The ADHD Doctor: How to Focus, Stop Procrastinating, Manage Your Emotions, & Feel in Control

0:00Today on the Mel Robbins podcast, worldrenowned ADHD doctor and psychiatrist Dr. Sasha Hamdani is

0:08here with the six signs you may have missed your whole life. How to focus, stop procrastinating,

0:15and finally feel [music] in control. This is the ultimate guide to adult ADHD. [music]

0:25Please help me welcome Dr. Hamdani to the Mel Robbins podcast. Thank you for having me. I

0:30am beyond excited that you're here. I have been wanting to do a comprehensive and eyeopening and

0:40helpful episode about the topic of ADHD with a medical doctor for over two years. This is

0:50a topic that impacts me at a deeply personal level. It impacts my children. It impacts my

0:57husband because he has to live with me. Where I want to start is if we take everything to heart

1:03that you're about to teach to us about what ADHD is, what it isn't. Mhm. And more importantly,

1:12what to do if this is something that sounds like you or someone that you love, what's going to

1:18change about my life? If you're dealing with this chronic overwhelm and it's been hard for you to

1:25place a name to what you've been experiencing and you've been beating yourself up for years,

1:30I think this is going to give you the clarity to see that number one, your brain isn't broken.

1:36This is just a different wiring. And number two, it's going to give you the language and the tools

1:41and the steps of where to go next so that you can actually start navigating this condition.

1:48You said something that just struck me because I think when you talk about the topic of ADHD

1:53Mhm. you immediately think about attention. Yeah. And you think about focus and maybe you

2:00think about like, you know, the little kid who can't sit still. Yeah. But you said overwhelm.

2:07Yeah. And beating yourself up. Yeah. Could you speak a little bit to the emotional side

2:14of what we're going to talk about and what might change based on what you're about to teach us,

2:20how much time you got, cuz I feel like that is the a huge overlooked part of ADHD. I think ADHD at

2:28its base, first of all, I hate the name ADHD. I think it's stupid. So, Dr. Hamdani, what is

2:35ADHD? Yeah. So ADHD is a neurodedevelopmental condition which stands for attention deficit

2:42hyperactivity disorder. I think ADHD at its base is a regulation issue. Yes, attention is part of

2:50it. Difficulty regulating attention, but also difficulty regulating motivation, difficulty

2:55regulating energy, difficulty regulating emotion, that's a huge one. Difficulty regulating sleep,

3:01difficulty regulating appetite. And anybody with ADHD has felt this. And if I'm speaking to you,

3:08these are things that you've probably experienced, too. Because it's not as simple as, well, I don't,

3:15you know, it's hard to stay on task today. It's okay. I am so overwhelmed and I have beaten myself

3:23up about this and now I feel paralyzed with this guilt and shame and this overlay of this emotional

3:30component. And I think unless we really really get on top of this and start looking at the emotional

3:38regulation part of ADHD, we're never going to fully encapsulate the full picture. I'm looking

3:44at our executive producer, Tracy, who I've worked with for 10 years, and I'm smiling at you, Tracy,

3:52because I cancelled two days of taping last week because I found myself in this state where the

4:02word I was using is I am so overwhelmed right now and I feel so flooded with emotion. I don't even

4:09feel like myself. I can't function right now. But I didn't think that was related to ADHD. It feels

4:20very affirming to hear that. Well, actually the wild swing of emotion, Mel, is a core part of how

4:34ADHD can present because it's not just an issue of your ability to direct your attention. It's also

4:43your inability to process emotion in a way that is somewhat modulated. It goes in wild swings.

4:49Mhm. And because if you truly are somebody that has this condition, you have always lived with

4:59wild swings. I don't even know what it's like to regulate your emotions. Like what what does that

5:04even mean in your world, Dr. Hamdani? What does regulate mean? Because if you do have ADHD or

5:12you love somebody who does, yeah, we're having a completely different experience of life than

5:18somebody who goes through life without an ADHD brain and body. For sure. For sure. And I think

5:24when you when you drill down and actually look at what regulation is, right? Like for mood, right?

5:33If this is kind of normal baseline and this is down in the depths of depression and this is like

5:42so happy and elevated, right? People generally they they have a normal eb and flow that can

5:50happen situationally with ADHD. It can feel like ups and downs and ups and downs and it's usually

5:57coupled with anxiety and productivity issues and all of this mashed together overwhelming. Yes.

6:06It's like you feel like a hurricane. You feel like a hurricane. Like I can start cleaning the closet,

6:11but then all of a sudden I crash and I've got clothes off hangers everywhere and now I'm like,

6:17what did I do again? Yeah. I think a lot of people can argue, you know, well,

6:22sometimes people have emotional dysregulation or emotional swings because they're not getting

6:28enough done. I'll tell you if like even in my own case, I can feel these kind of emotional swings

6:36and I can feel extremely overwhelmed and I might get to a spot where I'm getting all of the stuff

6:40done like all of the stuff I've delegated or I've gotten rid of and it's off of my to-do list and I

6:45still feel that overwhelm and that pit in my stomach and that just like I want to hide. I

6:53can't do anything right now. I just want to hide. That is emotional dysregulation where it's like I

6:58I I have the logical part of my brain that's like you don't have anything to worry about. You're

7:03fine. This things are going well. You're okay. But still, you're having these big ups and downs that

7:10you're dealing with at the same time. And I think that's so vital to talk about because that's what

7:14gets misdiagnosed. Well, my greatest wish for this episode, other than the person listening,

7:23really feeling empowered and seen and having your expertise to really help you take the next step

7:34to get the support that you deserve and to better understand yourself. And my second bigger mission,

7:40okay, is that this sparks a change in the way that ADHD is defined because you can see that

7:50if society thinks ADHD is jitteriness and, you know, kind of the typical little boy like our

7:57son was bouncing around in a classroom that can't sit still and can't focus. And if that's all that

8:02we think it is, then doctors and pediatricians don't have the right definition for it. So,

8:12of course, they're going to continue to go, "Well, only if you're jittery does it look like

8:16this." But anything in the realm of dealing with emotions must be something related to anxiety or

8:22depression. We're going to keep seeing this problem. Originally, the ADHD criteria was

8:27developed looking at hyper young boys. It's not even our criteria is not even built to look at

8:34everyone else. It's not built to look at girls. It's not built to look at adults. I think part

8:39of the biggest flaw in this, right, is that when you just moving on from like the hyper young boys,

8:46part of the issue is they're looking at these highly observable behaviors like these are the

8:51kids that are disrupting classes and these are the kids that can't stay in their seat, right? But

8:57what about all those other presentations where the only people they're disrupting are themselves and

9:03they are just getting passed from class to class to class to class and then later Mel those are

9:08the people that are getting diagnosed with anxiety and depression because by the way you're too old

9:12to have it now. That was me. Yeah. I've also never heard anyone say that the way that you can present

9:24there's the external disruption, but I hadn't ever heard anybody say or you could be somebody that's

9:34internally disrupting yourself. Yes. With your thoughts, with your inability to stay on task,

9:42with your emotions. That's exactly how I felt all the time. And that's what I hear day in and day

9:50out when I'm hearing from women over and over and over again that I my whole life I have felt like

9:58something was off. There was something missing and they have never put together those pieces and then

10:05their child gets evaluated and that's when the pieces kind of come together. I'd be curious to

10:10hear your thoughts about something. ADHD in kind of culture and society. Yeah. Kind of feels like

10:19an eye roll. Because people have thrown the word around so much and live in a world where everybody

10:29has fragmented their attention by being online. Yeah. And at the same time, we have a neurological

10:38condition which here in the United States is classified as a protected disability. Yes. We have

10:44all of this research around it. And so the term is kind of in popular culture and thrown around.

10:53You know what I mean though about the eye roll? Oh yeah, you got ADHD. It's not even that. They get

10:57those eye rolls from their doctors. M I have heard from another physician when I was talking about,

11:05you know, I I've been doing some advocacy work online talking about ADHD and he made he it was

11:12obviously a he made the comment, "Oh, so you can give Adderall to all the housewives who need it?"

11:18And I was like, "You're gross. I got to get out of here." Like, but it it like that is kind of what

11:24this what this feels like. It feels like that's just kind of the like medication is the easy way

11:33out and like everybody has it and it's easy to qualify. You talk to anybody who is trying to get

11:39a good ADHD diagnosis, there are so many hoops in place there. It is hard to get a diagnosis

11:45because it is like people are turned away from or discouraged just openly discouraged or hostile.

11:53The thing that I experienced as a parent is, well, oh, you're just trying to get your kid extra time

11:58on a test so you can get him into a good school. Yeah. I'm like, no, I'm trying to have him not

12:02struggle with depression and hate himself because he feels like a a freak in school. Yeah. Like,

12:09he's not a behavioral problem, you idiots. Like, this is a kid who's struggling. Yeah. And why do I

12:13have to cry in front of a bunch of administrators to get him properly assessed? And so I also feel

12:20because of parents pushing their kids and trying to game the system, there's also a little bit of

12:25like, oh, do you really have ADHD or you know, did your parents just push for this so that you could

12:29get the extra time and accommodations that way? And it's really hurt people and hurt our ability,

12:38I think, to get heard and to be diagnosed. And I think that's part of it for sure. I

12:45think there is, you know, people ask me a lot, is this underdiagnosed or overdiagnosed ADHD?

12:51And my answer to that is it's both, right? It's overdiagnosed in some populations and it's wildly

12:56underdiagnosed in some. Like there's some racial and socioeconomic populations where ADHD is so far

13:04down the list of what it could be. And it's just immediately this is oppositional defiant disorder,

13:09this is a behavioral issue, this is some other kind of weird attachment thing.

13:14So these kids aren't getting help. And then there are other people where it's almost like they're

13:18entering like a pill mill situation where like I know this one doctor and he's really

13:23loose with aderall. There's a wide range. And I think that truly I think that if we had better

13:34criteria that properly nail down what we're looking at more comprehensively then people

13:43wouldn't give these eye rolls. They wouldn't give like because we would be treating what

13:47we're looking at. I agree with you. What exactly is happening in the ADHD brain? So, this is going

13:56to be extremely oversimplified, but I think it's important. The way that I describe it is there's

14:02a couple of things that you a couple of areas of the brain that you really need to know about. And

14:06the first one is the frontal lobe. So, directly under your forehead. Think of that as like the

14:11very smartest part of your brain. Decision making, judgment, processing, that's your frontal lobe.

14:18Then you have this amygdala, which is this little almond shaped central area of the brain,

14:25and that's in charge of all of that emotional data. So with ADHD, you're dealing with a couple

14:30of things happening. Number one, you're dealing with a prefrontal cortex, smartest part of the

14:37brain. It's a little bit thinner and a little bit less responsive. Oh, really? Yes. And then you're

14:44dealing with an amydala that's a little bit more hyper reactive. And then you're dealing with the

14:50connection between the two which isn't as strong. So what you're going to get is you feel things

14:58strongly because that amigdala is like alarm chemicals like something is happening and that

15:03prefrontal cortex is sometimes slow to filter and figure out exactly what to do with it. M the other

15:10thing that's happening in the brain alongside all of that is you have to talk about dopamine.

15:16And again, when you think about ADHD in general, that's very oversimplified, but dopamine is that

15:23neurochemical that's in charge of alertness and attention and emotional regulation and mood. So,

15:31it's it's present and doing many different things at once. And a lot of people think that it's a

15:37lack of dopamine. you have low dopamine and that's what's causing all this. It's really

15:42that the dopamine you have present isn't in the right place at the right time. And so that can

15:48change with hormones, that can change with age, that can change with stress, that can change,

15:53that can just be an underlying deficit or dysregulation. So when you have those kind

16:01of factors all at once, you're dealing with just a tremendous amount of input that you're getting

16:08and a kind of weak filtering system. And so you're just you're doing the best you can.

16:14When you talked about the prefrontal cortex and being kind of the thinking and like the

16:18secretary of the brain, the processor, and then you talked about the amygdala,

16:22the little almond, it made a lot of sense to me where you're like, the input is overloaded

16:26and the connection between those two things is weak. Yeah. which is why it is hard for somebody

16:34that has this neurological condition called ADHD to actually regulate the signals coming

16:40into here and all the sensory crap coming into here. Correct. So that makes perfect sense why

16:45it would be hard if the connection's weak for us to take all the input into the thinking part of

16:51the brain and process it. Yeah. and at the same time take all the input into the sensory part,

16:59the amydala, and also appropriately regulate and process that too and send signals to your body and

17:04your mind. Now, when you use the word regulation, let's just say the person that's listening has

17:09never really heard that term or doesn't quite um know what you mean. Yeah. How do you want us to

17:17think about what the word regulation looks like? Because I'll tell you, as I'm hearing you talk,

17:21Yeah. I immediately had a flashback to going to Baker Library at Dartmouth College. Got my books,

17:30fully intending on studying Dr. Hamdani. Okay. I go to sit down. Now all I can do is hear my

17:36stomach. Now all I can do is hear the people in the corner over there. Now I'm looking at

17:40the person and an hour or two goes by. Mhm. And then I start to think, wh why can't I just do

17:48what everybody else is doing? what is wrong with me? Mhm. And I have example after example and

17:56the emotional side of this and the wreckage that it caused internally for me and the self-hatred

18:04that it causes. Mhm. That is like it there's a level of when you finally get a diagnosis,

18:11there's almost like relief and grief at the same time. Sure. because you start to understand how

18:17much unnecessary suffering you inflicted upon yourself because you didn't know what you were

18:23dealing with. Oh, and it's it's the same story you hear over and over again. I have had people who

18:31have come to me and they knew something was off. They have felt this guilt, this shame, and so they

18:39go to their doctor. The doctor is like, "This is anxiety. you're anxious about something or you're,

18:46you know, depressed about how things are. They're started on medication. Medication

18:51doesn't work. Okay, go back to the doctor. This isn't working. Try another medication. Go back

18:55to the doctor. I've had people that have been on 10 different medications. they have never found

19:00relief or they found very partial relief and then you actually evaluate them for ADHD and you get to

19:07the bottom of like oh okay you're having this emotional dysregulation that's happening all

19:12right let's treat the ADHD and all of this gets significantly better than any other medication the

19:21way that I describe it is for people who have diabetes and they start to lose their vision

19:29Now all of a sudden they go to their doctor and they're like, "I'm losing my vision." And then

19:34this would be like if the doctor was like, "All right, cool. Let's get you some glasses." No,

19:38the correct answer is let's work on the diabetes. Let's let's fix this underlying problem. And that

19:44underlying problem is that ADHD that's causing all of these things. You just described my life story.

19:51So undiagnosed ADHD. Yeah. super hard on myself, studious, hardworking, and had no idea what was

20:02going on, but had lots of anxiety. Yeah. And the anxiety started growing from middle school through

20:10high school. Got worse and worse and worse. And I got put on Zoloft at the age of 22. Yeah. I took

20:19Zoloft until my mid-40s because I was diagnosed with anxiety. Yeah. And while the Zolaf for me

20:29at least kind of turned down the volume of the chronic like state of alarm that I lived in,

20:36Mhm. it never really solved solved anything. Mhm. And it wasn't until our son Oakley was diagnosed

20:45with ADHD that I'm like, "Wait a minute." I went, I got a neurosych evaluation. I got a clinical

20:53diagnosis. I stopped taking anxiety medication. I haven't had a panic attack since. I haven't had

20:58anxiety problem since because the entire time we were treating the wrong thing. Correct. The

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22:11in your work that there are three different types of ADHD. Mhm. I didn't know that. What are the

22:16different types of ADHD? Okay, let me show you. Okay, first one, inattentive ADHD. And we touched

22:24on this briefly. Inattentive ADHD typically are the daydreamers. They tend to be forgetful,

22:32difficulty with organizing things, difficulty with remembering where you place something,

22:37difficulty with initiating tasks, difficulty with, you know, if there's a big task coming up in front

22:44of you, you tend to avoid that. So these are your typically this is how females assigned to

22:52birth present. Okay. Inattentive ADHD. Inattentive check. [laughter] hyperactive or impulsive ADHD.

23:04This is the second form of ADHD and this is well one of the ways that males can present and this

23:13is both physically and verbally impulsive. These are the kids that are having difficulty kids and

23:18adults difficulty staying in their seat. They're fidgeters. They are impulsive in speech in that

23:24they're interrupting. They are blurting out answers in conversation. They have difficulty

23:31participating in conversation. So this is this is that hyperactive type. And then the third type is

23:43the combined type picture. Oh, and combined type picture is just a combination of both of those

23:49um features. So you can have inattentive features and you can also have the hyperactivity component.

23:55Um, fun fact, this is what I am. How do you know? You know what I'm saying? Because it feels like

24:00it's a little general, like all of it. So, you can kind of find situations for yourself. But how do

24:06you know what you are? And why is it important to understand which of the three you might be? So,

24:12I mean, you really are going to know once you get a good solid evaluation, right? Because I

24:18think that part of getting a great evaluation, a very sound evaluation, is equal parts, yes,

24:25ruling in ADHD, but also ruling out everything else. I want to make sure that this isn't anxiety,

24:30that this isn't depression, that this isn't bipolar, that this isn't some thyroid issue

24:34or some medical issue underlying it. So there's within the evaluation where you're talking about

24:41ADHD, you go from childhood and you kind of look at longitudinal patterns because again with women

24:48specifically, it's hard because every month we look different hormonally. So catching you at

24:54at one spot in your cycle versus another spot, you might look different and you might present

24:59a little bit differently. So you're looking for longitudinal patterns. Can you break apart how

25:05does the emotional side impact girls? When you're looking at females um they typically fall into

25:15this pattern of more the inattentive presentation. So these are the daydreamers. They're forgetful.

25:22They have difficulty organizing things. They have difficulty with routines and and motivation to

25:29get tasks done. And so these are the people that in general can be a pleasure to have in class.

25:35They're getting passed along and they're doing well, but internally they're working so hard. So

25:41hard. And you know what? That doesn't get better. You get through um your elementary school years,

25:48you get to puberty, then all of a sudden you get smoked by hormones. Now hormones immediately

25:55change things. Now instead of physicians and again not the fault of physicians right this is a fault

26:01of criteria but now instead of physicians looking at this child and saying whoa like we missed

26:09something you're having like all these mood swings and school is hard for you and friendships are

26:14hard for you and all of that. They're saying you're a teenager. These are hormones. Get

26:21used to it. like this is what you hear as like a 13-year-old girl and then they have to get through

26:29it. So, you just kind of just bear it and then you get into college and your demands get harder. You

26:36start getting into more serious relationships and then maybe you get into a situation where

26:41you're trying to start your own family. Okay, now you're getting hit with another wave of hormones

26:45and actually during pregnancy estrogen levels are a little bit higher, dopamine levels are a

26:49little bit higher. So you might do okay, but then postpartum comes and rocks your world. And so you

26:55get this drop in estrogen, drop in dopamine, so you can't regulate the way you used to. And so

27:02now you go to a doctor again, you're like, "Things are bad." And they're like, "It's hormones." Like,

27:08"Let's put you on an anti-depressant cuz you're depressed. This is postpartum depression." And so

27:12it gets missed again. Then you get through all of that and you get through your reproductive

27:19years and now you're in pmenopause and things are chaotic cuz your estrogen drops again and you're

27:25like something is wrong. [laughter] Something is wrong and now it's well your you're hormonal

27:33like give it 10 years we'll see you later. Brain fog. Yeah, there you go. This happens during p per

27:37menopause. So we in fact that's you've described my whole life. I know I had postpartum depression,

27:45crashed. I started having severe brain fog and other symptoms from pmenopause. So, you

27:51get hormones which help but didn't help the brain fog. Yeah. And again, like it was just diagnosed

27:57with anxiety, living with anxiety, struggling, struggling, struggling, pushing through postpartum

28:05depression. Oh my god, the sobbing as you're breastfeeding. Like just I don't feel like myself.

28:09Oh my just and then pmenopause, then the creams, then the and then all of a sudden ADHD diagnosis,

28:17and it's like, wait, what? And it felt as soon as I was not only diagnosed but found the medication

28:24that worked for me, it's like all of a sudden after 47 years, I felt like I was in my body.

28:31Yeah. And that gets missed. It get missed over and over and over again because our criteria doesn't

28:37catch that. Is it common in women that if you have undiagnosed ADHD that it can cause anxiety and

28:45depression? Yes. Why? A lot of times like when you look at ADHD there can be anxiety and depression

28:53that come that is a separate thing that travels along with it. That that can happen. But for a

29:01lot of people because again circling back to that emotional regulation part of ADHD that everyone

29:08seems to miss and that is so critically important to getting a comprehensive picture of ADHD. Number

29:15one, if you've gone through your whole life and you've thought that there's something wrong with

29:18you and you're less than and you're broken, that's going to make you anxious. If you can't do the

29:24things that you know perfectly well that you are capable of, that's going to make you anxious. And

29:30you know what? It's probably going to make you pretty depressed, too. If you're going through

29:34these huge moments of this energy dysregulation where you are getting tons done and then it's like

29:42you've hit your max and then you crash, you have this huge crash and then you feel like,

29:47okay, I have literally nothing left in my tank. That looks like depression. But these are all

29:52emotional dysregulation issues that are happening and so that that's why you see that with ADHD. Um

30:00is there a connection between undiagnosed ADHD and eating disorders? Yes, there is. But I think

30:07that again that stems from dysregulation and it stems from a lot of ADHD. you're not able to be

30:19mindful about certain things. So sometimes it's not actually, you know, when people think about

30:23eating disorders, they think about, you know, on one extreme that you're not eating enough and on

30:28the other extreme you're eating too much. Like for the extreme where you're not eating enough,

30:32a lot of times with ADHD, sometimes it can be like you don't really have hunger cues. And

30:37and this is outside of the medication. It's just your body isn't communicating, telling you you're

30:41hungry. And I know personally if I get invested in a task that I'm truly interested in, I can go

30:488 hours and I'm not eating, I'm not drinking, I'm not getting up. Y on the flip side with like binge

30:55eating disorder and things like that, there can be a time where you're trying to stimulate your own

31:00dopamine. You're trying to like get things going without even knowing that's what you're doing. And

31:05you're grabbing for things and you're eating and you don't even know and you can look down. you're

31:08like, "Okay, that was a whole sleeve of Girl Scout cookies." Like that. So there's like you

31:13can be on either end. So yes, there are linkages with disordered eating on both ends. And what's

31:21interesting is again this kind of distinction that you're seeing, Dr. Hamdani, of the external

31:28presentation versus the internal turmoil. How I describe it is it's like the outside of your

31:34house is on fire versus the inside of your house is on fire. Like it just feels like both are on

31:40fire. [laughter] Both are literally in flames. The way we look at it now is we only care if we

31:47can see the flames. Flames are going on inside the house. What What would you say to somebody who has

31:55received this episode from someone that cares about them? Yeah. because the person who cares

32:02about them sees these patterns and has sent this episode, you know, in a text saying, "Hey, you

32:11know, I'd love for you to listen to this because this sounds a little bit like what you might be

32:15dealing with. What do you want the person who's hit play and is starting to really process what

32:23you're saying for the first time?" I think if you are listening to this episode, I don't want this

32:30episode to push you one way or the other. This is not meant to convince you that you have ADHD.

32:34This is not meant to push you in one direction. It's meant to ask you questions about your own

32:42internal environment so that you can start digging deeper and figuring out is there something here or

32:49is there something that needs to be addressed? And what I want to reiterate about all of this is that

32:55I think good compassionate care and diagnosis stems from a very non-judgmental and shamefree

33:02place. And so just being able to look at this episode and and whatever other research you do in

33:10a very compassionate and self-compassionate way, I think you'll be able to receive information and

33:16actually start to put together patterns about your own behavior a little bit better. And that might

33:20be ADHD, it might not be. What do you think the biggest misconception is about ADHD that

33:25keeps people, especially women, from getting help? That you have to treat it with medication. I don't

33:33think you have to. I there there are some people that are on medication and it is life-changing

33:38for them. And so I'm never going to and even when I was talking about anti-depressants before, same

33:43thing. That can be life-changing for some people. So, I'm never going to go back on that because a

33:49medication is a tool and can be wonderful. But also being able to actually commit time and

33:56figure out therapeutic tools that might work. It is also so critically important. And some people

34:03don't need medication. They they get through with doing cognitive restructuring and work through

34:09therapy that can be extremely beneficial. I so appreciate your answer. What I find reassuring

34:16about what you're saying is there are other ways you can support yourself and we're going to get

34:22into that very specifically about what to do and how to get a diagnosis and what are the things

34:28that you can do and what are the medications. Um you know I remember when I got my diagnosis it

34:35was both an extraordinary relief Yeah. and I had a lot of grief and anger. Yeah. Is that common

34:43to feel a sense of grief? Like when you finally understand what's been there the whole time? Yes.

34:53When I evaluate people, I actually tell them about that. Like I don't know what this evaluation is

35:00going to show or if it's ADHD, if it's not ADHD, but depending on what we go through, this is just

35:07a deeper exploration of what's going on in your body. And it might you might feel like this is an

35:13answer. This is what I've been looking for. And it might feel like I wasted so much time and I'm

35:19grieving that loss of time and potential and all of that stuff. And to them I say that is normal.

35:26Like you are allowed to feel those things. That's that's perfectly normal and there should be space

35:32for that because that is a very valid expression of what's happening. But I also tell them that in

35:38that time it wasn't wasted because what you were doing the hard work you were building routines

35:44you were building structures you were building workarounds that eventually as you have the right

35:50tools and scaffolding those are going to come in handy for you. those are going to make this

35:55process a little bit easier because I've also seen on the flip side of things when people are started

36:01on medication and they don't have that scaffolding in place and then when they're off medication it's

36:07like they're floundering again. So I think this multiffactorial approach of doing lifestyle and

36:13behavioral modification with medication if that's appropriate can be extremely helpful. It was

36:19life-changing for me. I'd love to talk about the connection between being high achieving Yeah. and

36:26how that especially in women can hide ADHD. Mhm. Especially from ourselves. Yes. So, I'm going to

36:36introduce you to the concept of masking. Have you heard of that? Uh not in the context of ADHD. So,

36:43masking is when you have it can be conscious or unconscious camouflaging of your symptoms. And

36:50this is something that women do exceptionally well because I think from a young age we're sensitized

36:56to do this because we don't want to be in trouble. We don't want to stick out of a crowd. We don't

37:03want to bring a lot of attention to us. I'll give you an example with me. Like I was a combined type

37:09presentation. So I was very hyperactive. Like I couldn't stay in my seat, a big fidgeter. But I

37:14learned I can't get up all the time in class. I'm getting in trouble constantly. So, I would

37:22like squish my thighs down on the seat or I'd grab the bottom of my chair and like try to suction cup

37:28myself to the chair because I'm like, I I need to physically restrain myself from getting out. Now,

37:34from a productivity and a masking perspective, you also see things like perfectionism. I don't

37:41want to get in trouble. you see things like um overcompensating, like I'm gonna stay at

37:47work extra long and I'm going to overprepare and I'm going to get things ready because I

37:52don't want to get in trouble. I know I'm going to miss something, so I'm going to prevent that

37:56from happening. Um, you see things like within relationships and knowing that there's like that

38:03emotional regulation. You see a lot of women just kind of accepting stuff that they might not think

38:11is appropriate for any of their peers, but they're like, I was probably in the wrong. I was a little

38:15bit too emotional. I chased them away. And so, in order to protect that emotional sensitivity, they

38:22don't want to get into conflict. They don't want to fight. They don't want to do things like that.

38:26So, I mean, there's lots of different ways that are directly impacting and and harmful to someone

38:33who is continuing this mask for a long time. Eventually, that mask gets too heavy to hold.

38:41Is ADHD a superpower? No. Everyone asked me that. I am so jealous of the people who say that it is.

38:50I'm jealous of the people who say that it is. And the reason for that is I feel like there are some

38:56things that ADHD has brought me that I wouldn't have otherwise. Like being on social media,

39:02going to the White House, getting book deals, like that is because of my ADHD. That's because of that

39:08hyperfocus. That's because I was interested in something and it it bled into this area. But

39:14there's also things on a day-to-day scale that I feel so limited by. And I feel like the analogy

39:22that I give is it's like a superpower that I have very little agency over because it's like you can

39:29fly now and that's your superpower, but you can't choose when or where. So, you're just going to

39:33blast off into space at any given time. [laughter] So, it's I feel like I love I love the concept

39:41of a positive reframe and I think there is some beautiful beautiful things about ADG. I really do.

39:51But I think there's also some things that are really difficult to deal with. And I think when

39:55people continuously focus on that superpower trope, it kind of for me it it it diminishes

40:03a struggle. And so I feel like the best way to approach ADHD is just realistically. They're

40:10good. Just like anything else, there's good stuff, there's bad stuff, and it's how you deal with it.

40:15I appreciate you saying that because I always thought that it sounded like toxic positivity.

40:19Yeah. By somebody who doesn't have ADHD. And when you also consider Dr. Hamdani,

40:27what you're teaching us, which is for decades, yeah, medical professionals,

40:34society, the DSM has not included the full scope of ADHD, especially the emotional dysregulation.

40:45There is no superpower to feeling constantly overwhelmed in your life. And yes, there are

40:54some small benefits. And I love the analogy that you said. It's like having a superpower you can't

41:00be in control of. Like I would love to be able to throw fire from my palms, but I don't want it

41:05going off at the wrong time. Yeah. And there's a lot of anxiety that comes with going through

41:13life thinking you can't trust yourself. Yeah. You can't trust yourself to follow through. You can't

41:19trust yourself to be on time. You can't trust yourself to remember. You can't trust yourself

41:23to not screw this up yet again. And so I really appreciate you saying that. Is there something

41:32surprising that you've discovered in your practice that most people with ADHD struggle with and may

41:40not even realize it? Yes. So, we've we've talked a lot about the emotional regulation side of things.

41:47Yes. There is a neurological phenomenon that you see in almost 100% of people with ADHD. They

41:53experience some component of rejection sensitive dysphoria. Rejection sensitive dysphoria. What

41:59does that even mean? That's a big thing. It's a big thing. It's a mouthful. Rejection sensitive

42:03dysphoria is this incredibly robust emotional response. Sometimes physical but mostly emotional

42:11response to real or perceived rejection or criticism or this fear of disappointing someone.

42:20It is this internal emotional response flooding of neurochemicals that happens. How do you

42:27define this? What this is? It is a neurological phenomenon when you look at emotional sensitivity.

42:34Okay. Right. And you have which you have if you are somebody struggling with ADHD. I'm saying

42:41just part of the human condition. Right. Emotional sensitivity in general. You have if you're saying

42:46this is kind of normal emotional sensitivity. You have emotions down, emotions up, situationally

42:53appropriate. You're right in the middle. You have lack of emotional sensitivity where people really

42:57aren't responding in the way that they should be. They don't feel big highs. They don't feel

43:01big lows. Maybe not situationally appropriate. Then you have people that are highly emotionally

43:06sensitive. And they are the people who feel things quickly and deeply and for a long time. Mhm. And

43:15I would put rejection sensitive dysphoria as like the the ending point of that as most emotionally

43:21sensitive because when they feel something even if it's not actually happening if they perceive that

43:27there is a risk that I'm disappointing you or that there's some rejection or the person doesn't like

43:31me their world caves in they start turning inwards and it becomes this flooding of neurochemicals

43:39and alarm chemicals that are happening that literally paralyze other areas of the brain.

43:45Wow. Mhm. Holy cow. Mhm. You have a brand new bestselling book, Too Sensitive. I love the

43:54title. Thank you. Why is this rejection sensitive dysphoria important to dedicate an entire book

44:03to this? Because no one talks about it. So, we don't have the tools and the language to

44:09treat it appropriately. Can you show us what this may look like in day-to-day life? Yes,

44:15I can. I can show you with text messages from you. Oh god. [laughter] Okay. Oh, these are So, the

44:23team has screenshot my phone. Okay. Go ahead. Or actually screenshot their phone and something that

44:28I've said. Okay. So, if we're looking at just this screenshot with you responding to something that

44:36I'm saying and all it says is no worries. Okay, for me what is happening in my brain is is she mad

44:45at me? Is she unhappy with me? Does she want me on the podcast still? I am spinning because in my

44:51brain I've attached a level of uncertainty because I'm afraid that there is rejection and criticism

44:58underlying this. And that to me is a direct reflection of my own selfworth. So I am going to

45:04spin on this. I'm going to ask other people about it. I'm going to show my phone to other people and

45:08be like, "What do you think about this message?" And I am going to waste a tremendous amount of

45:14emotional energy on this. Now, the things that I could do with this is that I could chew on it for

45:23hours and hours, which is what I love doing and that's what I usually do. Alternatively, I could

45:29do things like I could overcompensate. I could send you a text message back and be like, "Okay,

45:35I'm just making sure that we're cool." Or, "Okay, I I want to reiterate our plans." And you're like,

45:40"I am busy." I like the, you know, so there's there's a lot of emotional handholding I would

45:48need in that moment. I might do things like I get that text message, I've already decided that

45:54you're mad at me. I'm done now. And that that had been my trajectory in my 20s with relationships.

46:00I would read into neutral interactions. I would read them as threatening in some capacity and I

46:06would be like, I don't need this. I'm studying. I don't need this. And I would end the relationship

46:11because you're not going to push me away. I'm going to leave first. You see different patterns.

46:17And it is truly when you take a neurologically, emotionally sensitive person, which is something

46:24you see a lot of in ADHD, and you put them in these everyday kind of situations because of that

46:32emotional dysregulation, they have a hard time filtering that information because that emotional

46:39part of their brain is popping off before that logical part. So, they are just running with

46:43this flooding of emotional chemicals. And if you think about that, like this is the stuff

46:48that keeps me up. This is the stuff I worry about. This is the stuff I I reality test with people and

46:53they get so annoyed because I'm like constantly going and asking them like, "Is this normal? Is

46:58this not there?" There there's so much I I don't want to say life loss, but that's what it feels

47:04like. I'm just spending so much time doing that. I have spent a lifetime doing this. So if and yet

47:10at the same time I'm just doing the best I can to manage all the inbound. Anyway, if you relate and

47:18you read messages like this, what do you do? Yeah. And for the record, it's not just messages. Like

47:26it can be things like for me I'm so sensitive to tone, to shifts in tone. I'm sensitive to

47:33body language. Like I'm sensitive to like I can pick up an energy in a room before I go in. Same.

47:39You know, it's like so this is this is one of those things about being emotionally sensitive

47:45and then simultaneously being emotionally disregulated is that those things hit hard.

47:50Yes. So recognizing it is huge. That's a big big big thing that I I think is really important. The

47:57other thing that we see is important are things that work in the moment to reduce activation.

48:04Some easy ones are things like movement. And it doesn't have to be like do heavy cardio or or lift

48:10weights. Do some sort of movement that's going to increase that oxygenated glucose to get to that

48:16frontal lobe. So, okay. So, I see the text message now. I'm like, yes, I do squats. You can you can

48:24because think about what you're doing. Like once you understand neurologically what's happening,

48:27you're dealing with this overactive amydala and this underperforming frontal lobe. Oh, I see.

48:33Oh my god, I just got it. So in that moment, the input from just a simple text message is

48:39like Yes. And that floods your brain. Yes. And your thinker, your prefrontal cortex,

48:47Uhhuh. is like, I don't know what to do. I can't come online. Something's going on. Like, ah. And

48:55so neurologically even though a text message seems stupid and in inconsequential. Yes. Neurologically

49:03your brain is screwed. You you are responding to a threat like you have seen a murder. When you

49:09are actually assessing threat like whether it's a social threat, whether it's a physical threat,

49:14your brain doesn't know the difference in that moment. Your body is responding in the same way.

49:19So you're having this flooding of neurochemicals. And so what you need to do now is understanding,

49:25okay, my emotional center is overwhelmed. My frontal lobe is not working as well as it should.

49:31And then you look at that situation and whether it's like, okay, I can utilize movement and that's

49:36going to get some oxygenated glucose to my frontal lobe where it's supposed to be. And hopefully we

49:40can get that thinking back on board. The other thing you could do, delay the reaction. And this

49:45is something that it took me so long. I understand neurologically I am flooded right now. I know that

49:51in 10 to 15 minutes I'm going to feel different. And so in 10 to 15 minutes I will reassess this

49:58and I will even do things like I'll set an alarm. I'll set an alarm 10 to 15 minutes I'll come back

50:03and gosh darn it I do feel different. But I think what's important is that like with this

50:09book too sensitive. I don't want to make you less sensitive. I want to help you be more in control.

50:20I love that. I don't want to make you less sensitive. I want to help you be more in control.

50:27That is the perfect statement for us to then talk about how you feel more in control. Um because

50:36I'm sure as you've been listening or watching and you're really taking in everything that Dr.

50:43Hamdani is teaching you and me today. You are thinking of like 13 people in your life. Yeah.

50:50Or you are thinking, "Wow, this sounds like me." So, what are the steps you should take if

51:00you think you or someone that you love may be dealing with ADHD that's not diagnosed? Yeah.

51:09Let's go through this cuz I think a visual will help. So, I'm going to pull up a visual. Great.

51:17So, if you think you have ADHD, let's start with the first step. So, first step,

51:21track your symptoms. It is so important to number one, know your baseline. Number two,

51:27it's also needed to understand how your treatment is progressing. If that's kind of what

51:33it and whether that's therapy or whether that's medication, are those holes being fixed? Yes. So,

51:39what symptoms am I tracking? Okay. So, if you do these things, you get a gold star from me. I want

51:46you to track initiation of task, distractability during the task, like are you getting pulled out

51:52of the task, completion of task? So, I would lump that all into one, but I think it's important to

51:57make those distinctions like where is the problem? Is it starting? Is it staying in the task? Is

52:01it actually getting it done? That's important. Number two, I think that is vitally important,

52:06is sleep. Sleep. Track what you're doing with sleep. I want to know how long you slept. I

52:14want to know I if your sleep was fragmented. Are you waking up in the middle of night? Is

52:18it hard to fall asleep? So, give me as much data as you can. This can be notes on your phone. Like,

52:23this doesn't need to be something super formal. Okay? And the third thing that I want you to

52:27track that I think is really important is mood. I actually don't give a lot of guidance on this

52:33because it's almost an interesting diagnostic fact to see how you track mood. However you want

52:38to track your mood, just give me some sort of mood data point. Okay? Because I want to see number one

52:44how how that pattern progresses over time. And then especially for women, if you crossorrelate

52:50that with your hormonal cycle, I want to see that too cuz if there's a strong hormonal component,

52:54we need to look at that as well. Got it. So if I were to do this for a couple weeks,

52:58you'd get some good data because then you could go and has it been like this in the past? Ideally,

53:03ideally I don't want a couple weeks. I want like enough for two hormonal cycles. So Oh,

53:09so you want two months? I want two months. Okay, great. You can have two months. It's gonna take me

53:12that long to get an appointment with you anyway. So, okay. Track your symptoms for two months. And

53:16we're doing kind of productivity, initiation, distractability, completion, sleep patterns,

53:22and mood. Yes. Boom. Boom. Okay. Step two. Talk with a qualified professional about an

53:30ADHD. What is a qualified professional? Who do I go to? I know. So, here's the deal. There are,

53:37especially now, there are lots of different roads to get to where you need to get to, right? Um,

53:45let's start from my favorite. I'm biased cuz I'm a psychiatrist. I feel like going to a psychiatrist

53:53sometimes gives you the best evaluation. And the only reason I'm saying that is because you have

53:58the benefit of going to a medical physician. So, they understand medical background. you have the

54:03benefit of going to a psychiatrist. So, they've done the psychiatry residency where they've done

54:07the therapy side of things and they've done the medication side of things. So, it can be, you

54:12know, if if that person is appropriate for an ADHD um medication after this evaluation and has ADHD,

54:19this could be a one-stop shop kind of thing. But there is a desert and deficit Yeah. of access in

54:29many communities, many countries for many people. And you know, sometimes we're like, do I go to my

54:36primary care? Do I go to a pediatrician? Do I go to a nurse practitioner? Like absolutely,

54:40we're only as good as what our system allows because access to care is a huge issue. And

54:45that there's so many barriers to care. Whether that's there's literally not enough psychiatrists,

54:50whether that's a cost issue, whether that's a, you know, they aren't taking your insurance or,

54:56you know, there's so many different things or or that they're saturated. They're they

55:00can't see patients. You could go to your primary care doctor or your pediatrician or and that's a

55:07beautiful place to start. That's a beautiful place to start. Generally, there's a lower barrier to

55:11access with that. A lot of times they'll do an assessment that involves getting information

55:18from collateral resources. So talking to, you know, like for kids, they'll talk to parents,

55:23they'll talk to teachers, they'll get at scales to look at ADHD behaviors. So that depending on what

55:32is available to you. That's another road. Then you can do the therapist road. There's many different

55:38layers. You could do a neurosychologist who could do neurosych testing where you do a comprehensive

55:44evaluation of everything that's going on. Is this ADHD? Is this depression? Is this anxiety? Is this

55:50bipolar? So, they will do a full It's super long and expensive. And expensive. That's what I did.

55:56That's what we did with two of our kids. Like, and it was expensive. Like, I would not have been able

56:01to do it had all of this started happening and I was aware of what was happening like

56:06even just a couple years before that. So here's the deal. There are other resources. So besides

56:12the therapist route, besides the neurosychologist route, there are other layers of therapists that

56:18could potentially do the evaluation. Some of them like with nurse practitioners, not a therapist,

56:26a nurse practitioner is something different. Some of them can prescribe, some of them cannot. Um

56:30with therapists generally, they cannot prescribe. Right? But again, we're not talking about well,

56:36we just got to get the actual assessment done first so you know what you're dealing with. And I

56:42do find that this is a big roadblock. Here's what I will tell you about any provider that you see to

56:49save you time, to save you heartache, one of the most important things that I tell anybody who's

56:54starting this process is look up the provider ahead of time. Look at their reviews. Look at

57:00what they treat. look at all these things because it it's unbelievable how strongly some people feel

57:10about ADHD. Some people are completely unwilling to even address it. And so it it gets to be really

57:17difficult when you're going into an evaluation and it's hard to even get that evaluation from them.

57:23And so I think that the people who really enjoy treating ADHD, looking at ADHD, evaluating ADHD,

57:31they put it pretty prominently on their information. So I think that's important. You

57:36can look at reviews. You can get word of mouth and you honestly you deserve that. You deserve

57:42a good assessment that is personalized for you, right? And you're worth that. Yeah. Step three.

57:48Step three, discuss options. And there's lots of options on that board. Medication,

57:56therapy, coaching, tools, systems. Let's talk about the options. Yeah. A lot of people,

58:00they immediately think if I have ADHD, I'm going to be put on aderall and that's going to

58:06be that's what's going to happen. No. So, let's go through some of the different options. Number one,

58:14if you're looking at ADHD management, there is medication and there's non-medication. So,

58:20let's start with the medication side of things. Medication broken up into two big classes. There

58:25are stimulants and there are non-stimulants. Stimulants, the stuff you've heard about, Aderal,

58:30RI, Vivian, those are all in that stimulant class of medications. They work in two different ways.

58:36One is to help with alertness and to fight off those sleepiness. And two is to point towards

58:44reward. There was a beautiful Washington University study that was done on this

58:48just like Christmas of 2025, so it's relatively recent. But stimulants, the the issue with them,

58:56number one, they're controlled substances. So that gets a little weird. But number two,

59:01it's you can't stimulate a person 24 hours a day. Like you got to eat, you got to sleep,

59:07you got to do normal human functioning things. So even the long acting stimulants really you're

59:12getting about 6 to 8 hours of coverage if that usually it's 4 to 6 hours short acting 2 to four

59:17hours. So you're getting these like tall peaks of coverage where it's okay I feel like I am

59:25completely regulated at this point but it crashes down pretty quickly that you move next into the

59:32non-stimulant class of medications. So stimulants are one side. Non-stimulants, non-stimulants,

59:38you those are generally agents that work on a couple of different things. There's some that

59:44are anti-depressants, so they help with anxiety and depression at the same time. There's some

59:48that are blood pressure medications. There all these different types of medications that have

59:54multiple usages. And the thing that I generally like about non-stimulants is that a lot of times

1:00:02it's 24-hour acting, which people don't know about because a lot of times they're like, "Oh,

1:00:07if I have ADHD, I'm going to have to be started on this medication, which I'm going to hate."

1:00:11Non-stimulants, you're not going to have this 2 hours of coverage. You're going to get a 24-hour

1:00:17uh What are the names of non-stimulants? So, guanosine is one. Stratera is one. One

1:00:23you might have heard of is Wellbutrin. that's a non-stimulant for ADHD. So,

1:00:28there's there's lots of different agents that you could potentially think about adding that

1:00:35give you full coverage that possibly cover more than just the attention component that you know

1:00:43don't crash you down in two hours and instead just kind of raise that baseline. So, they're they're

1:00:48beautiful agents. It really depends on what you need. If the person who's listening is thinking,

1:00:56I am really resistant to the medication because I'm concerned about the side effects. Y if they

1:01:03were a patient in your practice, like what do you say to a patient in your practice when somebody

1:01:08raises that concern? Then don't do medication. So, if you if I explain exactly how those medications

1:01:14work and what they're what the intended effect and what the side effects are and and how to get

1:01:20on them, also how to get off of them. If I'm giving you all that information, you're like,

1:01:24"No, thank you." Like, I don't want that. That is a perfectly reasonable choice. We go based

1:01:31on what you feel ready for. It's not my job to push medication on you. It's not my job to get

1:01:37you there sooner. Like, do the tools. the tools are going to help you anyway. So, what are the

1:01:42top tools if you're dealing with ADHD? Yeah. And that diagnosis that are the most effective place

1:01:51to start. It can sometimes be really nebulous and hard to figure out exactly where to start, what

1:01:57lever to pull. That's when I think a therapist can come in very very very handy because they

1:02:03are able to take that data from your patterns, synthesize it, figure out where the holes are,

1:02:09and then figure out how to optimize and approach that. And I'll tell you from my own experience,

1:02:15I really started to drill down and work on the therapy side of things and what are the skills,

1:02:21what are the tools, how can I explore my own behavior so I can figure out what to fix. And

1:02:26that I think was lifechanging. What is the fourth step if you think you have ADHD? Okay, step four.

1:02:37Use trusted resources while you wait. I think this is important because I think a lot of

1:02:44getting assessed, it can take a while. It can take a long time and I if it happens, right? I mean,

1:02:51there's some people that don't have access to it. And so I feel like in that interim learning and

1:02:59exploring your own internal environment and also relying on resources that you know are reputable

1:03:05that are going to help you that aren't just some random person on the internet that's talking like

1:03:09you want to get information from things like journal articles or news like and again some

1:03:18news so newspapers that site journal articles. Well, I actually this is one of the things I

1:03:23appreciate about you that you put a lot of content online. Yeah. And so if you're having trouble

1:03:31uh gaining access and you are in the waiting game Mhm. following somebody like you Mhm. a medical

1:03:41doctor who's talking about this, who lives with this, that's a way for you to learn more and to

1:03:47understand that this is not a deficiency in you. this is something you are just going to learn

1:03:53more about and there are tools that you can use while you're waiting and you can learn more and

1:03:58become smarter about this while you're figuring it out and that's the whole point and that's why

1:04:03I actually wanted you here because you do put out a lot of content for somebody that's listening and

1:04:11um is thinking well this is definitely me but I'm now 40 50 60 it's it's just too late what

1:04:20What would you say? If I had 10 minutes left in my life, I would want to know if I had ADHD. Why?

1:04:30Because I want to understand my brain. I want I don't think it's ever too late to understand your

1:04:36brain. I just want to know. For me, going through that ADHD experience, I know firsthand how it

1:04:43feels to have that guilt and that shame compounded at every single thing. And for me to analyze every

1:04:51turn I've made and to think about it and where did I go wrong and what was happening and how could I

1:04:56have done it better to know that you I did do my best. This was a neurological phenomenon

1:05:04that was underlying all of this that was making it difficult. Like you still did a great job. You got

1:05:09through this. You built on this. I I want other people to feel that. I do too. Yeah. Dr. Hamdani,

1:05:20what are your parting words? It's never too late to understand your brain. I am so grateful that

1:05:31you're here. Thank you for having me. I cannot believe how much I learned today that I did

1:05:37not know. I feel more confident. I feel like I understand myself so much better. This episode

1:05:47is an extraordinary gift that you just gave us because we got to sit down in a private session

1:05:56one- on-one with a psychiatrist as renowned and as passionate and committed as you are.

1:06:05And I appreciate the accessible and realistic way that you talked about what to do next and what to

1:06:14do while you wait and while you figure this out. And so just from the bottom of my heart and from

1:06:20people all around the world that you will never meet whose lives will be forever changed because

1:06:24of what you shared with us today. Thank you. Thank you for having me. And thank you. Thank

1:06:32you for making the time to learn about ADHD. I hope you share this with people that you care

1:06:40about. This is a conversation that is for all of us. And these tools that we discussed today

1:06:46are things you can start to implement in your life or the lives of people that you love immediately.

1:06:51And in case no one else tells you, I wanted to be sure to tell you as your friend that I love

1:06:55you and I believe in you and I believe in your ability to create a better life. I cannot wait

1:07:00to see your comments. I can't wait to see this shared around the world. So, [music] thank you,

1:07:05thank you, thank you. I'm going to welcome you in to the very next episode the moment

1:07:09you hit play. I'll see you there. Thank you for watching all the way to the end here on

1:07:13YouTube. And if you're asking yourself, "Okay, what should I watch next?" You're

1:07:16going to love this video and I'll welcome you in [music] the moment you hit play.