ADHD Medication Shortages with Neurodivergent Pharmacist Priyanka Patel

Look who's back! The LEGENDARY Priyanka Patel returns to share her perspective as a Pharmacist with ADHD on the ADHD Medication shortage and Diagnosis crisis. Alongside some nostalgia from her previous ADHDAF Interview (listen HERE) and some of the ridiculousness in between! It's so interesting to see how much has changed for @littlemiss_adhd_ in the last 18months since she was last on... and hearing all about her upcoming book... SO EXCITED TO READ IT!   Thank you so much Priyanka for sharing your expertise and experiences to help raise ADHD Awareness and support the Neurodivergent Community! 
PS... don't mess with us! ;) xx

Trigger Warning: mentions of triggering topics including: depression, anxiety, ED, alcoholism, addiction, mental health struggles, suicide, suicidal ideation, mysogyny, internalised mysogyny, exploitation, ableism racism, societal pressures, cultural pressures, medical negligence, 
Also contains swearing. 

If you are in need of support YOU ARE NOT ALONE! There is immediate help out there so please REACH OUT
Search the ADHD Medication Directory if you are struggling to access medication during the national medication shortage HERE

Please sponsor Rosie, Darren and all the other LEGENDS cycling from London to Amsterdam in September to raise funds for ADHDadultUK and ADHD Liberty HERE

Apply to be part of ADHDAF Emporium: an online marketplace championing neurodivergent makers and small creative businesses HERE
Browse the first few handmade items by neurodivergent creatives HERE and read the blog about our first festival HERE

You can support the continuation of this podcast and connect with literally like-minded legends in the Patreon Peer Support Community
Thank you to the Members for keeping this podcast going for over 2 years!

If you've enjoyed this episode, please share it with others who would benefit from hearing; hit those stars, or write a review. All help others gain the information and validation shared amidst a global ADHD diagnosis crisis and ADHD medication shortage. 
We are all in this together.
LEOPARD PRINT ARMY! 

Transcript

 Now, anyone who has listened to your previous ADHD AF interview will know the answers to the question that I usually ask. So if you've not already listened, Priyanka was season one, episode 46, celebrating neurodiversity, which literally feels like a lifetime ago. Doesn't it? I got it, I know, I don't even know how long ago that was.

Ages ago. I think it was March 23, something like that. In it, your dog farted, which is one of the funniest things that's ever happened on the podcast. Gross. Oh my god, that's so funny! You left us with some very kind words when you said that your platform was inspired by ours. Yeah, I bludged my eyes out.

You're  not a dry eye in the house, we bludged our eyes out too. So thank you so much for coming back. You're correct, thank you so much for having me back. Not at all, I'd have you back every bloody week. 

Though blatantly obvious, the late Discovery diagnosed us and treatment at 38 for severe combined type ADHD in 2022. Not only improved, but genuinely.  Life, which I have since dedicated to fighting for change amidst the global ADHD crisis. As the acronym suggests, I swear like a sailor. And each episode will contain sensitive subject matter.

So please always read the description before diving in, where you will also find a link to resources for support. These crucial conversations with experts by lived experience are shared to inform, validate, shame, eradicate, and unite people. The ADHD community with a fair few laughs along the way. I've been labeled too much all my life but finally I celebrate my too muchness and use my justice sensitivity to let the world know that ADHD presents differently in each individual.

Self diagnosis is valid and that ADHD is not a trend. ADHD is real and I want all ADHDers of all genders to know you are not alone.  The leopard is a symbol of Aberdeen, Scotland, where this podcast began. It also symbolises bravery, the reclaiming of power, and I'm a total hun. So leopard printners become the uniform of the ADHD AF community, uniting to support each other and push for change, which together, we can make happen.

We are the leopard printners. Print Army, hear us raw.  Hi, I'm Laura and I am A-D-H-D-A-F-A-D. 

So we're gonna attempt quickfire. I don't fancy our chances, but let's give it a go. Name Brianca Patel.  Pronouns. She, her. Star sign. My sun sign is Scorpio.  I am a cancer rising. I'm a Leo moon. Location. Manchester. Occupation. Mental health pharmacist slash teacher practitioner. And social media content creator,  person, I don't know.

And, and author.  Potential author. Going to be  authoring, yeah.  Yes, me too. I'm with you. I've been writing the book so many times. It's actually changing to four different books at this point Oh my god, I know. I know I literally have about 10 potential book ideas that have come from this one book  Apparently that's what publishers like though.

So one day  Yeah, I mean someone does reply to me. That'd be nice. Yeah, that would be  What's your instagram handle little miss underscore ahd underscore Wonderful and your favorite film the heat Oh, I don't think They go with Sandra Bullock and Melissa McCarthy. Yes. Oh my god, that film literally is just, it's so good.

Favourite animal? Do you know what? I really like lionesses. I like lionesses. Yes. Yeah. That'll be the Leo in you.  Planning, love it or loathe it? Loathe? Is that even a question? Well, some people love it. Not me, but yeah. Oh god, no. No.  So your ADHD diagnosis status? Um, yeah. Diagnosed. Combined ADHD. Yeah. Early or late?

Late.  And was it easy or traumatic?  traumatic. Tell the listeners a bit about your platform and all of the work that you do. I got diagnosed with ADHD end of 2022. So I was 27. And the reason why I ended up thinking, Oh, do I have ADHD was actually because of a TikTok video. So that is what led me to go and do loads of research for like months and months.

I was, because I work as a pharmacist, I know what resources and information is like accurate. And, you know, appropriate to you. So I knew that I was looking at resources that were correct. I also spoke to some consultants kind of like on an informal sort of basis as well from work, just to kind of get a gauge of things.

And I was very certain that I was showing symptoms of ADHD. But then, as I think a lot of, particularly women as well, um, I probably can relate to is there was a lot of dismissal. I think I, it was my fourth GP that actually finally listened to me. And it was because I was just, like, having a huge meltdown.

I was like, I'm not leaving until you refer me, because if you don't refer me, you need to tell me why. So finally, she did refer me. And then, again, a very traumatic process in trying to get the diagnosis. Um, ended up getting diagnosed, and then I thought, you know what, that one video changed my life. You know, if I hadn't seen that one video, I don't even know if I would have been diagnosed by now.

And, you know, that's what led me to then make some of these videos on TikTok and stuff. So, you know, I didn't intend to actually try and build up a platform. That wasn't my, my initial goal. I was just making videos because I thought, you know what, someone might see it and it might help someone, you know?

And, um, then I thought, Oh, I'm a pharmacist. You know, I might be able to help people with some, some other like clinical, you know, medical information. So they can understand things in a way that. When you're neurodiverse, you know, we kind of communicate and understand things in a different way. So for me to be able to actually, you know, give out information in a way that, you know, people like me can understand, I thought that would just be great.

Uh, next thing you know, it's just blown up and um, I didn't really know how to handle it because you know, there were it was overwhelming but in a good way like I had people messaging me telling me like what a difference I'd made and how much help it was just amazing to know that I like, you know, little me was there doing something to, to help, like, even just one person would have, like, I would have been happy.

But to know that there was, you know, so many people who were finding it beneficial, that's what then made me want to just continue. Thanks to you and Dawn, of God knows how long ago, you know, I listened to your podcast when it was just, you know, in the ground. You know, it was very new then. And, you know,  I was listening to both of you before I'd even tried to seek diagnosis, you know, cause I thought it'd be nice just to listen.

And I remember I was just like, Oh my God, I love these two. Like they're so relatable  and they just make me feel a little bit less messy. To, you know, be able to go on your guys podcast.  I sounded like a bit dramatic, but it's like, you know, when you meet your heroes  again, don't do that. They're really annoying.

Do not live up to expectations.  So yeah, kind of what's happened and, you know, it's led to some incredible opportunities like, you know, I've.  spoken at medical conferences, um, you know, I've pursued research and trying to help change some of the, the, you know, the treatment guidance for ADHD because you know what?

It was infuriating that when you look at everything to do with ADHD treatment and management, it's all based on clinical research that's all been done on little boys. And then they are, you know, giving that and using that information for fully grown women. And to me, it just did not make sense. We are not little men.

We are completely different biological.  I'm having a mind blank, but you know what I mean. Yeah, and I think it's so fantastic. We know that TikTok videos get a bad rep, you know, we can all make a joke and, and point at the things and hold up five fingers and there are things that can be, or that have been criticized as being kind of blasé or misleading, but your case exactly, it just goes to show that These are introducing you to the door to then walk through because we all know that you're going to hyper focus hard and do your own research and then, and then from there, potentially get diagnosed.

And we know that self diagnosis is also valid and it has to be when you look at the statistics. Eight years, the BBC said. in some places. I am literally in the last stages of completing my prescribing qualification. Amazing. So I can be a pharmacist prescriber and then I want to start taking on and leading an ADHD women's clinic.

If that doesn't work but I'm also trying to incorporate a clinic That has patients with both ADHD and mental health problems because that's such a big issue that ADHD and mental health issues are treated separately when they can't, you know, they influence each other so much. And if anything, um, in the guidance that the NHS use, it even says that a patient who has ADHD.

Any mental health conditions, you know, they should be screened for  ADHD because we don't see that, you know, so it's really important that we're able to kind of bridge the two so I'm hoping once I get my prescriber qualification that I'll be able to do that because it's just I just, I just really, really want to help people like, like myself, but then also people that just, we feel so misunderstood.

And I know, personally, if I was there with a clinician that, you know, had the condition, first time knows it, understands it, has the clinical knowledge and expertise to help me, to me, I'd be like, don't leave me. Yeah, yeah, yeah, yeah.  It's so funny to hear you say when you're like, you know little old me because you are an absolute fucking badass I really wanna I'm gonna tell the story.

We're gonna tell the ridiculous story  But we're not gonna name names because we probably get it You know, it's so funny the other day. I was thinking about it What happened to that? Like, nothing happened! We got screwed over by a major publication. But Priyanka went full hardcore like Powerpuff Girls on them.

And suffice to say, a documentary which was released on this major platform, whose name we shall not mention, in which we were literally pitted against each other, as if we were enemies, having just literally spoken to you and actually friends. And not to mention that, when they decided to say that I was a pharmacist, they just so happened to put a video of me dancing and twerking. 

They literally made us look like fools, because they said about me, they've got a clip of me saying Yeah. Yeah, we don't really do TikTok and then use the clip from one TikTok video that I made once. It's just like, why do you hate us? Why are you trying to make us look bad? And then you had two clever men saying clever things while us hysterical women.

Oh yeah, sitting on their comfy chairs, like, you know, all official and oh god. It was so good though because Priyanka sorted them right out and after. Oh yeah, don't, don't, don't mess with me. You don't want to mess with ADHD anger, especially with me. I was contacting friends who were lawyers. I was picking apart the contract.

I was like, no, not on. And poor Nora, you were on holiday for your birthday. What happened was we just finished the Too Much tour, right? Literally just finished. And we were flying home. And that morning, the bloody, um, or the day before the ridiculous panorama came out. So that was like, so gut wrenching to finish the tour, having done so much. 

Smacked in the face with a panorama, get to the airport like, Oh it's out, it's out! Go to look at it and just, our jaws just dropped, I just started howling. I was crying my eyes out in like, whichever, I think it was Gatwick Airport, fly back to Aberdeen, having done this amazing like, 16 day tour, just like, well what was the fucking point?

Everything's fucked! And then you're just like, right, I'm on it, I've got a friend who's a Honestly,  I was not having any of it. Like you were so stressed and I was like leave it with me  Like no, I I cannot like I can't go to the to the post office to post this off and the thought Of having to make myself breakfast makes me want to pull my skin off But if you want me to sit there for hours contacting lawyers and picking apart a legal contract  Oh, you smashed it and you know what the poor guy actually felt sorry for him by the end of it It was just like you know You could have picked anyone to do this to, and you were fucked with the wrong people.

I don't even think he knew that we knew each other. It's just like, you're a dick. No, he wasn't a dick. He was a nice man. He just, it was a really dick move. And in hindsight, I genuinely don't think he realized what he'd done.  Yeah, I think he was a bit  I don't even know if ignorant is the right way. I think he just really wasn't, I don't think, you know, when you're just so, um,  kind of conditioned to certain things.

Yeah, like privilege and entitlement. He's just so in, he just had no Probably didn't realize. Um, you know, but yeah, I, like I said, it was, but yeah, nothing ever happened of that. Nothing. I completely forgot about it and I remember, you know, when you just randomly think about things, I remember I was sitting there washing up and then I was like, Yeah.

Oh my god, whatever happened to that? Why did everyone do that documentary? It's so funny because we had two doc people come to approach us about documentaries and neither of them came to fruition and it was quite, um, what's the word? Like demoralising. Because you're like, I didn't even fucking ask for this.

You put this on my plate. You got me all excited and then what happened? I know, there's been three occasions where I've put so much effort and time into, you know, doing an interview. It's so funny. And then it just doesn't go. So now I'm like, I'm not, I'm just not doing any of these things unless it's like something that can assure me that this is going to get in production stuff, because, you know, it's, it's not nice because it also, then we're so used to our voices being muted and, you know, not listened to.

And that just. further, you know, just adds to it. And, you know, the RSD and it was like, Oh my God, why don't they want me on there? It's such a funny thing though, isn't it? Because that's the whole point. Like in everything here on ADHD AF, I always wanted. To unite community on all levels. So the people that are on the podcast to their followers, to connect with all the followers, because that's the point is we're stronger together.

So I just love it. It was just like, no, you idiot. Like we're in this together. We're actually,  but anyway, as much as I wouldn't ever want anyone else to be in that position with me, it was nice that it wasn't, we went alone and like all three of us were just like, It's like, what is this? And the funniest thing was, I was taught, as ever, talking so fucking much, and then I was cut for most of it, it's just like I barely said two words, it's just like, you literally don't want me to say anything, do you?

There was a film for maybe, there was about at least an hour and a half worth of footage.  And I spoke at least half an hour about all the research I was doing. Did that get put in? But here she is twerking. Yeah, that was put in. Oh my god, I think we could just sit here and rant and rave about that. But we shouldn't, let's move on.

I have asked you this previously, but I'm intrigued to hear if 19 months on it's any different. So as we said, self diagnosis is valid, but one of the main points of this podcast is to push for systemic change so that we can access life changing diagnosis and treatment. Now, obviously you've said you want to be a prescriber, you want to start this place where people can be assessed for both because mental health conditions go hand in hand, but if you could look at, say, the NHS system as it is right now with all of these people waiting and you could just wave a magic wand right now and money wasn't an option, what would you do?

What do you think would be the most? Straightforward way to shorten these queues and get people the help they need.  So before I start and, you know, kind of speak about my recommendations or, you know, some insights to do with ADHD services, NHS, you know, my role as a pharmacist, etc, this is purely just meant to be for medical information purposes.

Um, please do not take anything I say as sort of direct medical advice. Uh, sometimes when I do speak, um, I might insinuate or suggest things, but it's just because. You probably understand, but the ADHD brain, your mouth doesn't catch up with your head. So sometimes And you're passionate AF. Yes, I'm passionate, I know.

And to be honest, I also know I'm right. But I have to make sure that I protect myself. So, guys Please don't take any of my advice as a direct  suggestion.  And if there is something that you want to do, then make sure you speak to someone appropriate. Okay. Because I'm not the person or the clinician that's involved in your care.

You know, I don't have any of the information to say with certainty. this is safe for you to do, this is accurate for you to do.  Um, but suggestions like what I've, you know, um, in terms of trying to navigate the, the NHS process and trying to find routes and stuff, you know, that can be taken as advice, but when it comes to actual direct medical care,  Just take it with a pinch of salt.

This is just for information just to help you understand. Um, but go to your clinician if there's anything you wanna do. 'cause they're, they're the person who has to do it, not me. Please don't  . So I firstly think one of the biggest issues is that there is not enough funding towards. secondary care ADHD services.

Um, they just do not have enough consultants, enough staff. So whilst they're, these weights are ridiculous, I first hand seen how hard they are working. And also because it's such a complex condition, and there's so much that needs to be done when it goes through the assessment, like an a proper thorough assessment takes at least To consultations, you know, and that's not even including all of the other stuff that needs to be done by the consultant, you know, so they're working their socks off, um, you know, and they can't do anything more.

So the, the, the issue is like, I think we are at a stage now where we are starting to see some really great change with getting these referrals done now. It's not, I think, compared to perhaps when it was like two, three years ago, when it was a lot harder, we are seeing. You know, greater awareness, particularly with identifying someone who needs to be referred. 

But, it's like, what do you do when, you know, everyone's just, it's like for example, you know, I don't know if, like, imagine everyone's trying to get through like one lane, right, and then it's like ten lanes all trying to merge in, you know, the more lanes you add to it, like, the more congested it's going to get, and everyone's trying to get into that one lane, you know, um, but that one lane can't get through.

Can't get bigger. They, you know, they can't do anything with that lane. So that's the situation we're in. So what do we do about all of this congestion going on here? So I personally think what is going to be, I think, helpful is they need to start, um, within GPs because they have other clinicians that are specialists with like diabetes or health or asthma, you know, um, Um, they could be nurses, pharmacists, other doctors, whatever, they need to start, um, getting, uh, more clinicians that are specialised in ADHD and training them up.

So these could be psychologists, they could be nurses, even pharmacists as well. And I think what they should be able to do is to be able to run through, um, because before you, um, actually get to the assessment, they ask you to fill out this questionnaire, right? Okay. Um, so they should be able to do that questionnaire with you, or you're able to do that questionnaire with them.

And they should have the expertise to kind of say whether or not this is something that warrants a referral or specialist investigation.  Because that would then cut out a lot of patients, because everyone who's being referred,  is being referred by a GP who doesn't always or necessarily have the, you know, the specialist knowledge to know if this is definitely something that would warrant ADHD.

This isn't to put GPs down or anything like that, like they have to learn and know about so many things as a GP.  Um, you know, the fact that there was a specialist consultant and you have to do specialist training to specialize in ADHD treatment, you know, it's um, you know, there was a different type of training that needs to be done.

So to have clinicians that are specialized in that I think would help. Plus, they would know exactly what to put on the referral, the amount of time wasted from when, you know, the consultants go back to the GPs and they're like this isn't it, that isn't it, you're missing this, we need more information, you know, That would cut out so much faff, and it would just make communication so much easier, and, you know,  they would know exactly what to put down, and what to send.

Do you not think, is there an argument for just training the GPs?  No, I don't think so. No?  They already have so much on their plate. They have so much to do. They like, there is a lot that GPs need to, um, kind of do within their role as a GP, which is why in the last five years, you know, you're probably noticing that when you do go to the GP, sometimes you see a nurse or you see a pharmacist.

You know, you don't always see a GP and it's because they're trying to lessen the load on GPs and trying to utilize the skills of other clinicians, you know, and that's a great way for the NHS to work. All four, and it's called multi, multidisciplinary  teams or something like that, you know. Um, just because you're not seeing a GP doesn't mean that whoever you're seeing isn't qualified to help you.

Um, so I think GPs already have so much on their plate, but if they also do want to take it on, that's entirely up to them. But realistically, you're not going to have every single GP be willing to do that. Um, but also the reason why I'm suggesting you should have more specialists to do this is because whilst they then, whilst then the patient is waiting for that referral, right?

Um, So you have a bit of clarity. Now this is where it gets a bit sticky because  On one hand, you know, it's, is it an official first diagnosis  or is it an indication or like, because there's always going to be a chance that when the consultant actually does the assessment, even if that's, um, you know, trained psychologists in ADHD thought the patient had ADHD, they don't end up being diagnosed and it could lead to a lot of confusion for the patient.

So I think. you know, very important to kind of, you know, if this ever does happen is to say to the patient, like, your symptoms do indicate, but we need to do thorough investigations, you know, and rule out a lot of things. So this isn't to say you definitely are going to be diagnosed with ADHD, but your symptoms are appropriate to warrant a referral.

And then whilst that patient is waiting for that consultant, this psychologist, or this pharmacist, or nurse, Someone should work with them on helping them with sort of therapies, with sort of implemented techniques, with looking at their medications to seeing, is there anything that's making their ADHD worse?

Or is there anything, like there are certain antidepressants that are better suited for people with ADHD.  So it's all about trying to create a holistic plan for this patient, because even, you know, I don't know, like, um, you know, For those who take medication, like, you know, I take medication, and it is great, but it's not a magic cure, you know?

It doesn't, it doesn't take away my, um, crazy mood swings, you know? It doesn't take away the, you know, when my brain just decides to just be like, okay, no, we're not doing anything. Or, you know, you know what I mean? Or forgetfulness, things like that. It's medication has to be there to be used as a tool. Just think of it as like a walking stick.

Right. Yeah. So it's helpful, but it's not, you know, I think a lot of people go to getting a diagnosis with the assumption that, okay, I'm going to get medication. It's going to sort everything out. Whilst it is very helpful. You know, we, we need to start implementing so many techniques ourselves from the start, because it's, it's about.

It's a different, we have to find a different way to live our lives.  ADHD isn't going to go away, no matter how much you try, it's not going to go away. And no matter how many, you know, types of medication you use and it's, it's something that you just have to learn to live with. And I don't think the, um, cause the ADHD services are so swarmed and so overwhelmed.

They don't have the capacity to even help patients with that. Most of the time, what they'll do is they'll do the thorough assessment. They'll, you know, ask you if you want to go medication and they'll titrate you up when you're stabilized. All right, good. You're good to go. I'll start up. Yeah. Yeah. That's, that's not what they should be doing.

Um, Um, but they, that's all that they are able to do because of how much work that they've got, how many patients they've got to see. They just don't have the time. So they're just doing all the essential things. So this is where someone in primary care can help, you know, someone who specializes, you know, even like an ADHD coach who was also a psychologist or a trained clinician,  you know, to be able to help that person that, you know, if they did have ADHD. 

Why don't we try some of this? Why don't we try some of that? Any, any kind of coping mechanisms, any kind of lifestyle changes that you recommend to someone with ADHD is beneficial to everyone, no matter what. So, even if you don't end up being diagnosed with ADHD, it's still going to help. You know, every kind of  Anything you suggest to help someone with ADHD just to make their life, you know, it's not, it's not a luxury for us to have things a bit easier or simpler, it's a necessity for us, but it's a luxury for other people.

So, you know, there's no harm done, if anything, that's the way it is.  So, you know, that's what they could do. And this also helps with the painful stage of limbo when you're waiting to hear from that consultant  And, you know, that can go, like you said, can go up to eight years in some places, like, which is, by the way, just insane.

Absolutely insane. That is, that, I don't understand how that is happening. But this helps that patient because at least there's someone helping them in some sort of way.  left to defend by themselves and struggle and, you know, this clinician can help explain this. And with false hope about the medication as well, that that's it, you take this, when even in the, in the, oh god, I can't even think of the words falling out of my head, in the instructions, in the medication pamphlet, whatever you want to call it, it says that it should be working together. 

With strategies, with support, and medication. It's not one or the other, it should be both. They're meant to be working hand in hand. You know, yeah, and that's how all of, um, treatment is if you think about it. Like, if you look at other health conditions, like diabetes, or like, um, even mental health, right?

They always, um, Um, put forward suggestions in terms of your lifestyle choices. For example, diet and eating, they'll always, you know, besides if you are on medication, they'll still tell you, work on your diet, exercise, you know, with mental health, go to therapy, try doing exercise. Yeah, so. Why are we not doing that and using those same messages with ADHD?

I feel there's a lot of focus and importance being put on medication as the only option, but there are actually people out there who manage to read ADHD without medication as well, because the condition's on the spectrum, you know? Yes, of course. So it's different for every single person, but this, you know, a potential clinician, this made up goddess who is probably going to solve everything in my world,  how can you do that?

They're just, they're, they're like a sort of ADHD guru to kind of help you. figure out what is this condition, what can I do now, because either way when you get put on medication you are still going to have to implement these changes, you know, like, and that's one of the hardest things that you have to come to realize and, you know, even being a pharmacist and being in the medical field and stuff, like, that wasn't something that I was aware of until I had to like, halfway, when I was like, why is this medication not doing everything I thought it would?

Um. Um, you know, so it's, it's like you're utilizing that time whilst you're waiting because there are things that can help with your ADHD symptoms. And the way that this, I think, would also be beneficial is because this might then lead to some patients who then realize, actually,  I just needed help with navigating it and I don't need medication, you know? 

And it would help them just be a lot more like, you know, kind of motivating and promoting them to take care of their condition and themselves and not let this condition define them and kind of take over their life, you know? It's about actually changing your lifestyle and live in accordance with it. So, you know, that's what they would do.

They would help, you know, ideally with the medication switching and things like that. And that's how they would make it easier. Um, and then the next thing is like when you get to secondary care, you know, that's where I think, you know, hopefully clinicians like myself who are like pharmacist prescribers, nurse prescribers, you know, have a lot more of them trained up.

to be specializing in ADHD. Um, and then what they're able to do is they're able to take over the titration because the consultant I think is probably the best person to do the diagnosis. And there are like advanced practitioner pharmacists and nurses who also might be skilled to do that. But when we are looking kind of in the short term, it takes a lot of training to get to that stage as well.

And so the consultant would be the one to do the assessments to do the diagnosis.  But then to save their expertise and time, that, that, when, if the patient decides to go on medication, that can then be given to a different clinician, like a nurse or a pharmacist. And pharmacists, we are experts in medicines, so it makes sense to have us help with the titration.

You know, we're the ones who, we can look at the rest of your medicines. Yeah. And see, How it interacts because even though there might not be direct interactions with some of them, you know It is going to still you know impact you and then we also need to look at things of like diet Are there any particular supplements or you know things like that?

Like a pharmacist will be able to give you that information tell you about the  pharmacokinetics and know if there's going to be something that impacts you. Like for example, with women, right? We metabolize longer acting forms of ADHD medicines faster than men. And I am living proof of it as well, because I'm on L Vance and it, it wears off at like 2 PM for me all the time.

So I take L Vance and then I take a top up. I'm short acting in the afternoon and that works amazing for me. And that's what, you know, you want to be able to have a clinician to do. And, you know, I was the one who actually proposed that to my consultant. And I was like, look, I want you to try this. Here are the clinical papers that support it.

Here is the interaction. This is the dose. You know, because I did all my research. But this is what I'm saying, and this is why you want to have, um, You know, I'm not saying that pharmacists are better than consultants in any way. I'm just saying that you might as well utilize other clinicians. Yes, absolutely.

Yeah, and so that then would ease a lot of the time from the consultant. Yeah. Then they can do more diagnoses, take on more patients. But then once the patient has got their diagnosis, if they're stabilizing medicines, you know, when they go back to secondary care, then we've got that ADHD  guru. Yeah, and then she does the follow up, you know, she helps and she basically will do the monitoring So then, you know a lot of GPs.

This is the issue that we have as well sometimes So when you get stabilized on any sort of medication or treatment in secondary care Regardless of what department it is, it could be respiratory, cardiac, you know, then we got ADHD.  Whoever has started that medication is obviously responsible for the prescribing and stuff.

Yes. But to make it easier for the patients, they opt to doing something called shared care. And that's where they ask the GP very nicely, can you take over the prescribing for me? Because this, and basically to say to them, look, it's safe. I'm happy with this dose, you know, I'm going to review this patient in six months or every year or whatever, and then it just makes it a lot easier for the patient to get that medication because they can just get it at the pharmacy instead of having to trek all the way to that hospital every single month.

to go pick up a prescription, you know, so it is a really great way, but there's a lot of, um, issues, I think, with when it comes to shared care and it really does depend on your GP. Completely. That panorama documentary, oh my god, I'm still livid because it caused so many problems. There's so many.

Absolutely. refused to do shared care if the diagnosis and medication was done by a private clinic. Yes. Um, you know, and some, most of them were just like, we won't do it unless it's done by an NHS consultant and it causes so many issues. And, you know, I don't know exactly  what, you know, I can't speak and say what is the situation right now with shared care, because it really does depend.

Um, but I am in the position right now where, so I had to titrate on LVANs. Because the medication I initially was on wasn't working well. So now that I'm titrated on L balance and stable, I'm now in the process of being transferred to shared care. So I'm really hoping that my GP is going to be okay with it.

So I think they should be fine because they agreed to do the first medication. But, um, because of the treatment that I'm on, And it's two different medicines, and you know, there's a lot of PRN stimulants, you know.  But we'll, we'll see, fingers crossed. That's probably the best, most detailed answer to that question I've ever had, so thank you very much.

And it's very different to what you said last time, which, as I recall, was something like, you wanted a really fun waiting room. Do you remember? I still want that! I still want that!  That's essential.  This is a bit more practical. I've been able to put on, like, my actual logical hat instead of living in my fantasy dream world.

I still want that fun waiting room with  abacuses and, like, squidgy balls.  I thought there were sweets as well. I seem to remember there were sweets. But, there is a question I want to ask you. Well, there's loads of questions I want to ask you. But, obviously, as you rightly pointed out, Some GPs will not take the diagnosis from private psychiatrists.

You've, you've talked a lot in your Ideal World description about how it takes a long time. It is a lengthy process because there's lots of tests that need to be done. Now obviously the argument of some of the GPs is that the private assessments are not to the same standard. It is easier because there's less time put into it.

Now for me I was one of those easier diagnosis, but like, I am ADHD AF. The thing is, I don't like the whole trying to, you know, the cancel culture of ADHD private clinics. Yeah. I think it's so, so unfair, and it's just very hypocritical, because that, on one part you're saying, oh this is all for patient safety, and this and that, but then it's like, But what are you going to do about it?

Right. There's just, basically there's something called right to choose. Um, you, are you familiar with right to choose? Yeah, yeah, yeah, yeah. But please carry on in case anybody else isn't. Yeah. So for those who aren't familiar with what right to choose is, um, it is, I don't know if it's like a service or whatever, but basically when you go to your GP and they need to refer you to something specialist, secondary care, if there are, you know, it's just too long with the NHS or they don't have the capacity.

The NHS. you know, provides funding to some of these private clinics. So this is authorized by the NHS. So what's happening is there, for example, are two ADHD providers called Psychiatry UK, ADHD 360, which are on right to choose, which means they have been approved providers by the NHS. Yes. So if you're then as a GP going to refer your patient to a right to choose specialist private clinic, But then you're not going to accept that diagnosis.

How is that fair? The reason why loads of people are opting for private is because the NHS is overwhelmed. Yeah, exactly.  This is a solution for that. But then. You know, you can't just you have to follow it through, you know, um and people as well I guarantee you that no one in their right mind is going to pay nearly two grand For an adh assessment if they really don't think they have it and that's why when for example people look at private  Centers and their you know diagnosis rates and they're like, oh it's so high it's because these patients And if you understood ADHD, then you would, then you would get it, right?

When someone with ADHD has got their mind fixed on something, like being diagnosed with a condition, we become experts in it, right? We understand everything. When I tell you that, like, it's just insane. And every single person with ADHD will tell you this, right before they decided to ask for a referral, they have done a deep dive, right?

They were, you know, reading that book, reading that article, and this is the book on it. This is the book on it. Before you people come through the door, absolutely. Yeah, so if there is anyone who you want to kind of see as if what they're asking for is actually valid or, you know, justified, someone with ADHD, yes, you know, we are the ones that are going to go down that rabbit hole of the hyperfocus and, you know, we want to, we are, the way that our brains are, is that we want to understand, we want to know every little thing about this.

Why is that happening? What's led to that? What's led to this? You know, that's just the way our brains work. It's, there's no stopping. So, you know, that's why there was also is a high diagnosis rate with these private clinics, right? And it's very difficult because I think when you look at ADHD assessments as a whole, I guarantee you there are NHS consultants who are probably themselves doing subpar assessments.

I don't have any proof and I'm not saying this is true, but I'm saying I wouldn't be surprised. Are you telling me that every single NHS consultant who does an ADHD assessment is not going to make one mistake, or isn't going to do something wrong, you know, we're human beings, I've made mistakes as a pharmacist, you know, you're a human being, it happens, right.

And I think what's really important is for when the GP looks at these referrals or recommendations, to continue medication from these private assessments is to look at the quality of the diagnosis and the report. And that's what they look at instead of letting their prejudice against, you know, what they all, you know, if they have, um, they don't like private clinics or don't agree with them, have a look at the quality of the diagnosis,  right?

Like there was one diagnosis is that, um,  It's not my place to say how I saw this or whatever, so I'm not going to say it. But anyway, it was like a small paragraph. And I was just like, that is not acceptable. My diagnosis sheet was like three, four pages long. Right. That is something that it qualifies for a good, um, assessment.

Right.  I think a potential way around this is having a sort of system where if that is a GP or someone that isn't happy.  to have a consultant maybe just have a second opinion. So there's some big people called the CQC, right? They're the ones who regulate all of these medical establishments. They're the ones who they will do surprise visits, make sure that you're adhering to the NHS framework, make sure you're doing everything legally, correctly, safely.

All of these private clinics are also regulated, sorry I had a mind blank, they're also regulated by the CQC. So, if the CQC is happy with their service, with their standards, yeah, that's it, that's it, rating, like what difference does it make if it's an NHS or if it's private? If they're still giving good quality care that's clinically safe.

and accurate, what difference does it make that they're private? You know, so I think, you know, it is also about, it depends on the GP because some GPs who have been working in the field a very long time, you know, they practice in a very different way compared to some of the GPs now. I think we are seeing a lot more GPs that are very open minded.

at the moment, um, that aren't very dismissive. I think we are starting to see some really great GPs coming because of all of this awareness around, not just ADHD, but just about, you know, just healthcare in general and, you know, actually wanting to help the patient and not just be so black and white about this criteria.

We need to do it according to this and this person. It's a really tricky one, but I think personally if anyone is in a situation where their shared care has been rejected, there are GP surgeries everywhere, right? There's going to be someone that will take it. Just because if your GP decides that they aren't comfortable with this, you can also ask other GPs in that surgery.

But you need to find out. Sometimes it might be a surgery decision, it might just be a thing that they do in the surgery saying we don't accept private. Yeah. So it doesn't matter what GP you speak to, but there are other GPs out there that you can ring their reception, explain the situation. Not everyone is going to say no, but even if they say no, don't just accept it.

You're entitled to your continuation of care. And also if they say no, make sure you have it in writing to understand why, you know, and this is where you want to ask them, like, You, you know, and this is where, like, for example, all of the things I've been saying, you know, get all that information to them, give them the facts of the CQC rating for that clinic, tell them, like, you know, my diagnosis report, you know, it goes through ABC, this is the criteria for a diagnosis, they ruled out this, that, you know.

You will, when you are fuelled with ADHD rage and injustice, I know you guys can do it, so don't worry. But, um, you will find another GP that takes it, so, you know, don't lose heart over it because there is going to be someone, and I've also found that If you politely hassle, I don't know, politely hassle, sometimes you do get listened to and you know, because at the end, this is something my dad told me, you know, it's like people want an easy life.

If you're going to be there to make life difficult, they will do whatever it is to make their life easy and sometimes it might be giving into your needs, but take that with a pinch of salt, guys. I don't want you guys to be doing like unethical things out there. I'm saying to do.  in terms of advocating for yourself.

Yes, absolutely. Do you know what though? Like,  I'm just absolutely astounded. And I mean, I don't know why because obviously it makes sense. It's like you were talking with the different lanes coming into the one lane, but we're still in the grips of this medication shortage. So what can you tell us as a pharmacist?

What do you know?  So it's very difficult because I have actually gone to the length of phoning up some of these pharmaceutical companies because,  you know, when you go, first of all, when you go to your pharmacy and you try and pick up the medication, first of all, please don't take You got frustrations out on them.

Okay, they are just the ones placing the order They do not make the medication at the back with cardboard boxes and tears Because they are just placing an order. If they could there'd be no shortages Like when I was working in community pharmacy because I used to be like, you know on the high street and stuff You would be so shocked the amount of people that did not understand the concept of how a pharmacy works.

You know, we order it in, it gets delivered. It's like placing an order on an online shop, like, you know, and that's not too kind of, in a way that, that might like, kind of, you know, take away this, you know, this seriousness and, you know, the importance of medicines, but I'm just trying to help people understand the process.

So what happens is if the medication doesn't come in. We don't get told. So when you go in and ask your pharmacist or the pharmacy staff, why is this not in here, they don't know. And they generally do know because I've, as a pharmacist in community, I've even rung up the suppliers. Like, you know, from the whoever I got it from and they're like, we don't know they no one tells us the same patient So that's why you know, I can understand the frustration from a patient point of view and it's like how are you gonna help me?

You're just saying you don't know i'm not got my medication like you're completely entitled and it's justified your frustration, but the thing is, please try and see the other side as well, which is hard when you have ADHD, I guess. Well, it's don't, yeah, you're just the messenger effectively, and you don't even have the message to give because you don't know either.

Yeah, yeah, and your pharmacists are there to try and help you, and I guarantee you, if the medicine hasn't come in, they've been ringing around other suppliers. You know, they've been trying to find other alternatives in the background, so, you know, they are trying to do what they can, but if it doesn't come in, it doesn't come in, and there's nothing we can do.

So, you know, I then actually, like I said, went to the lens of trying to phone these companies, like, themselves, to the medical information department, and Again, that they can't even give me information as well. And this is coming from people who work at these factories and manufacturer  warehouses and stuff and There's a lot of different theories, but you know, it's it's a combination of a lot of things I think so First of all, you know when you have such an increase in the amount of people getting diagnosed and the amount of people getting prescribed medication  You've got that supply and demand issue, haven't you?

So, yes. Before, like, kind of the whole, you know, prevalence of ADHD went up, you know, these manufacturers, over time, they kind of got a feel of the supply and demand. Of how much you had to make. But then out of nowhere, it's all shot up and they're there trying to scramble everything, all the resources, money, stuff.

Like, you know, you have to also think about like, if you're going back there and trying to figure out what to do. Like, actually, a good example would be, I don't know if anyone's watched Big Bang Theory, but have you watched Big Bang Theory? You know that episode, the Penny Blossoms?  So basically, there's an episode where Penny is designed to make these little Penny Blossoms, like a little flower thing, right?

Um, you know, she's selling like one or two here and there to people that she knows, then all of a sudden, out of nowhere, um, you know, Sheldon and Leonard and them, you know, she wants some help to make it bigger and stuff, so they make her a website, and then out of nowhere she gets an order for ten, like a thousand Penny Blossoms, right?

So they're all scrambling around, you know, trying to work themselves to the bones and they end up doing a whole all nighter to do the, the penny blossoms to make the order count. When they get the same order the next day that, you know, I think they ended up cancelling it all because they just couldn't do it.

So, you know,  um, that is just a brilliant example to kind of understand. Yeah. They're trying to, you know, try and figure out how to manage this huge, you know, surplus of prescriptions. Yeah. And also, just because there is an increase in prescribing, doesn't mean that prescribers are prescribing these medicines inappropriately, and it really annoys me when they say that.

Because whenever you look at patterns of healthcare conditions, and you see the increase in prevalence of them, there's also going to be an increase in prescriptions, you know, it's just a pattern, and that's what happens. As soon as something is made aware that's what's going to happen. You'll see it with any sort of medication and medical condition, you know, those kinds of things are trained.

They are, they've got loads of  you know, expertise. They have done so much training.  I know, and it's on, it's on them as well, their registration that they drive something appropriately. So, you know, Anyone who gets prescribed ADHD medication, it's been done by someone qualified and appropriate, right? Just because there's an increase doesn't take it away from that, you know?

So there's, you know, you've got the impact of kind of the supply and demand of it. And then you've also got the issue, and it potentially could be to do with Brexit as well, about trying to get some of these, um, you know, I don't know how to explain it. So, excipients  and, you know, for having me. It makes it sound like we're building something but anything but anyways everything that you need to basically make these medicines, right? 

Brexit I think has probably caused a lot of issues with that because it's called problems with kind of importing exporting, you know We don't have um From what I understand, the same ease we're trying to get things from other countries, places, you know, so that's caused a lot of problems. That's caused an increase as well in a lot of prices.

And it's, you know, there's a lot of stuff that just happens in, in the background that we as patients and consumers have no idea what's going on. But, you know, those are two of the things that I think is happening. A perfect storm. Yeah. And then the other thing, which also makes it difficult is LVANs. is still under patent in England.

So for those who don't understand what a patent is, it's basically  a sort of kind of protective, like, you know, I'd like to say it's like a little protective label. Yeah. So, um, it basically means when you put a new drug on the market,  you can patent it, which means no other, manufacturing company, pharmaceutical company can make that medicine.

They it's, it's, it's legal if they do that. So this past year, that protect them. So that means that medicine is basically one of its own. You can only get it from that manufacturer only brand, and it ends up being very expensive. So that's what happens whenever a new medicine comes to market. Right. But then once that patent expires. 

Any company, any manufacturing company can make it and when they make it and you see the box and it just says the medication name and it's not a brand, those are called generic medicines. They are a lot cheaper to make, a lot cheaper to buy, but they are the same thing. It's just a brand compared to, you know, it's like, for example, buying Heinz ketchup and then, you know, Tesco own or whatever, you know, sometimes you can't really taste the difference.

I don't know, one might look prettier or essentially do the same thing more or less of the time, but that is also to be taken with a pinch of salt because just because they are generics or a different brand, they're not the same thing. So there might be small little things that differ. Tweaks. Yeah. Yes.

Most of the time, nothing that's important. So. The patent for L vance, which is listexamphetamine, actually expired in America earlier, um, I think in August, actually just gone.  So that means now in America, they are able to make generic versions of L vance. And that,  I think, is going to make the medication shortage for L vance specifically, it will be a lot easier in America, but I don't know how long the process takes.

To right start making a generic medicine for the first time I don't know that but all I know is if you are like listening from America that you are in a better position than us In the UK because now yeah, you know with how much You  know, I'll bounce is a very very great medication and it is prescribed, you know a lot so I guarantee you there are pharmaceutical companies jumping on that to try and make Forms of it as well.

So unfortunately in england. I think that patent, uh for elvance is lasting until 2028  So we still have about four more years, which means that if you're prescribed elvance You can only take LVANs. There is no generic form of it. There's nothing else. You know how sometimes when you, you know, when you get a prescription for a medicine, they'll write down the medicine name, you know?

Even if the consultant writes Listexamphetamine, you're still going to get LVANs. LVANs. There's no other form of it. And that's what has made this stock issues. such a problem because LVANS is great. Like, I found it really helpful and so do a lot of other patients. So when everyone is on that and there's only one person, well not one person, one company making it, you know, of course there are going to be  stock shortages and it doesn't matter that there are only two licensed stimulants for ADHD, you know, and we only have two to pick from.

So what's going to happen is when one goes out of stock, You know, according to NHS, they put them on the other one, but then the same thing happens with the other one. And then the people, the patients who were maybe stabilized on methylphenidate, the other stimulant, when all of these LVANS patients are coming on methylphenidate, then these patients who are on methylphenidate, now their medicine's out of stock.

And then, you know, we end up going back and forth, It's so hard because there's no no one can predict what happens in terms of you know How do we know if somebody's going to go out of stock? How do we know if this is going to go out? No, it's so unpredictable So and it really really doesn't help when it's with something like adhd medication that has got extra precautions and regulations for it as well, but then it's also, you know, everyone is scrambling after this one brand, you know, we just, we don't have anything else to choose from.

So, you know, that's where like, you know, if you are having issues with stock shortages, you know, it's just, So sad that, you know, even myself back when I was having stock shortages before, like, you're rationing your tablets, you know, like picking and choosing the days where you can actually function or like, you know, we should not have to do that, you know.

Um, and it's just, I think it's that perception of what ADHD medicine does. I don't know what it is and why some people think that it's like a party drug, because I'm sorry, if taking a medication to help me fill the dishwasher is a party drug, then yes, I'm taking a party drug. D'you know what I mean? Like, we're taking this medication to function, and it's not Oh, and not to mention the fact that it's meant to be highly addictive, but none of us can remember what I was just about to say that!

Do you know how you know, I have to say about three reminders to take my medication in the morning. Or like I purposely put my medication downstairs so then I have no choice but to get out of my bed in the morning. I'm addicted to that. Do you honestly think that I'd go to those like, you know, the way I describe ADHD medication as well.

So imagine like, and we can go into kind of like the functioning of ADHD briefly as well, it's like. Imagine the functioning of someone normal is, is here and for the, obviously you're listening but it's, I'm, I'm putting my palm in front of my nose. The functioning of someone with ADHD is lower than that.

So like, my other palm is now by my chin. So when you take ADHD medication, this lifts your chin. the functioning  to that, more or less, actually even lower, to be honest, of someone who is, who doesn't have ADHD. So we can basically function to the same level as an average person. But what happens is when an average person takes ADHD medication, you know, they go higher and that's where there is the potential for abuse.

If it's not taken appropriately. And you know what, there are so many prescription medicines that have got risk of abuse. So many, but why do we never see anything to do with that? Like, do you know how many opiate prescriptions are given? But, you know, no one talks about the, you know, the, you know, how many painkillers are being prescribed on a daily basis.

You know, no one talks about, you know, the, the sleep medicines that are being prescribed on On a regular daily basis. Yes, and yeah, you know, there's just so much hate It seems and negative stigma related to medication and it's like do you guys not want us to just be happy? Like function first of all, you make are we able to get the diagnosis then you want to try and take it away Now you're making it difficult with the medication like, you know, just leave us alone for the love of god I know  Do you know, so earlier on you said, um, that you were, sorry, my brain's just catching up now. 

So earlier on you said about how, you know, for people that are awaiting, they're in limbo. So similarly for people that are unable to access their meds, you know, you can look at the strategies and different things and you can, you can support yourself in that way. Okay. What do you do? Because we know that no two people with ADHD experience it the same way, and different things will work differently for different people, but what are your strategies?

What helps you? So for me, I  Well, it really does depend on,  like I said, who you are as a patient. So,  um, again, guys, please don't take this as direct medical advice. This is just my experience as a pharmacist and knowledge, and this is my, my experience specifically. So, um, when there were shortages with my L Vance. 

You know, I got switched to a lower strength so I can make up the dose Um, yeah, but then also what you can what is another option is when you take L Vance, it's actually metabolized into something called dexamphetamine and L lycine. So L lycine is like an amino acid. And what happens is, this is how it enables L vance to work and as a prolonged release medication.

Because, you know, no matter what you do to L vance, you know, if you crush it, mix it, you know, try and alter with the capsule in any way, it will not make L vance. It, it will not absorb faster in your body. You know, it's, it's a fantastic kind of mechanism because what happens is it goes through enzyme reactions in your blood.

So the L lysine amino acid can then kind of come off. And then the dexamphetamine is what has its effect. So that's why it's such a great medication. And that's why I find it insane that people are saying that we are abusing LVANs when it's like, there's scientific information to prove that there is a very, very small chance of it being abused because it's physically and scientifically not possible.

Um, so yeah, so dexamphetamine is then essentially what has the effect. on, you know, helping alleviate some of your ADHD symptoms. And dexamphetamine comes itself as a generic medication. So for those, for me, when I was on LVADS and I was struggling with the stock shortages, you know, I was able to use the dexamphetamine instead.

As an option or like kind of, you know You know, maybe take a lower dose of l vans, you know top up with that an extra tablet of that Like it's different. You really have to fiddle around with it. And it's it's very hard when you're in titration It's not something you can do. Yeah, you have to be stabilized so, you know, those are the some of the things I did as well, but then also it's like it's so important that um, We focus on our diet and our lifestyle.

Yeah, because People with ADHD are more likely to have vitamin and nutrition deficiencies. They're more likely to have inflammation in their bodies, inflammatory markers, gut issues, metabolism issues. You name it, right? Anything that would make it harder for us without ADHD or kind of, you know, being able to respond to medication.

most people with ADHD will probably have that. So, you know, one thing which I think, people should be doing this anyway, um, you know, as part of ADHD treatment and management is, you know, getting a full blood work done to kind of see where your levels are at with all sorts of, um, you know, your, um, electrolytes and,  I'm having a mind blank, sorry.

So any vitamins or anything that can be measured, you know, sort of like your iron levels, your vitamin D levels, yes, all of those kinds of things. Because that will also give you an indication of if there is something that you are already really low in. Um, and to be honest, I think people with ADHD, there are certain vitamins that even if you do have like the right level, according to the reference ranges, you know, we need more.

You know, and it's really important to speak to your, your doctor or GP, even if you're taking supplements or want to take vitamins, make sure you talk to them because, you know, just because they're supplements and can be bought over the counter, right, you know, this doesn't mean it's compatible. There's still side effects of them, you know, you know, there still can be dangerous, but you know, There's certain things, certain vitamin B's that are really good for brain function as well, and you know, for sleep and those kind of things, and you know, vitamin D is absolutely essential.

We live in such a, you know, I mean there's a bit of sun, um, very rare, but we rarely get any sun, and I think that's why England is so miserable, and it's because vitamin D is so, you, I don't think we realize how important vitamin D is for us. It really does depend on you as a person. a person in terms of what specifically you struggle with in terms of your ADHD?

Yes. Is it more of the inattentive stuff or the hyperactive stuff? Because there's different vitamins that help with different things. But one thing that I will say that is good for people, you know, patients with ADHD to take regardless, um, of, you know, omega threes.  Capsules are just they're brilliant, you know, um, they've always been known to help with brain function as well and there's a lot of scientific evidence for that as well.

Um, whilst all of these supplements, please remember they are not being recommended specifically for ADHD as such. They are not, not medicines that have gone through clinical trials. to be proved to alleviate ADHD. What they are good at is helping to alleviate the symptoms that might be due to ADHD, such as the brain fog, the concentration,  the attention, you know, regardless of if you have ADHD or not, these are what some of these supplements can help with.

So, you know, there isn't any harm in trying. Um, but then at the same time, when you've got like a whole cohort of people saying, Oh, I've taken omega three and it's really helped. And all of those people have ADHD, you know, you can kind of unofficially say, Oh, this might actually help with my ADHD.  With us with our faulty dopamine receptors, to not get that reward hormone, which helps so much with motivation.

And then you're gonna add on top of that, so many of us struggle with our self worth  after a lifetime of of not fitting in, of struggling, of, you know, feeling like we're failing. How, how, How do we motivate ourselves to do these things? You know, so many times I hear people saying, well, you know, you need to eat well.

And then I know myself, I sit and watch the fruit rotting in the bowl. How do you feel for you specifically, Priyanka? How, how do you motivate yourself to look after yourself, to keep on top of taking the vitamins, doing the things that are good for you that are going to help you? Yeah. So, This is something that I'm still trying to figure out and I think yeah, it's not clear cut It's not easy.

Like I am coming up to what two years now since my diagnosis and I still have no bloody idea what I'm doing  But you know, it's really really difficult and I'm still figuring it out. But like there are certain little things that help So for example, um, I've got one of those sunset lamps And that really helps with, um, helping me kind of be sleepy in the night because it does a kind of like switch off thing.

And then when you put the alarm on, it gets brighter  and you know, it helps, it does help wake you up. And one thing that I've done is I put the alarm across my bed on the other side of the bed. So then when it goes off, I've got no chance but to grumble and get up and turn it off. And now that's the hardest part.

is getting out of the bed. And I think when you're trying to figure out what's the best way to manage your life, you need to do some deep diving and really,  you know,  take, um, really work on your awareness about yourself. Like if there's something that you're struggling with, it's about trying to understand specifically where, what part Is that struggle and most of it is with ADHD.

It's that first part, you know, once we start doing something It's not that easy. I mean I put off, you know sending an amazon package for months And then it took me a minute, you know,  most of the things that we don't want to do or we put off doing actually ends up being things that are, you know, they're not as bad as our brains have made us out to seem, but it's, it depends on you as who you are, how difficult that, you know, that task paralysis or that executive functioning is.

So, you know, you have to. Pick and choose with certain things and find what works for you. So like, And, and we know also that our, our ADHD symptoms are exacerbated by our hormone. So as, as people who menstruate at different parts in the cycle, things are going to be, Because once you get a hang of your cycle, you know, And then once you understand yourself, you will know, for example, like in the future, like the next month, if there's, you know, if you've got to do a presentation or something, if it's going to be in the week before your period, don't do it.

Or if there's, you know, if you want to celebrate your birthday, don't do it. You know, you want to do it just before, like, your ovulation or something, because that's when you're going to be at your best to enjoy it and socialize. Yes. You can plan your life perfectly around, and then also be easier on yourself, because when you have ADHD, your periods are just awful.

Like, it's, and then You're really up against it and you cannot find the strength to do anything. And do you know what? You're allowed to have days where you're like, you know what, I can't do it. I literally cannot. Yeah. But, it's, it's a fine line between that, Yeah. And then just getting down that dark hole where it's like, I cannot do anything.

And you know, the thing I think really, really helps people with ADHD is we need structure, but we don't have the ability for to, to maintain structure. So, you know, it's, it's really difficult. I think something for me, which personally helps is I have one of those, um, you know, those  sad lamps, which have the wavelengths, Of like, light.

Yes. Yeah, yeah, yeah. So, those are actually really great. And there is scientific information to prove that it does help, but what I do every morning, regardless of what time I get up, is I will sit on my sofa and I will read for like, half an hour, an hour in the morning with that lamp on. And what I think helps Just take, yeah.

If you tell yourself, I'm going to do something that I enjoy, that helps keep me grounded first thing in the morning. For some people, it might be a run, for other people, it might be watching their favourite TV show. TV show. Other people, it might be spending ages baking a really nice breakfast. If you don't, don't limit yourself to what you want to do, just, you will know yourself.

What is something that helps you quieten  your brain, that helps you kind of, you know, Set yourself up for the day and feel a bit motivated, you know, because when you are, when you have ADHD, right, you're so burnt out all the time. Just go, go, go, you know, and we're running from like waking up late and then going down and then this and that.

And like, we're just so high strung all the time. Right. So we need to make sure, and it's so important to put that time in for yourself to help just ground yourself. And stop like panicking and everything. And whilst it seems like in those moments, it's so hard to do because your brain is like, no, I've got to do this.

I've got to do that. I've broken the plate, this and that, you know, take it one step at a time. Right. If you're waking up late, right. What can you do because of that? Like, that's why I put my, my alarm clock over the side. So then it stopped me from sleeping or, you know, Have you got flexible working hours?

That if you do wake up maybe half an hour late, doesn't matter. You can just start and finish a little bit later. Like find something which yes, but I think one of the most important things, which really helps me as well is to do something that you find enjoy enjoyable. That brings you a bit of peace first thing in the morning and straight before you go to bed, no matter what.

And that is something that. You know, that is then the start of keeping that consistency. Because it doesn't matter if you do, like, what, 10 minutes of reading or an hour of reading. The point is, you are taking that time for yourself first thing. As long as that, that's all that matters. And you can switch it up.

Who's saying, like, one day you can read, the next day you can go do, like, a full, full body workout at the gym. Like, the fact that you're doing something that brings you happiness and peace first thing in the morning. And doing that consistently, then that is what helps. Um, yeah. And it's, I have to, I have to ask you though, are you actually tracking your cycle?

Cause I say I'm going to do it and I never do it. I do it. I do it. I actually do it. And, um,  what I do is I've,  I've also realized with myself, right. And this is what people need to know is as soon as we tell ourselves or ourselves or tell someone else, I'm going to do it.  Don't, like you are lying to yourself and you know you are lying to yourself and you know you are lying to other people and your brain knows that you are lying to yourself.

Like your brain is just in there like, mm.  Wake up. Yeah. Okay. Right. That bull  The moment you think that you have to do something just don't. Do it, I'm telling you, right now. And it really does, this is where, where I'm saying like, awareness is so important, because  if you're like, in the middle of driving, and you're suddenly like, Oh I've got to text that person, right?

You're not gonna go pick up your phone and then text them, right? Obviously, be sensible, and think about where you are at the time, but if you're just chilling there watching TV and you think, Oh, I was meant to put the washing on.  Go do it. And the reason I'm telling you to do it there and then, A, you're going to forget.

100 percent you're going to forget, but B, it's because your brain takes five seconds to talk you out of something, five seconds. And those five seconds are crucial because once you go past that, that's when our brain is like, Oh, Oh, I've got to go get the clothes. Oh, I've got to find the laundry tablets.

I've got to put it in. I've got to split it up. Oh, I've got to put the clothes up. Like  those five seconds will stop you from, from doing that because you are just, you just go, just do it right. Um, now, now, now, yes, exactly.  That's how, that's what's helped with my, my, you know, make sure I keep track of my cycle.

Um, cause what I've actually, and. It's just about creating habits because that really helps as well. So like, for example, when I go to bed and I put my sunset lamp on, I will sit there  and that, and I've made it a routine now that every time I get into my desk, sit there, I'll go onto my period tracking app and I will go and log all my symptoms, you know, write a little note in my journal.

But  I've started to do that consistently every single night. Then it just becomes second nature to the routine. Yeah. So that's what everyone, you know, also helps is like, sometimes having something to signal you that you know that you're doing that.  Because then it's second nature. You don't have to think about it.

It's like, yeah, it's just the repetition of it. Yeah. But, um, you know, yeah, it's, I know, like everything I'm saying sometimes I, I really feel there are people listening to this, just thinking like, oh, this girl does not know anything. It's not easy. I've tried this. I've tried that. And does she even know what she's talking about?

And I agree with you. I completely agree with you. Um, yeah. Like I said, it's been two years since my diagnosis. It's taken me a lot of trial and error. When I tell you I'm still in this stage right now, where I still am struggling to cook myself a meal at times, you know, I've got it all together, but these are just some things that I,  The things that you have found useful.

Yeah, yeah, absolutely.  Right. I am going to wrap it up because you know, Priyanka, we could talk all night. So what I'm going to ask you is one more thing, because I mean, I know we said, if you say something, it doesn't necessarily mean you're going to do it, but you are going to do it. So tell me about the book right now.

What are you doing? Oh my God. I can't believe that I actually forgot about it, but yes,  I'm thrilled because I, I've nearly finished writing my first book. So, but when I read these books, I just find like, I can't relate to any of these characters. Right. Um, it's very rare to see women of color sometimes.

And we are seeing a bit more, but most importantly, it's very rare to see any neuro diverse representation in these books. I mean, sometimes there might be traits of a character that you find. Oh yeah. Similar to me. Oh, the manic, the manic pixie dream girl. Oh yeah. Yeah. Not really. Right. There was never any, like, direct reference to something like ADHD or autism or, you know, something that's just authentic, in a way, to help women like me and you feel represented.

So that's when I had this insane idea, and I was like, let me write a book, let me write a story. story of a girl who learns that she has ADHD. Because we're so different, right? We believe everything else around us, and if everyone else is doing this thing or everyone else is saying this thing, that must be right, yeah?

So we're Exactly. And so we're gaslighting ourselves. So we're just a further abuse, yeah. Um, there is aspects of that to kind of show how, when you're a neurodiverse person, particularly when you have ADHD and low self esteem, how you are, you know, more vulnerable to be gaslit by other people around you.

The other thing which I thought was important was, you know, about the impact of culture and colour. So, you know, yes, the main character Maya is from an Indian background. Um, obviously it's because I have the, I am Indian myself, so that's the only perspective I can give. But also, when you are coming from any sort of minority as such, when it comes to culture, you know, there's that added pressure of when it comes to being a woman.

Let lone women with a DHD. So I think, yeah, parts of the, the family dynamics, you know, the pressures to find a partner and you know, what it means to be a woman. As such, in Indian culture, I think there are a lot of women of color who are, if they are new or diverse as well, like they will be able to relate to it because it's, it's like a triple whammy if you are a woman of color.

Yes. And I don't think there is any. Any really any awareness about that like, you know, and that needs to be spoken about as well because I think these kind of things are still kind of taboo in our culture, you know, ADHD is not really thought of real, or, you know, even mental health and we are making changes but we still have a long way to go.

So, you know, it's important to touch upon those things and how culture impacts that and how it can really, really affect the self worth. of a woman with, you know, with ADHD who is a woman of colour. Our low self esteem, our beliefs about ourself and about the world, they warp our perceptions of things. And this is a lot with people with ADHD is we always have good pure intentions, but we just self sabotage.

We don't go about things the best way. And then, you know, we don't make the best decisions and, but everything we do comes with love and care. And sometimes it's so hard when people can't see that.  Hard. Relate to that one. Thank you so much to the legendary Priyanka Patel, How We Love You So. I am so excited to read Priyanka's book.

She's actually sent me a couple of chapters, which I'm dying to dive into. If you are somebody who. Is struggling to access your ADHD medication with you. I've had a bit of an ordeal this week, but I won't go into it because we have already talked a lot. So I will wrap this up very quickly. Just to say the link to the pharmacy stock checker is in the blurb of this episode.

So is the link to sponsor.  Darren and Rosie and all of the wonderful people raising money for ADHD Liberty and ADHD Adult UK with their amazing London to Amsterdam sponsored cycle. And to everybody who has been asking me about the Emporium, we are getting there, I promise you, and I promise you it's worth the wait.

So if you have been wanting or toying with the idea of applying, please do because we're almost there now and it is so exciting. I cannot wait to share it. But the First stage of the Emporium is up with the wonderful merch collaboration. So go and check them out. You can also apply there on adhdfemporium.

com. So I just have to share this absolute corker of a most ADHD thing. First of all, thank you to everybody who has given me lots of lovely feedback about the episode with Big. The Big Man returns and we did have a giggle. So thank you. If you haven't already listened, you can listen via the blurb in this episode also.

But my most ADHD thing this week.  You absolutely couldn't write it. This is absolutely my ADHD in a nutshell. So I ended up staying with a friend because I couldn't access my ADHD medication. Happy accident. Had a lovely time. We were snuggled up in bed, little impromptu samba party, and she gets out her period checker app.

And I was reminded of this conversation with Priyanka just a few days prior. So I was like, Right, I'm going to do it. I'm going to do it right now. And then I was like, oh, hang on a minute. Actually, I think I've got a period tracker on my Fitbit app. I'm just going to go and look. So I go into my Fitbit app and I'm actually already tracking them.

Absolutely on the nose to the day. So I Have actually been tracking my periods for months, but forgot that I was doing it, so haven't been checking it. So there you go, that's my most ADHD thing of this week. Anyway lovelies, thank you again to Priyanka, thank you so much for listening. If you've enjoyed this episode, please do leave a review, hit those stars, share it with anyone and everyone, because all of those things will help raise ADHD awareness and let others like us know that they are not alone in their struggles and you are not alone in yours.

If you would like to connect with like minded legends, myself included, you can join the Patreon peer support community via the link in the blurb of this episode or just come and have a follow on  insta at adhdafpodcast.  Please remember that Self diagnosis is valid. If you are on a waiting list, you are not alone.

If you are considering getting diagnosed or have been diagnosed and the imposter syndrome has you, please know you're not alone in that either. That's really, really normal. And however things are with you right now, everything shifts and changes. Just like Priyanka's incredible suggestion for how to change the system has changed quite dramatically since March of last year.

We change and we grow and things move forward. Nothing stays the same for long. So be kind to yourself and big love.