Dr. Ethan Levine 

Hi, this is Dr. Ethan Levine, and I’d like to welcome you to our latest edition of the Mental Wealth Podcast. We are delighted to have as a guest Dr. Jenny Byrne, who I will please ask to introduce yourself to the audience. 

Dr. Jennie Byrne 

Yeah, sure. My name is Dr. Jenny Byrne. I am trained as a psychiatrist and a neuroscientist, and my work has circled around brain and behavior in many different ways. And I’m an author three times, and my most recent book is called ADHD in Professionals, which I think is what we’re going to be chatting quite a bit about today. 

Dr. Ethan Levine 

Dr. Byrne, I’m really curious about what got you interested in ADHD. 

Dr. Jennie Byrne 

So way back in my university days, I took this class in brain and behavior when I was a junior, and I just fell in love with it. And I started getting into animal models of things like depression, anxiety. I did research on that as an undergrad. And I realized that there was no animal model for attention or ADHD. And so I actually took a grad class and wrote a paper on, like, what if we could have a model? And then later on went to do an MD-PhD, and I did my PhD where I created a model of attention. It was in rats, so it was a basic science model, and I did electrophysiology. So I’ve been interested in attention for a long time, but honestly, in my training as a psychiatrist, you know, I got a 45-minute lecture once on ADHD in kids, and that was about it. So it wasn’t until I left academics and moved down to North Carolina, where I live now. I opened a practice. This was, you know, gosh, 20 years ago now. And it’s down the street from the University of North Carolina. And at the time, they weren’t treating ADHD. So they started sending all these people to me, these students and professors and doctors and lawyers. And I quickly realized I didn’t really know very much about actually how to treat ADHD. So I basically self-educated. And I went to conferences, I connected with some great experts like Dr. Rostain at Penn, which is my alma mater, and started seeing a ton of ADHD. And then once people knew I was treating ADHD, they started sending me more. And so it kind of became a specialty area of mine. And I’ve always been interested in ADHD over the years. And more recently, I started a new non-traditional practice. And once again, I was seeing a lot of ADHD, and it was very surprising to me that 20 years ago, since I first had a practice till now, the stigma level around ADHD and the misinformation was actually still very, very high. And I thought for professionals with ADHD, the stigma was actually even greater. And that was very discouraging to me, and that’s how I got reinvigorated on sharing good, high-quality information about adult ADHD. 

Dr. Ethan Levine 

In your book, you spend some time talking about the words ADHD, and I love your perspective. Can you expand on that a little bit? 

Dr. Jennie Byrne 

Sure. So I have a chapter in the book called ADHD is a Terrible Name, which is one of the first things I tell my patients and clients that I work with. It stands for attention deficit hyperactivity disorder. And the first part, attention deficit is a terrible name. because people with an ADHD brain can pay attention. And in fact, if they’re passionate about something or really engaged with something, sometimes they hyper-focus and they pay more attention than a non-ADHD person. So it’s not that they can’t pay attention, it’s that they have trouble modulating their attention the way they want to. So that’s the first part. The second part is hyperactivity. And I think this is a terrible name because first of all, not everybody with ADHD has hyperactive impulsive features. So there’s actually a type of ADHD called inattentive type where you don’t have those features. So first of all, not everybody has them. And then second of all, if you do have hyperactive impulsive features, when you are an adult, typically it doesn’t look like hyperactivity. It is more a, sensation of restlessness internally that you have learned how to kind of mask and not, not actually get up and run around the room like a little kid might if they were hyperactive. So that’s a terrible name. And then finally, disorder, I think is a terrible name because we think that 5 to 10% of the adult population has this kind of brain. It’s extremely common. It’s highly genetic. and probably has real advantages in certain environments. So if we think about humans as a population, right, like all humans are species, having different types of brains, having variance is healthy. Because in the population, you want certain brains to be good at one thing and certain brains to be good at another thing. So I know there’s a debate out there about whether to focus on strengths versus disability, and there’s like a whole history behind that, but I choose to lean more into the strength-based approach when I’m thinking about ADHD. So I like to think about it as a variant, and I like the word neurodiversity because I do think our brains are diverse, and there’s probably a really good reason for that. 

Dr. Ethan Levine 

Is that part of the reason why you use examples of real people in your book? 

Dr. Jennie Byrne 

Yeah, when I was writing this book, you know, I knew that there was scientific information out there, but there was so much misinformation. And so I thought that by choosing to focus on narrative storytelling from all the people I’ve worked with over the years and over 40 people I interviewed for the book, all different kinds of professionals with ADHD, I thought the narrative style would really help resonate with some people in a way that maybe facts and figures doesn’t always resonate. And so I chose to make it a little more narrative and hopefully people reading it can kind of see themselves or a loved one in the stories as opposed to just the scientific academic lens. So that was intentional. I can geek out and get really nerdy on the science, but I chose to make it a little more narrative for the book. 

Dr. Ethan Levine 

My assumption is that people come to you self-diagnosed to some extent. How do you work with someone who comes and says, I think I have ADHD or ADD? What do you do? 

Dr. Jennie Byrne 

I love when people come to me and say, hey, I think something’s gone on. Can you help me figure this out? A lot of people suffer so much stigma and shame and fear that they don’t even reach out. So I’m always happy when someone reaches out. Normally, What I like to do is I go through a pretty thorough assessment. And one of the hard things about ADHD is like, not everybody assesses it the same way. And the way I do it is designed around scientific accuracy, but also speed and ease to completion. Because one of the things about ADHD, it’s so hard to get all these tests done and all these appointments and, you know, it just makes you give up. So I do three things. I do a clinical interview. which is what most people do, talk about, you know, your history, what’s going on now. But then I also layer in a computer test of attention, which is very specific, looking for ADHD brain features. And I also do a executive function rating scale that is age and gender normed. Because again, people coming to me are often very high achieving, high functioning people. I mean, on the surface, people look at them and think everything’s great. And so again, that idea of a disorder, they’re dysfunctional in some way. Well, actually, they’re often doing pretty well on paper. It’s just that they’re working so hard to keep up or maybe, you know, their home life or their family life is suffering because they’re putting all their effort into work. So that’s how I do it. I also rule out medical things, medical causes of cognitive issues. I also look at coexisting. things that could be causing the change. So I look at depression, anxiety, substance use, other differences like autism. Sleep is a big one. You know, I’ve had a couple people come to me saying, Oh my gosh, I have ADHD. I’m sure I have it. I saw it on TikTok. And then lo and behold, we assess them and they don’t have ADHD. In fact, their sleep is just highly disrupted. And I had one young woman who was, she was great. She thought she had ADHD. We did the assessment, it was negative. And then we got into this conversation about it. I was like, walk me through your day in detail. And she’s like, oh, I’ve really cut back on my social media use. I was like, okay, that’s good. She said, yeah, I’m only scrolling 5 hours a day. And I said, wait a minute. And she’s like, yeah, I used to be online for like 14 to 16 hours a day, if you can even imagine. And so for her, it ended up really just being a matter of her sleep habits and her screen use. And then her cognitive symptoms improved. So sometimes it may look like ADHD, but it’s actually something different. 

Dr. Ethan Levine 

And why use a computerized assessment? 

Dr. Jennie Byrne 

Yeah, this is kind of debatable. So I know not everybody uses a computer test. One of the things I always say a little tongue in cheek is, you know, in psychiatry, we have a little bit of science and a lot of art. And so anytime there’s some science I can use, I’m very happy to use the science. There’s different tests out there. They’re all variations of something called a continuous performance test. The one that I use right now is called QVCheck. It’s designed in Europe. It’s got a ton of literature. It’s been around for decades. I’ve used it for 15 years myself. And what it does, it’s really cool. It lets me look at how somebody’s brain is actually processing stimuli. So do you have a slow reaction time? Do you have a variable reaction time? Are you making certain types of errors? What’s the pattern of movement? And so I can really correlate what’s happening in their brain with what their experience is of their symptoms. And the other reason I really like the computer test is because like a blood pressure monitor, if I treat the ADHD with medicine and then I take the test again, I can see it improve. So it’s kind of like blood pressure, right? Like if you’re a primary care doc, I’m not going to give you a blood pressure med and then just have you come in and say, oh, how’s it going? No, I’m going to check your blood pressure. Have a test to check blood. Why wouldn’t I check your blood pressure? So for me, it’s a little bit of a no-brainer. If I have a good computer test and I’m treating this with a medicine, why not check it and see how the medicine’s working, right? Sometimes the patient will be like, well, I don’t know if the medicine’s working or not, or I don’t know if it’s at the right dose. And this gives us a more scientific tool to actually see what the medicines are doing as well as what their brain looks like at baseline. 

Dr. Ethan Levine 

Catalog all that. Are you doing formal or informal research as part of that? 

Dr. Jennie Byrne 

With the patients that come in for assessment? We do the clinical interview, the executive function, and then the computer test, and then we put it all together. Part of the executive functioning scale is that somebody who knows you well also does the scale. So some of the most interesting things I find are that the discrepancies between what you feel about yourself and somebody who knows you well sees, and typically they don’t match. So typically there’ll be something that maybe the patient is really struggling with, but other people don’t notice because they’re so good at coping and masking or vice versa, something that the patient thinks they’re fine with and then their spouse says, whoa, this is a problem. So an example of that would be emotional dysregulation. Sometimes the emotional dysregulation is what’s really hard on the spouse or the family. And maybe the patient is not distressed by it at all. Like they’re like, oh, well, you know, I kind of get mad, but then I kind of calm down. It’s not a big deal. So it’s, I guess the research part would be like taking all the pieces of the puzzle and then looking at the individual person and seeing how the puzzle fits together for them. I don’t typically put them in research trials or anything formal like that, but I do inform my clinical work with my neuroscience background. I think I’m definitely, I lean, my style of practice definitely leans into brain function. 

Dr. Ethan Levine 

You focus a lot in your book on professionals. How does this show up in professionals? What are some of the challenges? 

Dr. Jennie Byrne 

What’s hard in professionals is these are people who, on paper, are very successful, right? Like CEOs of companies, doctors, lawyers, entrepreneurs, professors, and sometimes they felt like something was off and they’ve gone to a trusted primary care or therapist who’s well-meaning, but they’re told, oh, you’re too high functioning to have ADHD. And so there’s kind of this myth out there, which I’m hoping to dispel that just because You know, you have a very big job or you’re very successful or you’re very smart that you can’t be struggling quite a bit with an ADHD brain for the environment you’re in. So some of the little flags I hear are a history of like, if only. So if only, if only I could have gotten to meetings on time, if only I could get that wash done and put away, if only I could calm down quicker, if only, if only, if only. I hear that a lot. I also see a lot of misdiagnosis. So it’ll often show up as like, oh, I was told I have bipolar disorder. You know, I hear ultra rapid cycling bipolar disorder. I have bipolar disorder 10 times a day. And I’m like, well, that’s probably not bipolar disorder. So a lot of people who have just been misdiagnosed are like, they’re just not getting anywhere with the medications. But I’ll tell you, the most common thing these days I see is that people have kids. And their kids have been assessed for ADHD. And as a parent, they’re going through this assessment and they’re like, wait a minute, that sounds like me. That’s exactly how I was as a kid. Or wait a minute, that sounds like me. And it, because it is so genetic, I mean, it’s very common that people realize they have ADHD only after a child has gone through the diagnostic process. So that’s actually like a very common reason I’m seeing people these days. 

Dr. Ethan Levine 

And how do you balance the behavioral approaches versus medication? I hear a lot of college students, they’re going for Adderall. That’s what they want. 

Dr. Jennie Byrne 

Yeah, there’s a lot of buzz and stuff in the media about ADHD medications, but the reason for that is the most commonly used medications are stimulants, and those are controlled substances, meaning that the DEA monitors and controls these medicines. So it’s got this whole strange history of kind of policing and substance use. And anyway, so there’s a lot of misinformation. My feeling about medicine is that it is one of the tools in the toolbox. Not everybody needs to take medication for their ADHD brain. If you can shape your environment to fit your brain, great. Maybe you don’t need medicine. So a good example I give is physicians that I see with ADHD, a lot of them work in the operating room. And when they’re in a high adrenaline, setting where they need to be very sensitive and reactive and sharp, quick decisions, creative, they do great. I mean, they don’t need medication at all. Their ADHD brain is working great. But sometimes they have to go do e-mail or they get promoted and they have to do paperwork and then they just completely fall apart. So the medication is really there like as a tool. And what I want people to know is, first of all, Yes, stimulants are probably the most commonly used medicine for ADHD, but they’re not the only one. So there are good non-stimulant treatments as well. And also, just because you take medicine at one point in your life doesn’t mean you need to take it forever the same way. Maybe there’s times in life you don’t need it. Maybe things are gone great and you fit your environment to your brain. And then maybe life throws a whole bunch of stuff at you and you’re completely underwater and you need medication for a period of time. So It’s not a one-size-fits-all. It’s not a one size fits the whole lifespan. And it’s not the same for every environment. But having said that, medication does help a lot of people. On the other side, the behavioral part though, we do know that CBT for ADHD, so cognitive behavior therapy for ADHD in studies has been shown to be very effective, especially when combined with medicine. So the only tricky part with that is the CBT for ADHD is actually a little different than traditional CBT. The therapist or the practitioner who does CBT for ADHD needs to understand the ADHD brain and how things may be different. So for example, in ADHD, we’re kind of learning more about this idea of rejection sensitivity dysphoria, and it’s a different construct than other sorts of rejection in psychotherapy. So in psychotherapy, You know, people with personality disorders might be very sensitive to rejection, or you may have cognitive distortions about rejection. But in ADHD, it actually seems like there’s something about the way people with ADHD are either their brain works or the way they’ve been criticized over the years, where they have an exquisite sensitivity to rejection, which is a little different than in other people. So that’s like one example. The other classic one is like cognitive behavior therapy for executive functioning, time management skills, et cetera, can be very different for an ADHD brain than for a non-ADHD brain. So for example, visual stimuli are very powerful for ADHD brains. So sometimes it is actually helpful for them to have a somewhat cluttered environment if the clutter is what they need to pay attention to. So in other words, advice to like keep piles of papers around in a certain way may actually be more helpful to an ADHD person instead of putting it away in the closet. Because for an ADHD brain, if you put it away, it’s gone. They forget about it. So there’s like nuances to how you do CBT. It’s the same idea, but you need to understand the ADHD brain. You may accidentally send the person in the wrong direction. 

Dr. Ethan Levine 

You’ve managed people. in your career. What challenges does this present for managing somebody? 

Dr. Jennie Byrne 

So in my experience, most leaders and managers and HR people want to do the right thing. I think the vast majority of them want to do the right thing, but they don’t know what to do and they’re scared to do the wrong thing, so they just don’t do anything. But the reality is, if you’re a leader manager, odds are pretty darn good that you have neurodivergent people on your team, even if you don’t know it. So ADHD, if it’s 10 percent of the population, you got 10 people on your team. Statistically speaking, probably one of them has ADHD. So there’s some things that can be done without explicitly asking people to self-disclose if they have ADHD. So one of the things, and Ethan, I know you and I talked about this a lot, creating psychologically safe spaces for people to share like what works for them and what doesn’t. So an example would be everybody on the team has a little all about me page where I work back. you know, during these hours, 9 to 12. I, you know, communication works best for me if you send me frequent short messages. I don’t, I get distracted, so I like to turn off my alerts from 9 till noon and kind of like making that, that everybody does it. And that’s one way you can kind of open the door. And then there’s some very simple things that you can do that benefit people without ADHD too, like for example, normalizing movement. So like we’re sitting here on video sitting, right? which is pretty typical these days, virtual work, you’re sitting around, it’s not great for our bodies to just sit around. So normalizing with your team, hey, you know, we’re going to do a video meeting. If you want to come on, say hi, wave to me, go off camera, walk around. that’s totally cool. I may do that sometimes too. Or if you are in person, normalizing movement. So, hey, we’re in the conference room. Feel free, you guys, to stand up if you want, you know, stretch your legs. You don’t have to sit here the whole time. Or even a fidget, you know. If you guys want to fidget with something, I know you’re paying attention to me, and like, that’s totally fine. I’ve even seen meetings where people knit. because it helps them pay attention. So creating spaces for movement is one thing that’s really helpful for everybody, but especially for somebody with ADHD, especially with that like hyperactivity feature. And then finally, I would say like, if you’re managing somebody who may have ADHD, you know, just making sure that you’re doing frequent check-ins with them. And it doesn’t have to be long. It can literally be like a five-minute huddle, or it can be a chat. but just kind of proactively doing frequent short check-ins like, hey, here’s the first three steps. Got it? Good. Okay. You know, next thing. Okay, you ready for the next three? And it may feel like micromanaging, but sometimes it’s actually quite helpful. So instead of doing long one-to-ones or long meetings with the whole group, you know, think about ways that you can communicate in shorter, more frequent bursts and maybe setting expectations around responding to emails and DMs, like, hey, you don’t have to respond immediately. I want you to turn off your alerts every day when you need to do, you know, difficult things. So all of these little things probably benefit everybody in the workplace. And so you can do that in a way that doesn’t single somebody out or force them to come and disclose their status to you. 

Dr. Ethan Levine 

Do you see differences in gender, both in terms of how they respond to stuff and the frequency? 

Dr. Jennie Byrne 

So I would say in my research on the difference between, and I’ll just say men and women for the ease of conversation, there’s all sorts of gender identifications, but what I see is a pretty strong interaction between our culture for traditional gender roles and what ADHD can look like in professionals. So for example, girls are typically rewarded for being rule followers, right? Be a good girl, sit in your desk, don’t make a fuss, don’t talk, et cetera. So if they’re going to get in trouble for ADHD, it’s typically for talking too much, but they often learn how to control the physical restlessness, whereas a boy is running around and, you know, very physically active and people might not really have such a problem with that. So he doesn’t get in trouble until he’s really disruptive, like to the rest of the class. And then as life goes on, you know, women are still typically expected to be in caregiving roles. So at home, typically they’re still expected to do more than half of the housework. They’re expected to typically take care of children, maybe older parents, taking care of people in the community, whereas men are typically not expected to do that. So if you’re a woman professional with ADHD, you know, imagine that you go to work all day and you’re putting all your effort into managing your ADHD at work, and then you come home and you’re supposed to cook and clean and take care of your ADHD kids and the entire house. Like, I mean, it’s just a recipe for disaster. Whereas if you’re a man with ADHD who’s a professional, this is not always the case. I’m overgeneralizing. I find that at work, they have secretaries, they have assistants, they have people that help them, chief of staff, right? They have paralegals, medical assistants, they tend to have more support at work. And then when they come home, they will often marry somebody who does not have ADHD, who then will also kind of be the caregiver of them at home. So I have a lot of men I work with in ADHD who are in their, you know, 50s or 60s with this kind of traditional setup. And they had no idea they had ADHD, basically, because other people just ran around behind them all day long, being their executive functioning for them. So I think it’s a lot of the cultural expectations, but then you also have the layer of like our physiology and hormones. And so we do know that female hormone fluctuations, especially estrogen, impact cognition. And low estrogen states in particular, can be really hard on ADHD women. So a lot of women now are presenting for care in perimenopause when their estrogen levels have started to decline and they’re like, whoa, I used to be okay, I could cope, but now I just, I don’t feel like I can cope anymore. So I think it’s complicated. It’s both biology, but there’s a lot of cultural stuff in there too. 

Dr. Ethan Levine 

Does it become particularly acute for women who are in executive type roles? 

Dr. Jennie Byrne 

It can be. I mean, the common thing, I have a woman I just met a couple months ago who is a lawyer, and she’s got a very big power job. She’s a litigator, so she’s chosen a great part of the law for someone with ADHD because her brain is really good in the courtroom. But she told me, she’s like, I’ve had my electricity turned off at home because I forget to pay the bill. So she can go and litigate a high-level court case, but she’ll have her electricity turned off because she’s forgotten to pay the bill. So, I mean, pretty dramatic. And again, I think it’s just more cultural. The female executives really struggle because they don’t often have the same support system in place. Like, you know, full disclosure, I do not have ADHD, but I’ve been a female professional for many years. And people always say, Oh, how do you do everything? How do you do everything? I say, I don’t. I don’t. I hire someone at my house to cook and clean. I don’t do it. And you wouldn’t believe the horror and shock and awe when I tell people that I don’t cook. I still get this reaction today. I’m like, no, literally, my children do not allow me to go into my kitchen because bad things will happen. And people are really shocked by that, even today, you know, even at the age I’m at now. I just think the cultural construct is still there. We’re definitely like come a long way, but women, they’re still under a lot of pressure. 

Dr. Ethan Levine 

What kind of advice would you give people who start to suspect they’re neurodivergent or their partner or somebody in their family? What kind of advice would you give them? 

Dr. Jennie Byrne 

I believe it’s really important to know if you have an ADHD brain, because even if you never take medicine, you never do therapy, just understanding yourself and your brain, I always think is extremely valuable. And if nothing else, it will help others around you. So even if you don’t want to do it for yourself, you know, if you do it for the people you work with, the people at home, your kids, Like, you’ll be a better parent. You know what I mean? Just understanding yourself is really important. So I recommend that you get good information, first of all. So, whether that’s my book or other resources I have on my website, free ADHD resource list, if you want that. Read some good information. Over half the information on TikTok is wrong. Don’t rely on, I mean, I know you guys are gonna put some good stuff on TikTok, but In general, like go to some reputable places if you want to educate yourself. And then I recommend getting assessed and getting assessed by somebody who knows what they’re doing. And that’s probably not your PCP. I mean, some PCPs really understand ADHD, but it’s pretty rare. So I normally recommend that you start with either a coach who specializes in ADHD, a therapist who specializes or a psychiatrist who specializes or another kind of doctors. There’s some like pediatricians and there are some non-psychiatry physicians that specialize in ADHD. But I do recommend you get assessed because if nothing else, knowing how your brain works is really helpful. And if for some reason you can’t get yourself assessed, you really don’t want to do it, got you, I hear you, at least read good information. so that you’re hearing from true experts like what it means. 

Dr. Ethan Levine 

Yeah, it sounds like part of what you’re saying also is there’s still that stigma out there, and particularly for successful professionals. 

Dr. Jennie Byrne 

Yeah, one of the most common quotes I heard from people I see also from the people I interviewed from the book was, you’re too high functioning to have ADHD. People have been told that over and over and over again. So There is a lot of stigma for professionals. It’s very scary. People don’t want others to know. They’re worried they could lose their job. They’re worried people will not respect them anymore. And hopefully if you work in a place that’s psychologically safe, it’s okay to disclose. But the reality is there’s some environments where it is still kind of a dangerous thing to disclose and that may not be the best thing for you. So the stigma and the fear, I totally empathize, but At the same time, I really recommend that people get answers for themselves, even if you choose not to disclose it. 

Mukund 

Thank you, Dr. Byrne. In a professional setting, how do I identify if one of my team members is on is spectrum the right word to use, or what do I call it? 

Dr. Jennie Byrne 

The word neurodiverse, which kind of captures things like ADHD or autism spectrum. It’s kind of an umbrella term. I think some of the things that you might notice about somebody who has ADHD, especially if it’s not being treated actively with medicine, you might notice that restlessness. So the physical part of it, which is moving around, fidgeting, like it’s just torture for them to sit still in their desk, right? Like it’s so hard. You might notice impulsivity. So a real common thing in the workplace is they’re speaking before they’re thinking, they’re not catching themselves before things come out of their mouth. Even if they regret it later, they just kind of have trouble with the filter. They often talk quickly. They can interrupt. That’s another big problem is interrupting people. And then their emotional state can seem impulsive as well. Like something good happens and they’re like so excited with big emotion and then something bad happens and they’re like super depressed. And then an hour later, something good happens and they’re back up. So they may seem less even keel. They may seem like they have a lot of ups and downs. That’s kind of that one cluster of symptoms. And then the inattentive ones, you may notice that they’re easily distracted. That’s probably the key thing. So if you’re in a workspace and there’s something beeping over there, you know, it may not bother you, but like, wow, it may make it impossible for them to work. Or if the company culture is to have Slack, you know, pinging you, That may be fine for some people, but that may make them like, you know, impossible for them to focus. So like being very sensitive to different kinds of stimuli, especially visual stimuli, is really hard for them. Sometimes people with inattentive symptoms can look daydreamy, like they get lost in their own thoughts. So the classic like little kid who’s just kind of daydreamy, looking out the window all the time. Sometimes it has to do with task completion. So you’ll notice like, hey, if I need someone to pull an all-nighter, Jenny’s my person. You know, the ADHDers got that deadline. They’re really good at like pulling stuff out the last minute. It comes at a cost to them, but they’re really good at it. ADHDers do really well with like deadlines. But if you want someone to sit down and analyze spreadsheets all day long, and that’s not their passion, and they have an ADHD brain, like that’s kind of a recipe for problems. So those are like a couple of the traits, although I guess I do wanna say there’s a little bit of a myth out there that ADHD people just struggle with like task completion and procrastination. And what I see in professionals is sometimes they’re putting so much energy and systems and anxiety into like avoiding that, that they actually get like exhausted and rigid because all of the coping systems they have to appear normal to other people, then they’re just exhausted. and then they’re going home and falling apart. So you may not see it. They may have systems that are working to hide or mask what’s going on. And what you may not be seeing is the cost or the doctor that goes home and charts until 3 in the morning because they couldn’t get organized enough to get it done during the day, right? Or the parent. who puts the kids to bed and then they’re staying up till five in the morning trying to catch up on e-mail when there’s nobody like pinging them. So sometimes you can see it, but sometimes you can’t because they’re actually really good at hiding it. 

Mukund 

What can somebody do if the person’s team member exhibits these types of behavior? 

Dr. Jennie Byrne 

Yes, I mean, one thing, like I said before, is to try to create a psychologically safe space to talk about how you work best. That’s one thing. But if you’re seeing like performance problems and you’re like, I don’t know, is it ADHD? What’s going on with that person? And they have not disclosed anything to you, I wouldn’t ask them. That’s their privacy. You don’t have to know, but you could use a technique. And I don’t know if you guys like this technique, the kind of the conflict resolution technique, they call it Stabin or the DEER system, but it’s basically saying, hey, Jenny, I noticed when we have a meeting on Fridays, you’re coming to the meeting consistently 10 minutes late. When you come to the meeting 10 minutes late, it makes me feel blank. It makes me feel worried that you’re missing information. It makes me feel disrespected that everybody else is there waiting for you. It makes me feel confused because I know you really care, whatever. It makes me feel blah, blah, blah. You know, I need to find a way for you to get to this meeting on time. Like, can we talk about, like, what’s the best way to make that happen? Well, that’s the technique I recommend for a manager, but keep it really clear. Like, this is the behavior that I’m observing. This is how it’s impacting me. And this is what I’d like to see happen. And then how can we collaborate? to make that happen. 

Mukund 

So that’s actually a very good point. You want to concentrate on the outcome rather than going with the pre-assumed notion of what that particular person might be undergoing, right? 

Dr. Jennie Byrne 

And sometimes the person is painfully aware of their behavior to the point where like, yeah, they know, they just haven’t come up with a way to make it better. So sometimes by saying, hey, like, can we collaborate? Like, you know, should we put an extra clock in your office? Should we, you know, should I send you a reminder before the meeting? Do you want me to, you know, I don’t know. And then you kind of try to brainstorm and collaborate because they’re probably painfully aware that they’re late too. It’s that genuine, non-judgmental, curious stance that you’re trying to take as a manager, which is so hard, right? Because the behaviors can be really hard on everybody on the team. 

Dr. Ethan Levine 

It sounds a lot like appreciative inquiry and just trying to understand from a positive perspective. 

Dr. Jennie Byrne 

And I’ve managed people with ADHD, and I’ve been pretty sure they had ADHD, and they didn’t tell me for six months. And then eventually they told me, and I was like, yep, that’s kind of what I thought. And sometimes we’ve been able to come up with systems to accommodate them, and sometimes we haven’t. And then if we can’t, I think just having honest conversations about like, it seems like to be successful in this situation, you need these. these things, and I don’t know if I can get those for you. Is there another role at the company, if it’s a big company, or is there a way we could change the job? And I don’t know. I just, I feel like I see what you need, and I just honestly can’t get that for you. Like, what should we do next? And sometimes, you know, the job is a bad fit. I’ve had a young woman recently who went into kind of wealth management corporate America, and she said it was just the square peg and the round hole over and over and over and over. And one day she said she just woke up and she’s like, you know what, this is, this is pointless. And now she’s actually just been licensed as a psychotherapist and she’s loving it and she’s so happy and like she found her fit, you know, and sometimes it’s just honestly that job, you know, it just wasn’t right for her. She really just needed to do something different. I want to say one final thing, which is, people with ADHD often struggle, and so they’re very focused on surviving and kind of getting through the day, the week, the year. And I do want to say that my orientation is not just to survive. Like, I want you to survive, yes. I want to get things cleaned up so you survive, but I want you to thrive. And I wanted the book to paint some pictures of what it looks like to thrive with your ADHD brain in the professional setting. when you figured out all the pieces of the puzzle, whether that’s medicine or therapy, your environment, or you quit your job, or you stopped cooking dinner, which was one of my female patients. I was like, well, do you need to cook dinner? And she was like, I guess not. I was like, so don’t. And she stopped cooking dinner and she’s overjoyed. So anyway, I want to make sure people know that there’s more than just surviving. And I really believe you can thrive. And I hope the book offers some inspiration for what it can look like when people are thriving with ADHD. 

Dr. Ethan Levine 

Well, thank you so much. Really appreciate you giving your time to us. 

Dr. Jennie Byrne 

Yeah, thank you for having me here. I know you’re going to put it in the notes, but the book is on Amazon. It’s called ADHD and Professionals. Just search for it. My name, Jenny, J-E-N-N-I-E, Byrne, B-Y-R-N-E. I can offer ADHD assessments in 25 states and I can offer coaching in all states, actually anywhere in the world. And my website for that is constellationplc.com. And there are free ADHD resources on the website as well. So if that’s all you want to check out, you can go there and put your e-mail to get that as well. 

Dr. Ethan Levine 

Thanks. 

Mukund 

Thank you so much. 

Dr. Jennie Byrne 

Thank you. Thank you all. 

Mukund 

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