Summary
Overview
Dr. Sasha Hamdani, a board-certified psychiatrist specializing in ADHD, joins the show to discuss her expertise, personal journey with ADHD, and the nuances of diagnosis and treatment. She shares her late diagnosis story, explores how ADHD manifests differently in men and women, discusses rejection sensitive dysphoria, and offers insights into managing ADHD as both a patient and parent. The conversation covers everything from diagnostic challenges to practical coping strategies, with Sasha drawing on both her clinical expertise and lived experience.
Gender Differences in ADHD Presentation
Sasha explores why boys are typically diagnosed between ages 5-7 while women average 35 years old for diagnosis. She explains that boys present with more hyperactive symptoms that disrupt classrooms, while girls are often inattentive daydreamers who get overlooked. Hormonal factors, particularly estrogen drops affecting dopamine, and societal expectations for girls to mask symptoms contribute to delayed diagnosis in women.
- Average age of diagnosis is 5-7 for boys versus 35 for women
- Boys typically present with hyperactive symptoms while girls are inattentive daydreamers
- Hormonal shifts during periods cause dopamine drops, worsening ADHD symptoms by 30%
- PMDD (severe PMS) is significantly more common in ADHD population
- Societal expectations for females to mask behavior leads to undiagnosed high-achieving women
" There is a societal difference in expectations for females. So females are expected to kind of toe the line and mask. So what is acceptable for a boy to be doing in class is very unacceptable before a girl. So the girl now learns to hide that behavior. "
Sasha's Personal ADHD Journey and Misdiagnosis
Sasha recounts being diagnosed with ADHD at age nine after causing an insurrection in her fourth-grade classroom, but her parents didn't tell her the diagnosis due to stigma at the time. She was given what she thought was a vitamin, which helped tremendously through school. When she started medical school at 18, everything fell apart without her parents' support systems, leading to academic struggles and eventually learning the truth about her diagnosis.
- Diagnosed with ADHD at nine after substitute teacher incident, but parents called it a vitamin due to stigma
- Started medical school at 18 in a combined six-year program at University of Missouri Kansas City
- Failed neuroanatomy test by scoring 32% after not flipping over the exam page
- Parents finally revealed ADHD diagnosis when she struggled in college without medication
- Father helped her research ADHD in the library, learning together about her brain
" I stayed up, really tried to focus. And I was like, I know this brain inside out. It was really interesting to me and it was visual. And I was like, I got this. This is so easy. Go into the test. I'm like, this is amazing i'm getting all of them this is perfect i'm the first one out of that test and then they had this thing where they would like post your grades with your id number like the next day i'm like showing up i'm still looking for my id number and you're looking at all of these grades and you're like 90 80 whatever and i was like there is some loser who got a 32 and i was like well that's me "
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