been really an option for us anyway as women. Like life is going to be hard, we just need skills on how to do it so we don't, you know, die early and get sick, which is what tends to happen to us. So, you know, I see you're a race car, you know, and, and the answer isn't going to be toodling down the back lane, but you have to know that you can't have these bolts on your car rattling, cuz that's gonna cause a crash. And so get early about listening to what your nervous system needs. Who's your support team? What are these unprocessed traumas? Like you said, like we're all walking around with these unprocessed traumas. Let's process those. So those aren't having you moments where you lose your free will and don't feel like you, you know, in a room. And, and then let's look at that way. Let's go through your whole systems. Let's do a systems check and come up with a plan for you. So if we, uh, for a woman who wants to be high functioning, first of all, realize your whole life is integrated, right? Your home life, your personal life, your work life, it's all integrated. And you have to treat you like a whole person and see what it is that there are these things that need to be tightened, that need to be healed, that need to be worked on so that you can continue to have the excitement and the joy and like the meaning of doing this racetrack, but without your wheels falling off and you crashing into the stands. You know, and a lot of times for women what that looks like is they get ill. They get very, very ill in their late 40s. And women are very high functioning until their bodies say to them, you have got to stop. Because our brains can lie to us, but our bodies are always honest. And we are a lot of times as women taught to ignore what our body tells us. So I try to get people before that, right? Then you can, and you can even, you can even heal it to the point where their body's will heal themselves. But if we get it too— if it's too broken down and too damaged, like, you know, in older age, it's a lot harder. So the earlier you start to work on these things, the better.

So, I mean, the way that you care for your people just oozes out of you. And I mean, they're so lucky to have you. I, I can't even tell you how much I love what you're doing, and I feel really honored that I got to talk to you today.

Yeah. Thank you for having me. I really— I love, I love, love, love. Like I said, like, podcasts are where a lot of my clients get information. It's where women get the information they need. So I love it.

Good to know. Well, I'm glad I'm doing it then, because I'm enjoying it and I get to talk to fabulous people like you. So I know our time is up and I could talk to you all day. I've loved talking to you and I just want to thank you so much.

Yeah, thank you for having me. This is so fun.

This is Rebecca Green, and I want to remind everyone to spend every day laughing, learning, and loving. Thank you for tuning in to the Winey Palooza podcast. If you like what you heard, please be sure to subscribe so you never miss an episode. While you are there, leave a review. I love to hear your feedback. Thank you so much for listening. Until next time.

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