Dr Louise Newson [00.00.00] So today, on my podcast, I've got Jack Suddaby who is founder of podcast house and also runs Distracted podcast, we talk about ADHD, what it's like to have ADHD, how it could be diagnosed and how we can manage it. And we also talk quite a lot about the brain and how it works or works differently for certain people, it's a great conversation, and I hope you learn a lot from it. So Jack, I am in your sitting room. This is your studio

Jack Suddaby [00.00.31] I know

Dr Louise Newson [00.00.32] and I love it. It's, it's just such a sanctuary. It's great. Now, I've been on lots of other people's podcasts, including yours, talking about ADHD, but it's something I was never taught about at medical school. We hear it. My children talk about it. Patients talk about it. When people say, I've got ADHD, you can see other people looking is, what is it? What's going on? And I, I just thought it'd be really useful just to unpick it like, what is it? Is everyone with ADHD the same? Do they all need treatment like there's so much I just thought I'll ask you, but before I launch into too many questions, just tell us a bit about your backstory.

Jack Suddaby [00.01.10] I found out I had ADHD, like, a couple of years ago. I've - I was in a relationship, and it was like the first time that myself was fully reflected back. I saw not just the good bits the bad bits as well. And I was like, why am I not listening all the time? And like, why am I getting distracting and showing up late and all of these bits? And suddenly I had someone who was actually getting annoyed by it, instead of just my family or whatever, you know who were just like, oh, whatever. And so I was like, it was over lockdown and every, it was sort of an explosion of mental health, especially ADHD. And so, I was like, oh, maybe it's this. Maybe I can pin it to this. And I was in the barbers, and I did like, an online test, and it was just through the roof and I did it again with my mum, and she found it hilarious, because it was basically just ticking off every question was, like, designed for me, and then I did the test, went privately, did the test, and got ADHD, and then became, since then, I just sort of had this thirst for wanting to know more about it. Year or so ago, I started a podcast called Distracted, where we get on a bunch of guests and talk about all things ADHD.

Dr Louise Newson [00.02.21] And people are talking about it more, aren't they, but you know, when I was at medical school many years ago, in the 80s and early 90s, there was a little bit about ADHD. It was always naughty boys that couldn't sit still. But it was always boys, not, not men, and it was, it was if they ate too many sweets, or, you know….

Jack Suddaby [00.02.39] Well, you're four times more likely to be diagnosed with ADHD if you're a bloke, but you're just as likely to have ADHD if you're a woman,

Dr Louise Newson [00.02.47] Yes

Jack Suddaby [00.02.47] Because you know 50% chance of getting it from your parents. So, it's just boys are hyperactive, we're loud, and it gets spotted at school because it's more problematic in the classroom, whereas a woman or a girl typically comes out as masking, or it's in your head and anxiety, it sounds like a lot of a lot worse deal in many respects, because it's all internal. You've got that hyperactivity, but it's, it's inside your head.

Dr Louise Newson [00.03.14] Yeah, and then you can't see it

Jack Suddaby [00.03.15] Yeah, so no one knows, and you don't even know it's so foundational that, and because you're masking so much you're getting treated for anxiety or depression, you'll be much more likely to have all of these things if you've got ADHD as well, and, and so you're getting treated for these symptoms, when, actually, sometimes it's you've got to sort the ADHD or even just understand it, because that's, that's basically the big takeaway that I've had over the last few years, A: from being diagnosed, but also from starting the podcast, is a lot of it, it really goes back to shame, and like feeling shame for these, these bad qualities, and just recognising that you have it and understanding it goes so far to stopping yourself from feeling so guilty or rubbish about yourself and not being great at, you know, doing the bloody washing or whatever.

Dr Louise Newson [00.04.05] But it is. It's the guilt, isn't it? And I think it's the lack of self-belief that there is something that's not quite right, but what is right anyway? That's a whole different conversation, but it's, you know, in medicine, I was always taught you listen to the patient, you understand them, you try and help them, and then you might make a diagnosis, and treatment is really at the bottom. And if you look at complaints for doctors, the most common complaint is not being listened to, not being believed. And I see this a lot, obviously, in my work with hormones, but people who've had ADHD for many years, don't you say they've been gaslit really? They've been told they've got anxiety depression, which they might have, but they're worried because they're always late. They're letting down their friends. They're not putting the washing on or whatever. But once they realise what's going on, it's it's quite a relief for people, isn't it?

Jack Suddaby [00.04.58] Yeah, a lot of people that come on the podcast say that they almost grieve their past life, because for all those years where they've blamed themselves or not themselves, or just masked, pretended to be someone they're not, in so many different environments, it really weighs heavy. It's like putting on lots of different cloaks. You put so many on it. You know, it can feel a lot.

Dr Louise Newson [00.05.22] But there is this thing of trying to conform, isn't there that, you know, school is really difficult for people, a lot of people, for all sorts of reasons, whether physically or mentally or often both, because they're trying to conform, aren't they? It's a very tick box. But even out in society, people expect people to behave in certain ways or do certain things. But I'm very interested in the brain. I'm really, really interested in neurophysiology, neuro anatomy, neuro pharmacology, neuropathology. So, everything related to the brain, when it works well and when it doesn't work well, and all these amazing neurotransmitters, these chemicals and hormones that work in our brain. So, we we still don't know much really about ADHD in a very molecular way do we?

Jack Suddaby [00.06.09] Well from what we know really it’s about alack of dopamine in the brain. And it's not really a lack, it's more just we don't we're not managing it well. We're effectively searching for more dopamine that makes us more impulsive. We can't stay focused as much. That's what a lot of the medication does it, like Ritalin, it, it gives you more dopamine, so you have a base level, so you're not constantly task switching.

Dr Louise Newsom [00.06.35] But dopamine is our reward hormone, isn't it? Really, it's that. You know, when people do something pleasurable, they feelgood about it. But if you don't have that, you don't feel quite as good doing the same thing that you've done before. But there's also, you don't want too much dopamine either, it's the neurotransmitters, it's a fine balance. It's like a seesaw, isn't it?

Jack Suddaby [00.06.56] Yeah.

Dr Louise Newson [00.06.56] But they also dopamine changing will have an effect on noradrenaline or cortisol, or serotonin, all the other hormones and neurotransmitters in the brain. It's amazing how closely they all work.

Jack Suddaby [00.07.09] Yeah. I mean, for me, it's like, I love it. I actually like the imbalance. I mean, sometimes it's not great, but I can hyper focus on something when I find something I love, and I'm lucky enough to do podcasting and run this space, so I get to do what I want to do all the time. And so I find it much easier to fall into that hyper focus state where I can just go in for six, seven hours and get so much done. And it feels amazing. So, I'm lucky because I figured out what I liked very early on. But for some people, I mean, I got fired from four jobs before.

Dr Louise Newson [00.07.44] Did you?

Jack Suddaby [00.07.44] Yeah, I was constantly getting fired because I was just, if I wasn't good, didn't like it, I was rubbish. I was really not engaged, scatty, not turning up on time, just all of the classics. And I used to think, I remember when I was like, 19/18, I was like, why am I always getting fired? Is this normal? Is this everyone? And then, you know, kept doing podcasting and was like, oh, I'm not getting fired from this.

Dr Louise Newson [00.08.08] Yeah, it’s interesting isn’t it. Yeah. And I do think it's also, like, a bit of a misnomer, because it's attention deficit hyperactivity disorder.

Jack Suddaby [00.08.17] Yeah

Dr Louise Newson [00.08.17] Which is quite a long like, what does that really mean? But you've already said that you've got ADHD, but you don't really have an attention deficit, if it's something you're enjoying.

Jack Suddaby [00.08.26] Yeah.

Dr Louise Newson [00.08.27] So that makes it really confusing for people, doesn't it? Just those words.

Jack Suddaby [00.08.30] We need to almost update, update it. It's so broad as well. It's such a broad we could start making subcategories. It's like having a, like, a category called action, or just like horror. You know, you can you. We can start making the subcategories now, and I think it would help people.

Dr Louise Newson [00.08.49] As a doctor, I only want to make a diagnosis if it's going to change treatment or outcomes for a person. And like you say, for lots of people, knowledge is such a power and having that knowledge is really important. But our brains are changing all the time. They're evolving, and they, they change depending on what we eat, what our lifestyle is, what our sleep is, what our social interaction. Everything is changing. So, I sort of sometimes worry a bit for two reasons. Firstly, there is a lot of money to be made with ADHD at the minute, but there's also a medicalisation side, like you've already said, there are drugs. And, you know, I'm a medical doctor. I prescribe all sorts of drugs. And drugs can be very important for the right person, for the right reasons, and often drugs we give short term, not always long term. And I worry about medicalising too many people. Is it good that people are just being labelled without really understanding the brain and how it changes? And you might think you're fine as a woman, and then suddenly your hormones change, and that's going to play havocs to your ADHD, who's helping people with that? You know?

Jack Suddaby [00.09.56] Yeah, I think everyone, this is why it's got so popular on TikTok and Instagram is because everyone can relate to all the symptoms. Everyone's turned up late for stuff, and everyone's not bothered by things they don't like. Like, it's when it's, it's a disorder, yeah, when it's actually impacting your life to the point where it's disrupting it.

Dr Louise Newson [00.10.15] Yes

Jack Suddaby [00.10.16] I think for me, getting the diagnosis was really to tell other people that I had it with certainty, almost. I knew I had it in my bones. And everyone else I've spoken to who hasn't had the diagnosis, who also really feels it, they just know. You don't have to get sort of and for my for me, anyway, it felt like just sort of a stranger over a zoom call for 60 minutes less, probably 45 he asked me a bunch of questions, which was, effectively, do you have ADHD or not? And then at the end of it, they were like, right, great. Do you want the drugs then? And it did feel like it was funneling me to just take the drugs instead of like, okay, how do we set up a a system where you can better help yourself in these areas where you're struggling, instead of just like, here's some meds.

Dr Louise Newson [00.11.02] Yeah.

Jack Suddaby [00.11.02] And look, that was my experience, and that was the one, the one private place I went to.

Dr Louise Newson [00.11.08] Yeah.

Jack Suddaby [00.11.08] And so it's all going to be different, depending where you go.

Dr Louise Newson [00.11.11] Of course it is - absolutely and for some people, you know, they have the most amazing experience. But I, I also feel in medicine, things are really siloed more than they were. You know, I had a very general training. My psychiatry training was very general. My medicine training was very general. But now everyone is sub special, specialized. In psychiatry you have people that only deal with ADHD or only deal with schizophrenia or whatever. But….

Jack Suddaby [00.11.35] It’s almost like having physio for one part of you, instead of having an osteopath to look at the whole picture.

Dr Louise Newson [00.11.41] Absolutely, yeah, it's like, if you know you've had a heart attack, and not not look at your blood pressure and not look at, you know, your nutrition and everything else as well. It just feels really incongruous with how medical training should be. And I think also what you want to do is be able to have this longer-term relationship with people as well, so they really understand. And you know, my oldest daughter is always late, and she drives us mad, and she's always just lost her keys.

Jack Suddaby [00.12.06] Yeah, yeah yeah

Dr Louise Newson [00.12.06] But when she said, oh, I've read or seen on TikTok that people with ADHD are more likely to be late, they're less likely to unload the washing machine or whatever, it's like, oh, okay, that's made her feel less bad, if you see what I mean.

Jack Suddaby [00.12.18] But also, what it does, is when you kind of accept it, you're like, right okay, I've got these things. I'm not I can't just fix myself. Like, I'm just gonna be better at, like, keeping my keys in my you just go, no, no, I'm actually, I'm gonna be bad at doing that probably forever. So, let's set up some sort of system so I have, like, a really bright phone case that's red with a zip pocket to put my keys in, so I can call my keys if I ever lose them, you know. So, I always have, like, really basic baby stuff, but it's helps, and it stops you from going, oh, I'm just, I'm just like this, I need to, you know, yeah, cuts out that noise.

Dr Louise Newson [00.13.00] And that is the noise, and life is really busy anyway, and then if you've got people that don't understand and then are blaming you the whole time. But I do worry if people don't get this holistic care, it's a very different way your brain works. And I find it's so interesting the brain, how it's it. We can remold it, we can rewire it. We can get all this neuro you know, changes in the brain. You know, the brain can grow and develop all the time, and these new neural pathways can, can it's like a tree. Do you know what I mean?

Jack Suddaby [00.13.31] Right so if you - it's like building up habits. Basically, once you start building up a habit of always keeping my key in my right pocket.

Dr Louise Newson [00.13.35] It totally is - it's that muscle memory. You know, the more you do a yoga practice, it just is second nature, isn't it, or whatever. And it is this, what I was taught at medical school, the brain like molds and develops, and then as a teenager, and then it settles down, and then the brain cells just die with time. But it's not. We're constantly getting new brain cells this new it's like, but you want to prune those branches and then just get the tree to grow better.

Jack Suddaby [00.14.03] So you can still grow throughout your whole lifetime?

Dr Louise Newson [00.14.05] Absolutely, throughout your whole life. It's really important. And we've got these sort of these growth factors, these, in the brain, and they can change according to the environment. So, if you have a very inflammatory diet, you have more inflammation, you're going to have less growth factors, so your tree will not – it will be more like weeds. Whereas if you have an anti-inflammatory diet, you know you eat better, you exercise, hormones can stimulate these, these growth factors as well. Then you can see if your brain is more organised, the cells work better, and that helps with all your sort of brain memory and everything else as well. So…..

Jack Suddaby [00.14.44] Well, you can feel it after you just have a healthy meal.

Dr Louise Newson [00.14.46] Of course you can.

Jack Suddaby [00.14.47] You just feel more alive. I had a pizza lastnight because I came home late

Dr Louise Newson [00.14.51] Oh dear

Jack Suddaby [00.14.52] And just this whole morning, I've been feelinglike sluggish and weird, and that's just like a micro example of course

Dr Louise Newson [00.14.57] Yeah, but you can see that. But if you're not getting help, and a lot of people with ADHD won't get help, and then they might turn to drugs, and then they're drinking more alcohol, and then they're eating worse, and then everything feels worse, and it's this sort of spiral, and then your brain is like, oh my god, chaos, chaos. And that's where I feel like going back to the basics is really important so we can understand. And of course, you know, if you've just had an argument with your partner, and I, of course, I'm going to eat worse. So, my diet was a lot worse then. I wasn't doing yoga every morning because I had the children, you know. And so, it's this downward spiral. But I think the conversation is great, isn't it? People must be learning, you know, from your podcast. But there's, there's so much more out there isn't there for people to understand.

Jack Suddaby [00.15.43] Especially for women I think as well, it's really exploding. I mean, probably across the whole health industry, it's exploding. For women, my girlfriend is an osteopath, and she's constantly like, is this right? Is this right? Because it's, there's so much new information all the time now.

Dr Louise Newson [00.15.59] Absolutely.

Jack Suddaby [00.15.59] But for ADHD, especially women, like we said, it's less diagnosed, and there's way less tests on women. So, yeah, it's kind of like a revolution, and the more conversation, the better. You know, there's everyone always says, oh, everyone's ADHD now. And I just think it's such, so silly. Why would you not want to empower people and give them an opportunity to learn about themselves?

Dr Louise Newson [00.16.19] I think it's also, it is can be a superpower for lots of people if they find the right, like, right well, career, job, you know, just, just lifestyle, everything else as well. And I think it's similar in some ways, to dyslexia. My middle daughter was diagnosed. I knew she was which was diagnosed with dyslexia, and actually that just meant she had extra time in exams, took the pressure off. It means she can explain to people. And she's got a very visual mind, you know, very visual. And it's, it's, in some ways, she doesn't need treatment, but it explains to people. And I think it's, it's all about explaining to people what it means. And I think we're sort of getting there with ADHD, but people still don't quite, because of the disorder bit. It sounds almost as a disease. And I think that's where people can be misjudged actually.

Jack Suddaby [00.17.06] Interesting. I would say it's, I would say, actually, for younger generations, it's a different conversation.

Dr Louise Newson [00.17.12] Do you think?

Jack Suddaby [00.17.13] Yeah, I think it's more kind of accepted in younger generations now, especially like 27 below, I feel like it's kind of okay - we get it.

Dr Louise Newson [00.17.23] That's great, because I feel I see a lot of women in their 40s who have been diagnosed, often it's symptoms will get worse because their hormones have changed, and they then say, I wish I'd known this 20 years ago. I wish that that now, I understand how I've behaved and how things have been, and especially this hormonal variation.

Jack Suddaby [00.17.45] Yeah. I mean, you met, you mentioned PM, sorry to cut you off. You mentioned PMDD. I mean, from the studies I've seen, it affects about 4% of women.

Dr Louise Newson [00.17.54] At least

Jack Suddaby [00.17.54] But with ADHD, well, probably many undiagnosed. But with ADHD, it's 40%. So you're far more likely to get it with ADHD. And imagine not knowing you had ADHD and just having these extreme sort of hormonal changes every month.

Dr Louise Newson [00.18.11] Yeah

Jack Suddaby [00.18.11] And then realising you have it in your 50/60s, going through menopause.

Dr Louise Newson [00.18.15] It's really scary. I was talking to someone yesterday who just listened to one of my podcasts, and he's remarried. He's divorced. I knew that, but then he said, that's why we had such a bad time. I had no idea, because it was once a month, a few days, her behaviour was awful. Her drinking was awful, just shouting was terrible.

Jack Suddaby [00.18.38] Total self-sabotage

Dr Louise Newson [00.18.38] It is then this self sabotage is really common, actually, isn't it? People want to look after themselves, but it's almost, you have this, can have this downward spiral as well.

Jack Suddaby [00.18.47] It’s weird. I get it sometimes, like, it's almost, for me, it's like one when it passes a point, I just, like, if my room gets past a point of messiness, I just completely sacrifice the room. I'm I don't. It's done now. It's messy.

Dr Louise Newson [00.19.02] I’m laughing cus my daughter is like that

Jack Suddaby [00.19.04] I cleaned it up the other week, and I've managed to maintain it. It's fine, because it's like, well, it's clean. Now I can keep it clean, but it's a it's a weird psychological point that you can't break otherwise it goes into chaos.

Dr Louise Newson [00.19.18] But that's what you need other people to help you. It’s interesting, because my two daughters are living together at the minute. One's incredibly tidy, and the other one likes it to be tidy, but she’s quite messy. And it was just interesting. One of them was saying to the other when you've eaten, see putting the plate in the dishwasher as an extension of your meal. And Jessica was like, oh no, I see it as something different. I see it as I eat, yeah, and then I clear up later, she said, no, no, you can't do that. I can't live with you if you do that, because I can't have the dirty plates on the side. So, Jessica was there, like, oh, I get that. Okay, I'm going to do that.

Jack Suddaby [00.19.50] Right

Dr Louise Newson [00.19.50] It's very simple. It's just interesting. That's where the brain, I think, is, is so magical, because it can be changed. But I think the way it can be changed and other influences have so important for people to understand. And I know I harp on a lot about hormones, but obviously you've got the beneficial hormones that we give to people, but then you've also got contraception. I know we've spoken about this before, these synthetic hormones that are blocking our natural hormones working. So, although people don't get this variation, they often then find things very difficult. Their mood can go down, their concentration can be less good, they can be less motivated, and if they're also then on drugs. For ADHD, you've got double whammy, actually.

Jack Suddaby [00.20.34] Yeah, I hadn't thought about that. Do you prescribe hormonesto men as well?

Dr Louise Newson [00.20.37] I don't, but I'm very interested in hormones to men. I often diagnose because actually, testosterone is a male and a female hormone. But a lot of I'm in a in a group with a lot of doctors who are, do specialise in ADHD and men as well as women. And like I do with women, they notice with men, testosterone is makes a massive difference. It's very, sort of calming on the brain. It makes it very - a lot easier to think when people take testosterone as well. And testosterone is made in the brain. It's a really important neurosteroid, and when you've got good levels of testosterone, you're going to have better levels of dopamine, serotonin and everything.

Jack Suddaby [00.21.15] Is that why I feel so sharp like after a gym session, because I would have produced so testosterone

Dr Louise Newson [00.21.21] Often – yeah probably because muscles produce testosterone as well, and that's why exercising is really important, because our muscles and our bones are metabolically active. The you know, those hormones go in the blood, go into the brain, massive and that, you know, you get this endorphin hits as well, don't you?

Jack Suddaby [00.21.36] Oh, yeah. I mean, I think exercise, it's like, such an obvious one, but for people with ADHD specifically, it's like, huge.

Dr Louise Newson [00.21.43] So important

Jack Suddaby [00.21.43] It's huge, yeah, just to get that hyperactivity out.

Dr Louise Newson [00.21.48] Yeah, yeah, yeah absolutely.

Jack Suddaby [00.21.49] Just to get it out. And I just feel, I just feel like I can focus better after doing exercise.

Dr Louise Newson [00.21.55] I mean exercise is, you know, if we could prescribe it, it would be the best drug ever, but it's just underrated. But it's so important.

Jack Suddaby [00.22.03] It's like one, it's like one of the most important things anyone, everyone needs to do it. Like, if you can….you need to be able to do something

Dr Louise Newson [00.22.08] Totally, nobody regrets doing exercise

Jack Suddaby [00.22.12] It's sort of hard to ask people to do it because it's seen as a bit offensive, I think.

Dr Louise Newson [00.22.15] Yeah, but we need to do it more.

Jack Suddaby [00.22.16] Yeah.

Dr Louise Newson [00.22.17] So, lots -  so much, we need to just know more, understand more, but I'm really grateful that you've been so open. And I think just get people to think differently, hopefully and think about their brain. Think about how we need to look after our brain.

Jack Suddaby [00.22.29] Yeah

Dr Louise Newson [00.22.30] But three take home tips, so…..

Jack Suddaby [00.22.32] Oh, okay yeah. I knew this was coming……

Dr Louise Newson [00.22.34] No pressure…you knew this was coming! So, if someone's thinking they might have ADHD.

Jack Suddaby [00.22.39] Yeah.

Dr Louise Newson [00.22.39] And they're just a bit confused, what are the three simple things that you would say?

Jack Suddaby [00.22.44] You can just take an online test, which is like a nice gateway into something external, going yes, yes, yes. It takes, like, 10 minutes. I did a bunch of different ones, and the questions are similar, but that can really help also, just if you're watching videos on social media, follow a few like ADHD related pages, and if it really feels like it's connecting with you, there's a reason for that. There's probably a reason for that.

Dr Louise Newson [00.23.14] Yeah, it resonates

JackSuddaby [00.23.15] When I when I first found out and I saw content online, God, I just went obsessive. I was watching so much because it was so lathartic? Lethargic?

Dr Louise Newson [00.23.25] Cathartic

Jack Suddaby [00.23.25] Cathartic. I just felt so heard, and there was a community there, which was similar to me. And again, it was like that first step in removing the shame.

Dr Louise Newson [00.23.36] Yep

Jack Suddaby [00.23.37] So that's what I'd say, binge social stuff and do some online tests and speak to family and friends, because it then it doesn't feel like a big thing in your head.

Dr Louise Newson [00.23.46] Absolutely.

Jack Suddaby [00.23.47] You'll also find probably that if you've got ADHD, some of your mates will as well. You, you tend to attract each other.

Dr Louise Newson [00.23.53] Yeah, so sharing is most important, and sharing knowledge as well. Which is great. So, oh, thanks, Jack. It's been great.

Jack Suddaby [00.23.59] Thanks for having me on

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