Unlocking ADHD Brilliance with Tracy Otsuka

• Learn about the three telltale signs of ADHD (06:52)
• The importance of recognizing and understanding ADHD later in life, particularly for women (19:43)
• The powerful connection between ADHD and creativity (25:40)
• The intuitiveness of women with ADHD (29:33)
• The importance of a proper ADHD diagnosis (36:13)

“The ADHD brain thrives with positive emotion and positively wilts with a negative emotion. “

“I really believe that ADHD is evolutionary. And it’s this intuition that we learn to trust when our brains can’t be trusted.”

“With ADHD, we all have different symptoms. And so during perimenopause, when my estrogen was bouncing around, I had not only the general symptoms of perimenopause that everybody has because every woman, right? Because their estrogen goes down. On top of that, I also had the ADHD problems with not enough estrogen that leads to not enough dopamine. There was finally a reason, and once there was a reason, then I could work around finding different strategies, different workarounds.”

“This is neurobiology. This is not a character flaw. This is not a moral failing. And so I am going to focus on what I do well and what my gifts are rather than focusing on all the things that I can’t do. Because, again, for every negative trait, there is an absolutely positive trait.”

NICOLE

Hello friends. Welcome back to the School of Self-Worth. I am your host, Nicole. Today, I am beyond thrilled to welcome our guest, Tracy Otsuka, to the podcast.  Tracy and I were set up, blind date style, by a mutual friend at a recent work conference, when we got to room together and we literally had such a blast hanging out, talking about everything we were learning at the conference and really getting to know each other, the way you can only know someone when you are their roommate. It got me even more excited to share her wisdom, her insight and her spark with all of you, because Tracy is a certified ADHD coach who hosts an incredible podcast and she’s just released her first book, ADHD for Smart Ass Women, and whether you have ADHD yourself or you know someone or love someone who has ADHD, I promise you will learn so much about how it impacts the way that they think and how they operate in the world, and you’ll really start to understand the brilliance that is actually hidden in their brains.

So get ready for such a fun and insightful conversation. I totally, totally loved having Tracy on the podcast, and if you are a high-achieving career woman who wants the exact, step-by-step to understand the secret language of intuition, I’ve got a private podcast that gives you a complete behind the scenes on how to master intuitive communication patterns. If you are like, “Yes, I want that”, dm me secret on Instagram at Nicole and I will send over all of the details.

Okay, friends, let’s dig into this inspiring conversation. Let’s get into it. Welcome to the School of Self-Worth, a podcast for ambitious women who know they are worthy of an astoundingly great life. Join us weekly as we get on the right side of your intuition, redefine success, and reclaim your self-worth. I’m your host, Nicole, an award-winning journalist who left it all behind to become a best-selling author of three books and work/life balance expert, helping ambitious women unlock their intuition and step into a life of fulfilment and radical joy. Every single week, I will bring you diverse and meaningful conversations with successful women from all walks of life who share insight about what it takes to be brave, joyful, and authentic every day. Every episode is thoughtfully designed to leave you feeling empowered with tangible tips and advice that will lead you to your next breakthrough.

I just have to say this first because Tracy and I were together a week and a day ago before recording this. Yeah, we were roommates for three nights at a conference in LA. We had never met before, and had been “blind dated”, set up as roommates by a friend of ours, and we had the best time. So it just feels like a reunion to have you on the podcast, Tracy. Welcome to the School of Self-Worth.

TRACY OTSUKA

I am delighted to be here. You are the missing part of my brain, for sure. And what I will say is that whenever I show up to talk about ADHD, we’re always able to change some lives. So there will be someone out there listening who’s thinking, this has nothing to do with me. And all of a sudden, by the end, they’re, “Oh, that’s what’s going on. I need to go get diagnosed.”

NICOLE

Well, talking to Tracy about ADHD, which my husband experiences, and it was so insightful. There’s just so many things that have come out of our conversation. So let’s just start with some basics, Tracy, because I think this will help. Tracy has a new book coming out, which is all about this topic. I would love to hear first if you could just actually talk about the basic definition of ADHD. What are some symptoms? Because I know even talking to you, I realize there’s different types. If you could just give us a rundown.

For anybody who doesn’t experience it or doesn’t know that much about it, I will say this: I am positive that every person listening has a person in their life with ADHD, whether you know it or not, so this is for you, whether it’s your partner or your kid or your best friend, or also you could potentially have this as well. So Tracy, could you just kind of give us some baseline information to start?

TRACY OTSUKA

Absolutely. ADHD is a neurobiological condition. DSM Five is the diagnostic and statistical manual of Mental Disorders. What a beautiful name. And they consider it a disorder. So, ADHD, attention deficit hyperactivity disorder. I do not. I consider it a neurobiological condition.

It basically means you struggle with sitting still, so you’re hyperactive, or you’ve got hyperactivity going on in your brain, which is something that is kind of new. Meaning we’re finally starting to understand it, especially in women. We may struggle to think before acting, meaning we’re impulsive, and we may also struggle with focus, which can make us seem like we’re a little bit all over the place. But what I want to say is, I do not believe that ADHD is a disorder. There was actually a statistic for a study that was released last year in February or March. It was a big Canadian study, and what they determined is that 43% of all people with ADHD are actually in excellent mental health. And I’m like, “not okay mental health, not good mental health, excellent mental health.”  I was in the middle of writing my book then, and that’s what just gave me the 100% direction. All I could think of is a landing strip with a plane coming in. It was so clear, because I have always believed that ADHD is not a disorder. ADHD is a difference, and this study basically proved it. The problem is that in the mental health space, nobody is talking about that study. And my thought is, why aren’t we focusing on what those 43% of people are doing well? What allows them to be in excellent mental health, instead of focusing on the pathology, our weaknesses, and everything we can’t do or we’re doing wrong? ADHD, it’s focus, it’s hyperactivity, it’s impulsivity. We’ve got that down. But there are three telltale signs that I see a lot when ADHD comes up that people don’t know about.

The first one is unexplained underachievement. So if you’re the kind of person who you just know you are capable of so much more than what you’re doing, you know, you’re not living to your potential, but you can’t figure out why, I would look into ADHD. It can even be that outwardly, everybody else is like, “Oh, my God, she’s so successful, or he’s so successful”, But you know you’re capable of so much more. Number two, you’re consistently inconsistent. So the big hard things, you just blow it out of the park. You are friggin brilliant. But the little everyday kind of stuff, like paying bills and showing up on time and not forgetting that you promised to meet a friend here, or missing a Zoom meeting, like a business meeting, that kind of stuff, those sorts of administrative type details, they just confound you and you’re terrible at it.

For a kid, it can look a lot like, for example, my son would get A’s and D’s in the same subject in the same week. So because you’re so consistently inconsistent and the outside world sees this really bright human, the thought is, well, they’re lazy, they’re not trying hard enough, they’re not applying themselves, so that is the message. Those are the messages that a lot of people get with ADHD from the time they’re kids and first in school.

The third thing is that typical productivity tools that work for everyone else, they don’t work for us. Things like ‘eat the frog’. We’re supposed to do the big hard thing first thing in the morning. And I tried so much to do this for my book. I wanted to get it over with first thing in the morning, and I really struggled to write. Writing requires a linear brain. I’m all over the place, and it’s really hard for me to put in the one, and then the little ABC and then the two, and to organize that. It’s hard. So I tried to do it first thing in the morning, but I couldn’t do it.

Things like time blocking, where you’re supposed to put your whole schedule together a week before? No! we like to be in a free flow of space and time, where we kind of do things when we feel like doing it. And how am I going to know that at 02:00 on Wednesday I’m going to feel like writing that article for Attitude magazine or like, Nike? Right? Just do it. Well, if we could just do it, we would have just done it. We wouldn’t need that. It doesn’t work for us.

However, in all of this ADHD, what we have in common, because, as you said, you can have some of the symptoms, just slight symptoms that are actually really effective. I am driven beyond driven. That is a form of hyperactivity. That means that I can really make things happen and I can make them happen quickly. I wouldn’t give that up for anything. But you can also have some really severe symptoms where you can’t even get out of bed and you’re struggling with anxiety and depression and all kinds of other comorbidities. Typically, though, what I have seen is the people that struggle the most with ADHD are people who’ve had pretty substantial trauma. And that’s not just big t trauma. That’s not just violence that happens to you or you lose a parent when you’re really young. It can be the little cuts that you get every single day having ADHD. So the little t trauma, and you just feel like you’re never good enough, you don’t fit in, you don’t know why you think you’re stupid.

Just all of that questioning that goes on, and all of that together can end up being one big trauma, which ultimately is why you struggle so much with ADHD. Because the ADHD symptoms of trauma, hyperactivity, lack of focus, impulsivity, being all over the place, you’ve got that little t trauma, right? And then you pile on top of that, the ADHD symptoms. So you can imagine that you really are all over the place. You really are completely unfocused. You are beating yourself up, and the hyperactivity is in your brain. And women are only now starting to really be diagnosed, girls and women, because we didn’t understand that ADHD looks very different in girls and women than it looks in men. Specifically, we are twice as likely to have inattentive ADHD.

That is not me. I am hyperactive as the day is long, but I’m also combined type. So there’s three types: Impulsive, Hyperactive, Inattentive, or Combined type, where you have some symptoms of both. You can imagine if you’ve got these symptoms on top of the trauma symptoms. Those are the people that really, really struggle with ADHD, and there are twice as many women with inattentive ADHD as men. And inattentive ADHD for a child will look like you’re sitting in the back of the classroom and you’re spacey and you’re in your own little fantasy world, and it’s not until the teacher says, “Oh, hey, Tracy!” That you’re like, ”Oh, well, where am I?” You kind of get back into reality and even realize, “What class am I in?”  Versus for an adult. Do you work primarily with women?

NICOLE

I do, yeah.

TRACY OTSUKA

Is it exclusively with women?

NICOLE

I’ve occasionally worked with men one-to-one, but in my types, it’s like my work.

TRACY OTSUKA

So then adult women will look more like the absent-minded professor, brilliant in their area, but then their car is a mess, their house is a mess, they can’t get any food on the table. They can’t even shop. Basically, if you’ve met one person with ADHD, you’ve really only met one person with ADHD, because the symptoms all look different, and that’s what makes it so confusing. But what they all have in common is they all have interest-based nervous systems. So if we are doing something in an area of interest, we pop into hyper focus, and we’re brilliant when we are required to do something that is not of interest, like a neurotypical. So it’s importance based, right? Meaning that it’s important to you that I do something. It’s important to my teachers that I do something, or my parents or my partner. Those people can do it. Versus if you have an ADHD brain and you have an importance, or an interest-driven brain. You can try. We can do it using certain strategies, but it’s really, really hard for us, so because we can do things we’re interested in, that’s why everybody will think it’s a moral failing. It’s a character flaw. She could do it if she wanted to, but she chooses not to. And really, it is neurobiology.

Do you want me to continue going through how it looks different in women?

NICOLE

Yeah, I think it’s super interesting. I was going to say this before you keep going, because one of the things I noticed even in the conversation we were talking about, like you said, people don’t focus on the excellent mental health. And that was one of the takeaways I had after you and I were roommates, because you just need to address it with the way it works for that particular person, and then it takes down the more extreme symptoms, and then they can actually be really happy and successful and existing in a way that works for them, versus feeling that stress. Or like you were saying, when you have those little traumas piling up every single day.

That’s one thing I think I had never really recognized or realized for people, if you can just accept that each person probably needs a different way of dealing with it. But once you really find that way, then they really have a lot more ease and flow in their life, is what I’m hearing from you?

TRACY OTSUKA

Absolutely. What it all comes down to is positive emotion. The ADHD brain thrives with positive emotion and positively wilts with a negative emotion. So you can imagine these kids, and the statistic is something like, by the time a child is ten, that child with ADHD has heard 20,000 more negative messages than a child who doesn’t have ADHD, which is wild because it’s so much negative messaging. You know what I mean? I work with people all the time. I would say probably more neurotypical, though. I have some clients with ADHD who, and we work so hard on this, we already say need minimum six positive thoughts for every one negative thought. So then if you’re thinking with the ADHD brain, it’s like just way worse than that. And sadly, the ADHD brain, because it’s so creative and it’s just thoughts, thoughts, thoughts, thoughts, we can kind of veer towards the negative. It’s so crazy because we’re generally such optimistic people. Like, if we got to the store one time, in 15 minutes, because it was a holiday and there was no traffic, and the stoplights were out. In our brain, we always get to the store in 15 minutes. We just have that ADHD optimism. But the same part of it, and especially if there’s trauma, is this negative loop because of something called the task positive network and the default mode network. Have you ever talked about that with anybody?

NICOLE

No, I haven’t.

TRACY OTSUKA

So there are two networks in the brain, and with the ADHD brain, they’re glitchy. So the average brain, the neurotypical brain, will start working on something and they’ll be in the task positive network. And when they’re done, they will switch out of the task positive network, and they will move into the default mode network. Now, the default mode network is where our creativity is. It’s where all of our thoughts are. And so it’s really great, but it also has some of the brooding, ruminating stuff going on, right? And you remember with the ADHD brain we can pop into hyper focus. Hyperfocus can be good or bad, and sometimes we can pop into hyperfocus where we’re just focusing on, well, why did I do that? And what did I say to that person? And just all of this overthinking. So with the ADHD brain, we can be in action in the task positive network working on something, and all of a sudden, because it’s glitchy, our switch is glitchy, suddenly we’re in the default mode network, which I call the demon network, right? And we’re questioning, ”Oh, this sucks, this is terrible. Everybody’s going to hate this”. Whether it’s art or writing or whatever, we’re stuck then in the default mode network. It’s like how do I get back into the task positive network? Well, the deal is the way you get back in is through action, right? You do something to get out of your brain, you go pet your dog, you go call a friend, you go out and run anything to get out of that default mode network. A lot of us that have this drivenness quality, that are also entrepreneurs, that are action takers, we have learned that when we’re in action in the task positive network, that’s when we feel really good, right? That’s when we feel in positive emotion. Like doing the scary stuff is actually what fires our dopamine. If we can teach ourselves that kind of strategy and we can hyper focus on it. I don’t feel good today. What can I do that’s kind of scary, that will get me into action, and then I do it and I celebrate it. You’re firing your own dopamine. So it really is about learning how to work with your own dopamine, because the thought is that our brains don’t make enough dopamine. That’s ultimately what the problem is with ADHD. We don’t know if it is that we don’t make enough dopamine, or we don’t process it in the similar way? So there are weaknesses around that, but for every weakness, there is an opposing strength, right?

NICOLE

Well, everything you’re talking about, and we talk so much about self-worth on this podcast, so I could see that with anyone with ADHD, that journey around self-worth would be just treacherous in a totally different way. It’s already difficult, I would say, for the average human to navigate that. It’s challenging because we have this negativity bias in our brains and there’s a lot of difficulty for us. Then we live in the world where we have phones and things pinging us and there’s so much stuff going on that’s impacting our ability to see ourselves for who we really are.

Now you’re talking about adding in this whole different level of challenge within the brain, which leads me to you, and I’m curious for you then. How did you start to navigate it in a way, or really first figure out that you had ADHD and then how did that affect your journey with self-worth and understanding yourself on a deeper level?

TRACY OTSUKA

I was diagnosed after my son was diagnosed, at twelve, and we took him to a psychologist who supposedly specialized in ADHD. She told my husband and me that our job as his parents was to reduce his expectations, so we wouldn’t be disappointed in life. This was, I don’t know, nine years ago, this was not that long ago. I had no idea that I had ADHD, but I remember thinking, why would you ever tell any human that you don’t care if they’re intellectually disabled. I wouldn’t tell a human that. Then I started to do the research, and she recommended a book, which I bought, and it was so negative. All it talked about was all the ADHD related car crashes and how we have a shorter lifespan, and it was really depressing. I was not going to give this to my son and talk about this. I’m going to have to forge my own way.

I started to do research, and I found these two doctors, Ned Hallowell and John Rady, who taught at places like Harvard, and they were the experts in ADHD, and they were much more strength focused, so I decided to follow them. The book was called ADHD Driven to Distraction. When I read it the first time, I didn’t see myself in it at all, because women have different symptoms than men. And then I read it the second time, and somewhere in there it said, hyperactivity. Drivenness is a form of hyperactivity. That’s when I realized he got his ADHD from me, because I did have some focus issues, and I definitely had executive function issues. I’m completely time blind. And ADHD is ultimately a problem with your executive functions, meaning planning, scheduling, time blindness, working memory, as you saw so beautifully exhibited a minute ago, motivation, like how to start, but then also how to stop. Right? We struggle with transitions. I saw those things in me, and I always wondered about them, but I was nothing if not driven.

People would look at me and say, “Okay, she went to law school. She went to graduate law school. She worked as a lawyer. Then she ran a high end women’s wear business. 60% of her business was Salomon Nordstrom.” I worked for two dozen banks during the whole foreclosure crisis, basically selling their foreclosures, their repos. I loved that job. I knew there were things about me that were really different, but I never struggled with the self-worth. In fact, I was probably the opposite. I was extremely confident. It was that drivenness, right? That hyperactivity, impulsivity and fearlessness that would allow me to do stuff that other people would say doesn’t make any sense. And I probably should have heeded it sometimes, but I just went with it.

I didn’t struggle with problems until perimenopause, what we now know is that estrogen modulates dopamine, and we know that the struggle is the lack of dopamine, or the way we process dopamine. And all of a sudden, my working memory got so much worse. This confidence that I had, if I can do it, anybody can do it. Just going out there, that drivenness, that fearlessness. All of a sudden, I started to really second guess myself and started to have the voice in my head like, “What are you doing? Do you think you can do this?” I would constantly discount it and I would keep going, but it was getting harder and harder for me, and I didn’t know what it was. Things that were so my hyper focus, has always been parties. I love to cook. I was the kind of person who could have 75 people over for dinner and I wouldn’t even think twice of it.

I’ve always joked about Martha Stewart, her daughter Alexa was diagnosed with ADHD, and I’m certain Martha has it, because I’d see the stuff she’d do and think, that’s not good enough. That could be better, that could be more visually appealing. My friends would be say I’m nuts. But as long as they got invited to my parties, right, it was all good. I got to the point where when my kids went to a private school, a catholic school, and they would have these events where they raise money. What are those called? Charity thing. Dinners.

NICOLE

Fundraisers.

TRACY OTSUKA

Fundraisers. That’s it. And I would always donate a meal. Usually it was like twelve people, and it would be fabulous. It was right when all the foreclosures started happening, and they had a year to book it, and when she called me, it was a year and a half. A year and a half later, I was like, I don’t want to do it.

I can’t do it. I can’t rely on myself. I can’t even follow a recipe anymore. I can’t do this for twelve people. My working memory was so bad, and it was my time management where I would literally sit in the kitchen and be spinning because I couldn’t figure out, what to do first, what to do second? When does this come out? When does this go in? I was always bad at it, but I could somehow organize it so I could get it done right.

Creativity is one of our primary strengths. In fact, scientists also say ideation and all the ideas and the creativity, that is what we do really well with ADHD brains and so that is what I was able to focus on, so the other stuff I wasn’t so good at, I could kind of make it work, but I was a disaster. As a result, I did everything to not do it, and I remember telling the woman who ran the whole thing that, sorry, I can’t do it.  I remember feeling so bad about that and also thinking, “What the hell is wrong with me? What happened to my confidence? What happened to my ability to just do these big things and think nothing of it?” I really thought I had dementia, and ended up going to so many different people. My primary doctor, my gynaecologist, a hormone specialist, a psychologist. I was tested for Parkinson’s. I went to a naturopath.

None of them ever mentioned ADHD. In fact, the psychologist that I went to said I had dysthymia. I don’t even think it’s a diagnosable thing anymore. That label is now gone. But I’d always been so upbeat and positive and happy, and I was anxious. I used to think I caused anxiety. I don’t have anxiety. I was starting to feel anxious, and I was starting to feel a little, I never called it depressed, but it was just this low level.  I wasn’t excited about things the way I was before,  so when I went to the psychologist, she was Chinese American, she said it’s because I’m Japanese, I’m Asian. The bloom comes off the rose, and we are just such high achievers, and it’s never going to get as good as it was before because I’ve done all these things. So that’s just what it is. I’m not anxious, not depressed, not any of those things. And I remember going home, and thinking that I am something, because I can’t remember anything anymore.

My confidence was shot, so once my son was diagnosed, that’s when everything started to come together. I put it all together that drivenness is a form of hyperactivity. And the other one was, ….I can’t remember what it was. It’s like this is how my brain works, I have to find the first word, and when I can find the word, then everything else connects to it. But there are certain words and certain phrases where  there’s a hole, and they’re just so easy for me to forget.

NICOLE

Well, I was going to say first that you’re doing a great job describing what’s going on in your brain. So that’s helpful to me, and I know it’s helpful to all of our listeners, but I’m curious if it is related to the creativity and the ideation and the intuition, which is what I do. But if that’s the word, part of it, that’s the word.

TRACY OTSUKA

Yes, it is. Not everybody has a problem with working memory. My son has no problem with working memory, but I actually think that’s because he also has dyslexia, and so he has learned his auditory memory, and he just can remember everything. But I actually think it’s because he also has that dyslexia, he’s gotten so good at speaking and the working memories always going there for him. But what I was trying to say is we also have, and I cannot remember the phrase, but what it is, is intuition. So we can walk into a room and know what’s going on without knowing the people at times. A lot of that is because if you can’t rely on your brain, right, and you can’t rely on your working memory and you can’t rely on your focus, your attention is so dissipated. You don’t have focused attention. It’s not linear how you go in and you get all the information you need to determine, okay, what do you need to do next? Your focus is so dissipated that you notice everything. You notice the look that someone has, like the twitch that their eye makes or how their mouth moves when they’re not telling the truth or how there’s some sort of rustling in the leaves, and that signifies something. A lot of this is because I really believe that ADHD is evolutionary, it’s this intuition that we learn to trust when our brains can’t be trusted, so we tend to be very highly intuitive. So it was those two things that really made me realize that, “Oh my gosh, it is ADHD that is going on with me.” But still, I was tested three times because I kept thinking, how can I be accomplished? How can I be successful? How can I be like before, so confident? And how can it be ADHD? There’s so many parts of ADHD that this doesn’t sound like, but you have to understand that you meet one person with ADHD, you’ve met one person.

With ADHD, we all have different symptoms. During perimenopause, when my estrogen was bouncing around, I had not only the general symptoms of perimenopause that everybody has because a woman’s estrogen goes down, on top of that, I had the ADHD problems with not enough estrogen that leads to not enough dopamine. So once I put 2 and 2 together, it was such a relief, and I was tested for Parkinson’s, and I realized that, okay, I don’t have dementia. This is just my brain and the shame or the beating myself up, “Well, why can’t you remember that word? Or how in the hell did you forget to pick up your kids? How did you even forget you had kids?” Because that can happen to me at times, too. I’ll get so hyper focused, I’ll forget I even had kids.

So all those things were happening, and finally there was a reason, and once there was a reason, I could work around finding different strategies, different workarounds.  I also discovered that this is neurobiology. This is not a character flaw. This is not a moral failing. And so I am going to focus on what I do well and what my gifts, are rather than focusing on all the things that I can’t do. Because, again, for every negative trait, there is an absolutely positive trait.

When we are diagnosed with ADHD, typically we’re only told about all the things we can’t do. We’re not told that 43% of all people with ADHD are actually in excellent mental health. So that really helped self-esteem, right?

NICOLE

So much of what you say resonates with me. I mean, being married to somebody who also has it, even just having that conversation with you in LA, I feel like I know him better. I understand him better because those things are happening. And then even what you were saying about being really intuitive, that makes sense, because he is also highly intuitive. We can go to a party, and he just has noticed everything.  I’m a very aware person. I see everything. I don’t miss very much, but he catches things that I don’t even see sometimes. It’s kind of amazing to be around that.

I get it now from what you’re explaining and saying, and I also love what you’re saying about that focus on the positive, because I feel like ADHD often has a very negative connotation, like you think of a hyper child, who can’t sit still in school, and it’s not helpful for anybody. But the thing that I’m actually curious about, because I feel like kids have been the focus for a very long time, and I am experiencing a lot of friends or people, adults, who are getting this diagnosis much later in life, and I’m curious about why that’s happening? Is it just more study of it, more awareness of it, or understanding of it, that’s prompting it? Or are people just saying they may have ADHD, and that’s what’s causing all of these challenges?

TRACY OTSUKA

Well, I think that they’re finally realizing that, first of all, girls have ADHD. And yes, they’ve been diagnosed for ADHD for a long while. But the truth of the matter is, most doctors, most therapists, most clinicians, they don’t even know what ADHD looks like, so they don’t know if it’s not the ten year old boy who’s climbing the walls, who’s annoying everybody, who’s externalizing his symptoms, getting in fights, being oppositional, right? If it doesn’t look like that, they don’t even see that it’s ADHD. And for girls, because of the inattention, they’re twice as likely to have inattentive ADHD. They can look like the girl that’s sitting in the back of the classroom, who doesn’t even realize what’s going on until they’re called on because they’re in their own fantasy world. Or they can look like the woman who is an absent-minded professor, brilliant at what she does well, and kind of a disaster in everything else. So what girls and women tend to do is, they internalize their symptoms and they beat themselves up about it, right? There’s a lot of shame, and a lot of it is society, too. We are expected not only to manage our own administrative executive function challenges, but we’re also expected to manage the home and our partner, and all the administrative stuff related to having a family.

If you are really bright, which most of us are, and you got through college and you did really well, and then you’re in your job and you’re doing really well in your job, but you’re kind of hanging on, right? All of a sudden you have a kid, and everything goes to hell. Because it’s not just the kid, it’s the house, it’s your partner, it’s everything, if you think about it. So the reason this is so serious is because 24% of women with ADHD will attempt suicide. It’s a really serious statistic, and that’s not part of that 43%.

A big part of the reason is because girls are expected to be neater. They’re supposed to be more organized, they’re supposed to be more polite. They’re supposed to be less all over the place, less loud, less chatty, all of that. Well, they can be chatty, that’s one that I’ll give them!  But the thought is, “Oh, that’s just a girl”. No, that’s typically a girl with ADHD, that’s hyperactivity. But it shows differently in girls than it does in boys, and differently in men than it does in women.

I think what happened is TikTok, right? All of these women we were going to clinicians, whatever, whomever, and we were told it’s anxiety, it’s depression, or it’s all in your head, it’s nothing, honey. Or it’s perimenopause. I mean, that was a big one. It’s hormones. It’s always hormones, right? What happened was, during COVID, a lot of us were trapped in our homes, and all of a sudden, we not only had to manage everything else we’ve been managing, but we also had to manage our kids’ education. We had to manage getting them on zoom, making sure their homework was done, making sure they had some sort of social engagement, and that was  literally the last wheel off the cart, we could not do anymore. So a lot of people started talking about it on TikTok, and because the doctors weren’t listening to us, we started getting curious that it’s not anxiety. I mean, it can be anxiety and depression. It can be comorbid. But often you treat the ADHD, and the anxiety and depression also subside, or go away entirely. And it makes sense if you’re constantly like that swan, everything looks perfect on the outside, but you’re paddling as fast as you can just to keep up, just to stay up. It makes sense that this would generate anxiety and depression, because you feel so much shame around it, and being able to keep up.

The other thing is that girls are typically diagnosed much later than boys. They see the symptoms later. So with boys, it’s seven, to let’s say, ten for girls. Again, it’s puberty, because it’s about hormones. Estrogen modulates dopamine, and so whenever we have bouncing around, the dopamine is bouncing around. So during puberty and pregnancy, I have never been as efficient, my gosh, if I could have my pregnancy brain! Yet all my friends were so tired, and couldn’t do anymore, they felt so behind, and I was just like a whirling dervish, because our body makes so much estrogen when we’re pregnant, and postpartum is another time.

And then, of course, our estrogen really goes down greatly postpartum, which is why many women with ADHD struggle with postpartum. What is it, postpartum disorder? Is that what they call it? Yeah, postpartum depression. But then the hormones really take a dive during perimenopause and menopause, so it explains something that I call maturity onset ADHD. So you are just flying with the ADHD right up until your estrogen starts going lower and lower and lower, and all of a sudden you start struggling with things like anxiety, dysthymia or depression, and just confidence, and you don’t know what it is. I literally felt even my handwriting changed, which is why I got tested for Parkinson’s. I couldn’t do up little buttons anymore. It was just so weird, and it was all related to this lowering of dopamine levels.

NICOLE

What you’re sharing is so insightful, and I’m sure for any woman who may think they have it, or just starting to understand it, that it’s just a totally different level of things to manage, and it has nothing to do with you needing to work on anything. It’s just actually imbalances that are happening in your brain that you need to work out. I feel like it’s a really powerful thing, though, because it gives you that power back to say, “Oh, there’s something I can do about it.” Versus feeling at the mercy of experiences in your life.

TRACY OTSUKA

And the beauty, Nicole, of ADHD and strategies for ADHD, is that it works for anyone. So if anyone is feeling a little anxious, a little down, a little lacking in confidence, all of the things that work for ADHD pretty much work for anyone. My number one thing is exercise. Exercise increases our dopamine. In fact, in the UK, exercise is the first line of defense. That’s the first prescription that’s written if you’re depressed, because when you exercise, it’s only 25 minutes, at 70% of your highest heart rate, your max heart rate, it is as effective as a course of Adderall and a course of Prozac at the same time, as far as lifting mood. So if medication works for you, great. I wish it worked for me. One time it did, and I felt I’m so grateful for the one time it worked because I was going to be giving a speech. And again, I have no working memory. I cannot memorize anything. Everything has to come from just me.  I was going to give a speech, but I could not memorize the speech. I took Ritalin one time, and it was like the sky opened and I literally drove home and recited that speech five times without a glitch. It only worked that one time. It never worked again. I still keep thinking there must be a medication, there must be something. I keep trying, but nothing works, so I have had to use strategies like exercise that don’t involve medication, but they truly even like the strategies. As far as organization, they work for everybody. It’s not just for people with ADHD, or it could be, “Oh, well, I struggle with this, this and this, but I don’t struggle with that last thing, so maybe some of these strategies will work.”

NICOLE

I mean, it makes sense to me, exercise is a huge thing. Tracy and I have only just recently gotten to know each other, but I wrote a fitness column for six years for the Seattle Times. So for me, it’s always been the way that I can feel consistently stable and good about myself. Tracy saw me get up at 06:00 a.m. every day, to go on a walk, because we were in this conference for hours and hours and hours at a time, and I cannot function, I cannot process my life without movement. Moving my body just helped me deal with stress and build up in anything that’s going on, so it makes complete sense to me that that would be another really great tool for anybody, because we’re just designed to move, whatever your brain composition, right? We’re designed to do it and so it helps you no matter what. So I love that.

TRACY OTSUKA

Well, and we should point out that Nicole got up every morning at 06:00 a.m. and actually went and worked out, versus I was not going to get up at six, and my thing was going into that gym was like, too much, so I didn’t work out and then proceeded to lose my laptop with my computer and my whole life in it, I lost two pairs of glasses, but all of these things were returned. It’s ADHD optimism, they’re going to come back. I left my phone with all my credit cards and my driver’s license in a restaurant bathroom. On the last day, I don’t know if you know this, Nicole, I got a text from the people that were running the conference to say they have my notebook. Apparently I had written my name and address in it, and I was just like, that’s the final straw. But this is exactly what happens when you’re completely overstimulated. Right? And I was stressed about the book, and I had so much I should have been doing, so I’m half at the conference, half with the book, but the big thing for me was the lack of exercise. That is what starts my day, and I didn’t do it.

NICOLE

Yes, and I understand. I mean, we were up late, we were doing so much. But I also have learned, and for me, it’s just like a life strategy. It’s like if I don’t do that, I will just lose my mind. I just cannot tolerate anything that’s outside of it. By the way, 1000 person comfort zone is definitely outside of my comfort zone. It’s a lot, just so stimulating, and I’m a borderline introvert/extrovert. It was a lot. So I can understand that if you’re somebody where you’re always dealing with a lot of stuff in your brain, that exercise would be a keyway you have to manage it.

TRACY OTSUKA

It’s energy, right? If you’ve got all this energy in your brain, you’ve got to have a way to get it out. People who really struggle with inattentive ADHD, depression, anxiety and those thoughts, have to go work out, because how do you get rid of that energy? I mean, you can do tapping, you can do somatic therapies, there’s yoga, all that kind of stuff, but for me, the fastest, easiest way is something aerobic. That really makes me go to my max heart rate.

NICOLE

Well, that makes so much sense.

I have a few fast action questions. Crazy lady told me that’s not really her thing, so let’s just try one.

TRACY OTSUKA

I don’t have a fast action brain.

NICOLE

Let’s just try one and see how it goes, and then we’ll go from there. I don’t know if you’re watching TV right now, because I know you’re super full up, but what was the last thing you watched on television?

TRACY OTSUKA

MSNBC. Rachel Maddow.

NICOLE

Okay. See, you got it. You did it. Awesome. And then let’s just do one easier one. What are the top three most used emojis on your phone?

TRACY OTSUKA

Oh my gosh, I am so corny. Anything with hearts. The one with the heart eyes. The one with the hearts all around it. The heart. Oh, and the squirrel. I always do the heart and the squirrel together.

NICOLE

What does that mean for you, the squirrel and the heart together? Like, when you’re telling somebody, ‘squirrel and heart’. Does it mean you just love squirrels, or things are crazy right now?

TRACY OTSUKA

It’s just like how they’re always squirrelling. Squirrel means you’re all over the place. You’re collecting nuts. You’re all over the place. So the squirrel emoji is ADHD, and the heart emoji is me.

NICOLE

I love that. That’s cute. And for those of you, if you’re not watching it, she was holding a stuffed squirrel, or a real one, I can’t tell, but she’s got a squirrel.

TRACY OTSUKA

A friend got it for me.

NICOLE

Super cute. Like a stuffy. A squirrel stuffy?

TRACY OTSUKA

Yeah. His name is stuffy.

NICOLE

That’s awesome. Okay, also, your book is coming out soon, so tell us a little bit about your book, Tracy. Please check out her book!

TRACY OTSUKA

I wrote this book because I just knew I had to change the conversation on ADHD or around ADHD, because I kept meeting these brilliant women. Every single one of them that came onto my podcast. I’ve met thousands of women at this point in time, all with ADHD. They all have a brilliant brain. Their charge is to figure out where their brilliance lies, and so many of them are focused on the shame and everything they can’t do right, instead of on their strengths, and as I said, positive emotion is just where we have to be. So if I can take an ADHD woman who’s all in shame, and really point her towards all of the things that she really is so brilliant at, it’s amazing how literally there’s a 180 in sometimes five days like that, quickly.

I wrote this book because I want women to fall in love with their ADHD brain. There are so many gifts to ADHD. Let’s figure them out. Then there are strategies for the things that you struggle with. And you know what? This is more than turning pages in a book. For me, it’s about changing awareness in women’s lives and really rewriting the chapters right. Or let’s say rewriting the ending, because when we realize where our brilliance is, the sky’s the limit. You’re never too late. The magic about ADHD is when we can get into our purpose, we are very mission driven because we have all these ideas, right? So which idea do we follow? That’s usually the problem. We’re doing all this stuff and because of our background, it makes no sense. If we can focus on our purpose, then what happens is, because we’re so mission driven, everything we do is built around that purpose. We do things so quickly because of hyper focus, and I have seen women who are literally just depressed and doing absolutely nothing, and the next year I don’t even recognize them! That was my goal. And they’ve gotten there through the podcast, so my goal was to take what we do in the podcast and convert it into book form, so that it’s quicker.

NICOLE

Beautiful. I love that. Well, make sure you grab a copy of ADHD for Smartass Women, because I’ve ordered my copy already. I can’t wait to read it. It’s going to be such a lifesaver, I think, for so many people who are listening and wondering, or even again, if you know someone with it, you’ll just be such a better friend, partner or parent to them by just knowing so much more about that. Also make sure to check out her podcast, because there’s lots of brilliance there and we’ll have all that linked in the show notes.

TRACY OTSUKA

I will just cite the link: ADHD smartwomen.com book. If you go to that link, there are also bonuses to purchasing the book. So please do.

NICOLE

Yes, go grab those bonuses. And again, we’ll make sure we get that link in the show notes as well. Tracy, what a delight to have you on School of Self-Worth, and just also to connect with you in person. This way, it’s so much fun, and I feel like we’re so aligned in the kind of things that we teach and work on, I really love hearing about how you’re out there helping women in the world. So thank you so much for being on here.

 TRACY OTSUKA

Thank you. It was a pleasure.

NICOLE

Thank you so much for tuning into today’s episode. Before you go, don’t forget, if you are a high-achieving woman who wants to uncover your biggest blind spots preventing fast intuitive decisions, I’ve got a 72-second assessment for you, so make sure to dm me quiz on at Nicole at Instagram.

Again, thank you for being here and for listening. We read every note that we get from you about how the podcast is making a difference in your life. Please know how much we appreciate each and every one of you. Until next time, I’m Nicole Tsong and this is the School of Self-Worth.