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Amy Marschall and Discovering Her Diagnosis

As a licensed psychologist specializing in ADHD, Amy Marschall found herself diagnosing people during the pandemic, and then asking questions about herself.

Transcript

Lindsay Guentzel (00:02):

Welcome back to Refocused with Lindsay Guentzel. What you’re listening to today, it’s a little bit different than the podcast episodes we’ve shared with you before. This episode, this person’s story, is a part of Refocused, Together, a special series the team at ADHD Online and I have been working on for ADHD Awareness Month.

Lindsay Guentzel (00:22):

Every day throughout the month of October, we’ll be sharing a different person’s ADHD story, which is fitting because the theme for ADHD Awareness Month this year is understanding a shared experience. And I can’t think of a better way to really get a sense of that shared experience than by telling a different story every single day. To be clear, yes, that’s 31 stories in 31 days. Did I mention I’m a bit of an overachiever?

Lindsay Guentzel (00:50):

My name is Lindsay Guentzel, and along with the team at ADHD Online, I’m so excited to present Refocused, Together, a collection of stories aimed at raising awareness on just how complex ADHD is and the different ways it shows up in people’s lives.

Lindsay Guentzel (01:06):

When we share stories, it’s easier to find the perspective, ideas, and tips that help us live our best lives. I’m interviewing people with varying backgrounds, diagnoses, experiences, and perspectives. We’ll hear from working parents, advocates, engineers, writers, PhD candidates, and more, to learn that while we may be different, we are all united by our own ADHD journeys.

Amy Marschall (01:42):

My name is Amy Marschall. I am a licensed psychologist, and I’ve been diagnosed with both ADHD and autism. After specializing in both of them for work, I have a lot of knowledge from the clinical side and also from the living with it side. I do a lot of work with diagnosing and helping support other people who also have these diagnoses.

Lindsay Guentzel (02:11):

Amy Marschall is a psychologist trained to identify ADHD in others, but it wasn’t until January of 2022 that she knew she had ADHD. She was a quiet, book smart kid, and described her high functioning anxiety quite beautifully, like a duck, calm on the surface, but kicking like crazy under the water to keep everything going. She got into a good college, went on to graduate school, and earned her license. Her specialty became ADHD evaluations, and she clicked with the kids because she found them relatable. Neuro-divergence starts in childhood, but isn’t apparent until demands exceed resources.

Lindsay Guentzel (02:53):

Fast forward to April of 2020 when many adults realized that lockdowns and work from home rendered their coping skills pretty much null and void. That’s when Amy found herself dealing with burnout. She was also in this rare ethics code problem. How do you find referrals for yourself when you are the psychologist and your practice is the resource for ADHD testing in your area?

Lindsay Guentzel (03:16):

Eventually, Amy found a professional to work with and tests confirmed that she was like many other women with ADHD, misdiagnosed and flying under the radar for years before getting the proper help. That knowledge has allowed her some grace, especially when she forgets a meeting or doesn’t text someone back for a few days, and she is currently working on a book to help undiagnosed, neuro-divergent folks identify themselves and seek support. I hope you enjoy my conversation with Amy Marschall for Refocused, Together.

Lindsay Guentzel (03:56):

For full transparency, here is where I tell you that I’ve actually spoken to Amy before, back when we decided we were going to launch a podcast. I don’t even think it had been named yet. Amy and I sat down and had an amazing conversation, and actually, that conversation was really kind of the starting point for a lot of the early kind of paths that we carved out for the podcast. And I loved hearing your story, and so I’m so glad that you’re back for ADHD Awareness Month. Thank you so much for sharing your time and your story with us.

Amy Marschall (04:31):

Yeah, thanks for having me and having me again.

Lindsay Guentzel (04:33):

I know, it’s like déjà vu in the best way. If you’re listening to this or you’re watching this, you’ll very quickly learn that Amy has incredible energy, and as I was getting ready for this interview I was like, this is what I need in my life, so I’m so glad that I get to share that with people.

Amy Marschall (04:49):

Aww.

Lindsay Guentzel (04:50):

Let’s start at the beginning because you have a very unique story. We can talk about ADHD diagnosis stories. Everyone has their own, and they’re happening at so many different points in life, but yours came in kind of a very, I will say, interesting, kind of funny. I mean, I’m sure that there are words that you have that you use, so why don’t you just start … yeah, why don’t you just start by telling us a little bit about that.

Amy Marschall (05:17):

Sure, sure. So I’m a psychologist, and one of the things that I specialize in, one of the things my practice focuses on is diagnosing ADHD. I work with a lot of children, adolescents, but also adults. And so I went through the grad program, I went through the internship, which focused a lot on ADHD, the post doc that focused on ADHD, and then I’ve been licensed and in practice doing that for six years now, and I was not diagnosed until last year.

Amy Marschall (05:51):

The ADHD diagnosis came in December, autism diagnosis in March of 2022, so very recently still. And I noticed a pattern in my practice, because we talk about with ADHD, it’s something you’re born with, so if you have ADHD, you’ve always had ADHD, whether you knew it or not. We’ve found that for many people, symptoms don’t emerge until they’re older because it occurs when, as we say, demands exceed resources.

Amy Marschall (06:23):

So basically, a lot of people can compensate for a lot of different reasons, or mask, or basically not show their symptoms. And so I noticed in about April of 2020 that the number of adults who were calling me for ADHD assessments just spiked. And my theory, and I’m not sure how much actual research has gone into this, my own practice is an anecdote. Some people in my consult groups have also observed it, but the plural of anecdote is not data, so that’s not necessarily a study itself, but it was saying the pandemic seemed to be the event that caused demands to exceed resources, and I was noticing in myself some things that I kind of always just dealt with and lived with, and I figured was just everybody has trouble doing things sometimes, got more and more, and I realized, well, pretty much all my friends have ADHD.

Amy Marschall (07:20):

So I said, “Hey, I’ve noticed more and more of these things are kind of like what you’re talking about when you talk about your ADHD.” And several people were like, “Yeah, we thought you knew.” So I reached out to get tested and find out for sure, and it’s kind of hilarious to me that none of my supervisors ever said anything, people who are supposed to be diagnosing this professionally, and that I didn’t notice it in me either after years of doing it professionally.

Amy Marschall (07:49):

And there’s a reason we don’t diagnose ourselves. I mean, self diagnosis is a resource that a lot of people go with, and some people don’t have access to testing, so it’s valid from a community standpoint, but there’s a reason clinically why you can’t just say, “Oh, I have the training to test, so I’m going to test myself.” But it really just shows that, I mean, how good are we at screening if I got through the entire program and all these people whose job was to know who has what diagnosis didn’t see it in me?

Lindsay Guentzel (08:22):

I’m curious, some of those conversations you were having with the friends who have ADHD, what were some of the things that you were noticing or things that stood out? Because I think for a lot of us, especially women who are diagnosed later in life, we’ve spent so much time masking, we’ve spent so much time body doubling. We are very good at coping and making things happen, for ourselves and for the people around us, and so a lot of times it’s things that are less visible, and I say emotional, and I feel like that really disconnects from the fact that it stems from the brain. I think we have this very Disney idea, like your thoughts come from your brain and your feelings come from your heart. And it’s like, well, not really.

Amy Marschall (09:05):

Technically, your feelings come from your brain too, that just-

Lindsay Guentzel (09:08):

Exactly. But it is that, like the heart and the love, it’s all connected there. So what were some of the things that stood out for you?

Amy Marschall (09:13):

Well, hyper focus is one. And I mean, the term, with ADHD, the attention deficit is misleading on its own because it’s not so much that you can’t pay attention to anything. It’s that it’s hard to hold that attention if it’s not a thing that you actually care about, and that you don’t always get to pick what the thing is going to be. So I would notice like, oh, hey, well, I’m getting stuff done. It’s not the urgent thing that I was supposed to be doing, but it’s a thing and it’s getting done, so I must be able to focus, just not necessarily on the right thing. And never doing one thing at a time. It’s always like six things going on at once. It can’t be silent, always something in the background. When falling asleep, I can’t fall asleep unless there’s something, and it has to be like a storyline going on. I can’t do white noise machines. They’re awful.

Amy Marschall (10:10):

But the hyper focus, not focusing on the right things, the doing a million things at once, the executive function kind of issues. My work stuff, I’m always on top of it, but it’s not always the functioning for the personal things. I routinely don’t eat lunch because the next thing I know, it’s 6:00 PM and I’m like, “Oh, hey, that’s right. Lunchtime already happened today.”

Amy Marschall (10:39):

So I think for me, a big thing is the fact that the hyper focus happens very intensely, and we don’t think of that as ADHD because it’s like, well, if you’re paying attention to something.

Amy Marschall (10:52):

There’s also the myth that if you have good grades, you don’t have ADHD, which technically used to be a diagnostic criteria and is probably part of why it wasn’t considered for me when I was a kid because my grades were always good, but I always kind of felt like I was a good student, but not a fantastic student. I never had the 4.0. And I always kind of felt like I could, if I could just get myself to actually try harder, and that was mostly an internal thing. Adults were like, “Hey, you’re doing great. 3.5 is not a bad GPA.” But in my mind I was like, well, yeah, but I kind of didn’t put in my full effort for whatever reason, and if I had been able to, I think it would’ve been all the way up there. So, noticing that not being up to your potential just because you just can’t make it happen.

Lindsay Guentzel (11:45):

Hindsight and rumination go hand in hand with later in life ADHD diagnosing, and I’m curious if there are moments you look back where you can really see it coming out in life prior to your diagnosis. Because I mean, I know your story. As I mentioned, we’ve spoken before. I know about all the amazing things you’ve done, and we’ll get to that later in the conversation. I compare it to my own story where I left high school and I went to college, and the wheels fell off in the most dramatic, humiliating, horrific, life-changing way. And I’m curious if when you look back, if there’s moments you see where it is coming out, seeping to the surface, and you were able to kind of squash it down or set that aside.

Amy Marschall (12:34):

Yeah. I mean, when I was applying to grad school, there were a lot of moving parts to that, and I had this system and it was very intricate. And I started graduate school in 2010, so this was 2009 that I was applying. And back in the day, this was … some programs didn’t have online applications, some programs it had to be hard copies, and then other programs where it could be online or it could be a hard copy. So I said, okay, everything is going to be a hard copy. It has to be exactly the same for everybody.

Amy Marschall (13:10):

And I had this filing system, and I had post-its everywhere, and I had, “This is for this and this is for that.” And then I had all the files of all the personal statements, because every program has a different personal statement. I don’t know if they still do it this way. And then I was like, I had the parts where the statements overlap, so I was pulling and copy-pasting from here and here, and my letters of recommendation, and it was all … And then I had a spreadsheet where I checked things off as they were done, and I just had this big pile of those massive application envelopes that people used to use and carrying those around.

Amy Marschall (13:49):

Basically, I carried them with me everywhere because I was so terrified I was going to lose something vital. And in hindsight, I mean, I know applying to grad school is intense for everybody, that’s what applying to grad school is, but I don’t think most people were keeping their files on their person at all times because they were afraid of losing them. I think most people were probably like, yeah, I’ll just leave it. And the checking, triple checking, I think I put it there, but did I really? Because sometimes I think I put something somewhere and it’s just gone, and I just don’t know where it is anymore.

Amy Marschall (14:29):

I’ve actually joked with my husband that if you’ve seen the Paranormal Activity movies, well, in all of them, they’re always told like, “Well, if you pay attention to it, it gets worse. You have to ignore the demon and he loses energy.” But at the beginning of the first one, the first sign is that the demon knocks their keys onto the ground and they’re like, “Oh, our house is haunted. The demons knocked the keys on the ground.” And I’m like, if that was our house, I would come downstairs and be like, “Why did I put my keys on the ground?” The demons would never gather any energy because they’d move my stuff around and I’d be like, “Oh. Well, I don’t remember doing this, but that sounds like me.”

Lindsay Guentzel (15:10):

What was I trying to remind myself of?

Amy Marschall (15:13):

I don’t know, maybe I would put this over here. Maybe I would stack all the chairs on the table. I don’t know. Maybe I was bored.

Lindsay Guentzel (15:20):

I want to touch really quickly on what you mentioned about the applications and how, in your head, they all had to be a certain way and you had a certain setup for them. And it reminds me, I was thinking of this the other day, how the reason I ran my first marathon was because it was the longest distance I could run. In the race I was running, there was the marathon, there was a 10 mile, and I think there was a 5K. Well, I had to do the best one. I couldn’t in my head, and I’m still working on this, I couldn’t separate myself from the fact that 10 miles is a great accomplishment. And so it’s interesting hearing you say that, like in your mind you were like, “No, this is the right way to do it,” and I’m sure that there were a ton of applications that it would’ve been so much easier had you just gone digital.

Amy Marschall (16:03):

If I could have said, “I’ll do the online ones that will let me do it online,” but I couldn’t … And I mean, some of the sameness, some of that could be the autism side of things with the ritual and routine, but I do think a lot of that was ADHD because I was like, “I’m not going to be able to keep track of this unless I do it all exactly the same way every single time. I’m going to lose something if I’m not doing it the same way.”

Lindsay Guentzel (16:28):

I want to talk about how your diagnosis has changed the way you work with your patients, but before we get to that, I want to talk about areas of improvement. And these conversations are different with everyone that I’ve been talking to because everyone got their ADHD answer at a different point in life. And so you accomplished a ton prior to your diagnosis, but when you look at how it affects your life, where does it stand out as the most detrimental?

Amy Marschall (17:04):

Sure. I mean, so I have trouble stopping. I’m very much, one of the hyperactive symptoms is going as if run by a motor or something like that. I always forget the exact wording, but we picture that as a six-year-old boy who’s running in circles, but that’s not always what it looks like. For me, I get into my work stuff and I’m like, I’m going like I’m on a motor. I cranked out I think four psychological evaluations yesterday because I was just going, and my husband got home from work and he had dinner and he was like, “Hey, are you going to come eat?” And I was like, “Yeah, just a minute.” You just can’t stop.

Amy Marschall (17:39):

Which, again, and this is one of the problems, by the way, with functional labels for everything, because I would be … Basically, I’m considered high functioning because I can work a lot, and that’s true, and it’s awesome that I can pay my mortgage, but it’s also not … It really gets praised as like, hey, you get to keep going, and I’ve hit burnout a couple times in my life and it’s not a good thing, and you really don’t get taught balance because it’s just, “Oh, hey, you can work a ton. Isn’t that fantastic? Look how driven you are.” That’s great that I get to help a lot of people, but it’s not just this fantastic, wonderful thing. It’s exhausting, and it’s really hard to know when to stop or how.

Lindsay Guentzel (18:24):

Right, exactly. I relate so much to what you’re saying, and especially in the midst of this hustle culture, like what’s your side hustle? How are you working all the time? And people look at people like you, I have tendencies in similar areas, where it’s like you don’t know how to slow down, and so you just go and you go and you go until something breaks.

Lindsay Guentzel (18:48):

Let’s talk about what you have changed since getting your diagnosis. And I know that also takes into account the autism diagnosis, which for a lot of people, it goes hand in hand. They get one, and then the other comes, or vice versa. What have you made alterations to in your life? What have you added? What have you taken away? What do you see as like, “Okay, I know what I’m working against, here’s what I’m going to do”?

Amy Marschall (19:19):

Sure. Well, I mean, I was working from home, but I did make the decision, and this wasn’t like, “Oh, I have ADHD and I’m autistic, I’m going to do this,” but it kind of just, the timing. I made the decision, I’m in the process of transitioning from working for an agency to working in private practice. Some of my hesitation was that there’s things, when you’re private practice, there’s stuff you have to keep track of that the organization was doing for me, but realizing that the challenges of some of those things weren’t just like, “Oh, that’s stuff I’m bad at, therefore I can’t do it.” But, “Oh, hey, I can find a way to do these things that works for me.” And that’s really nice because the organization that I’m transitioning away from is a great place, and I’m going to be referring clients to them and they’re going to be referring clients to me, so it’s not a bad blood situation by any means, but I get to be my boss, which is kind of nice. And so I’m trying to figure out the balance with when it’s purely just up to me.

Amy Marschall (20:23):

I also get to make certain decisions on my own. The organization that I’m shifting away from wouldn’t tell me not to share my diagnosis. In fact, I’ve had colleagues there who are open about various diagnoses that they have, and it’s not a problem. They would be supportive of that. But I would like to be able to advocate for certain things in the field, in the community. I want to be vocal. I want to help my clients individually, but I also want to be a voice in the world, and I don’t want to have to think about, how is this reflecting on my employer? I don’t want my employer to have to … I don’t think I’m saying anything terrible. But I don’t ever want them to be like, “What’s she going to say?” I don’t want that to be a thought. I just want to be like, “Is this the right move for me? Is this the right thing to do? Do I feel safe doing this?” And then there’s not the added factor of, “Do I need to run this by a supervisor?”

Amy Marschall (21:22):

Because even when you’re off the clock and the people look you up and they see who you’re affiliated with, and even though we are allowed to have lives outside of our work, there’s a lot of people who really don’t think that. And they’ll be like, “What would your boss think if you were doing this?” And it’s like, “Well, it’s none of their business. They’re not paying me right now.” But that’s a thing that happens, and I don’t want them to have to navigate that. I don’t want them to have to respond if someone gets annoyed with something I said and decides to blow up their inbox. I just want to be like, “If you don’t like what I said, you can contact my boss. She’s me.”

Lindsay Guentzel (21:56):

No, but I totally know what you’re saying. I love that you are transitioning to this next chapter because a lot of the people I’ve talked to who have ADHD are their own bosses, and it’s something that they have sought out, whether they knew from the beginning, they always knew like, “I want to be an entrepreneur. I want to start something. I want …” I don’t even think it’s sometimes the control. I think we think it’s the control, but I actually think it’s the freedom.

Amy Marschall (22:27):

Yeah.

Lindsay Guentzel (22:28):

I’m curious if that has always been in the back of your mind, or if this is something that has kind of sprung up as you got into your career and you started working regularly and seeing patients and kind of realizing what your goals were, or can you look back and see, were you the one in the group projects who always took the lead? Where does that kind of stand?

Amy Marschall (22:49):

I mean, my initial thought was I didn’t want to do private practice because … Well, my main two reasons were the overhead and the billing. But there are electronic health records that do the billing for you. I actually did my billing this morning. It’s like a one click thing. And I think I had to call tech support because I didn’t know how to input a code, and they talked me through it.

Amy Marschall (23:13):

So the billing is not as complicated as I thought it was, but that’s an ADHD thing. There’s this thing that’s probably a relatively simple task, but I don’t know, intimidated by it. It seems bigger than it is. I’m not sure how much effort it’s going to take, so it just doesn’t happen. So, I was anxious about the billing side of things, and offices are incredibly expensive, but I’m almost entirely work from home. So the office is this room in my house, which means that I can deduct part of my electric bill on my taxes, so I actually come out ahead.

Lindsay Guentzel (23:47):

How is working from home for you?

Amy Marschall (23:49):

I like it. It’s not for everybody. And frankly, it’s not for everybody with ADHD because you do have to work in the same building where you live, but we actually have been able to do a setup. So we were in an apartment, but we bought a house recently. Yay. And so now we are in a situation where this room, my home office is Amy’s office, and it’s not Amy’s office/the guest room/storage/whatever. This is just, this room is my office and nothing else. And when I’m off the clock, I leave and I close the door. So, I have an office that’s separate from my living space now, and that’s been amazing.

Amy Marschall (24:34):

But another thing for me, I mentioned that I’ll hyper focus and I’ll realize I haven’t eaten. Oh, my God, I think I could count on both hands the number of times I’ve remembered to bring my lunch when I’m going into the office. The kitchen’s right there. If I forget, I can go and get it. So, I really like that I don’t have to … and I don’t have to remember, “What do I need to bring into the office today?” because it’s right there. I don’t forget things because they all stay in one place.

Amy Marschall (25:06):

So, I just have that boundary of this is my workspace, the rest of the house is my home, and then there’s not that overlap of space that’s a little bit of both. But it’s much easier to be organized when there’s not multiple locations. I still go in one day a week. Last Thursday, I got to the office and I was like, I brought my laptop and my charger but not my keyboard. There’s been times that I get to the office and I’m like, okay, I have everything but the charger. I better hope my computer doesn’t die before the end of the day. Yeah, you don’t have to remember things.

Lindsay Guentzel (25:41):

And that is, I think, such a struggle for so many people with ADHD. It’s just like our brains are wired to work against us in that way. But a normal person, I hate using the word normal, but-

Amy Marschall (25:55):

Neuro-typical.

Lindsay Guentzel (25:57):

Thank you, neuro-typical. I got to break myself of that. It’s just like this bad habit. But yes, neuro-typical people, they would make that mistake and they would let it go. And rumination, great part of ADHD, we can hyper focus on that mistake and just let it wreck us. And it’s like to other people, neuro-typical people, they’re like that, “Oh, you’re really thinking about that?” I have brought up things to friends or family about little mistakes that happened years ago, and they’re like, “You’ve been thinking about that this entire time?” I’m like, “Oh, yeah, yeah. When would you like to go through the list?”

Amy Marschall (26:35):

Yeah. Well, I know there is the tendency to fixate on things, but I do wonder if some of that’s trauma because we’re so used to like, “Oh …” Because a lot of it is when you forget something simple, it’s often, “How did you forget that? It was so small, it was so minimal. How could you do that?” And so then we internalize that, and then that becomes your internal monologue of like, “Wait, what do you mean? Oh, I screwed up again. Oh, it’s such a simple mistake. I make all these simple mistakes. Why am I so terrible?”

Amy Marschall (27:09):

And so we have the tendency to fixate on things, and then we also have that lifelong messaging, “Why do you keep making such simple mistakes?” And we talk about the ADHD paralysis of, “I have to work in four hours. I can’t do anything because I have to be working in four hours.” And I think I made a joke about that, that I was like, “I set aside three hours to work on paperwork, but I have an appointment in three hours, so I can’t do anything.” And my friend Dana, who also has ADHD, was like, “Well, how much of that is a trauma response? Because everybody has been ragging on us every time we’ve been late our entire lives,” and so your brain is like, “Okay, but if I get into this, I might hyper focus and then I’m going to be late and I’m going to let everybody down and it’s all going to be ruined.”

Lindsay Guentzel (27:57):

It is. It’s the lovely snowball effect. It is, yes. And I appreciate that you touched on trauma because I think that definitely plays a massive role in how a lot of us view some of the things that we are just not set up to be good at. And if you’re not taught them and it’s not ingrained in routine, it isn’t going to happen. And it’s just, it’s this vicious cycle.

Lindsay Guentzel (28:23):

I would love to talk about how you think you have changed in your profession now that you have been diagnosed with both ADHD and autism, and how that new knowledge plays a role in the way you’re connecting with the people that you’re working with, because I imagine that some of them are people you were working with prior, and so it’s like this come in one day and you’re like, “Oh, I have some news.”

Amy Marschall (28:52):

I didn’t do that, but I did make the choice to be open about my diagnosis, and part of that is there is a lot of stigma. Being open about my diagnosis is activism in itself because there is a stigma. When I was applying to grad school, I didn’t know I was autistic. I didn’t know I had ADHD, but I knew that I had anxiety and I knew that I had had anxiety for a really long time. So my first draft of my personal statement was about living with anxiety, and my advisor said, “If you submit that, you will not get in. No school is going to take you if you admit that you’ve had a mental health struggle.” And that’s the message is like don’t share it, but it’s weird because you’re in the program and they’re like, “We need to fight stigma. It’s our responsibility in the field to fight stigma, but you dare admit that it’s you. It had better not ever be you. It’s okay for other people, but it better not be you.”

Amy Marschall (29:50):

And so there’s kind of this mentality that if you have any diagnosis yourself, then you can’t … you’re not competent, which is really, I think, insulting to my clients. Like, oh, it’s okay for you to be autistic, it’s okay for you to have ADHD, but you could never be in my role. I’m so much better than you because I don’t have these things. It’s really condescending, if you think about it, but it’s hard to be open.

Amy Marschall (30:17):

There was, I believe, a psychiatrist who shared on social media how he’s on medication for ADHD, and a group of people who are very, very anti mental health medication were saying that he should have his license revoked because he was clearly not stable enough to be working if he needed to take medication for his brain, that he should be fired, that his license should be revoked, that all of his patients were in danger because he was on a medication for how his brain works.

Amy Marschall (30:51):

So basically, my decision to be very vocal about it is that I would like us to get to a point, because it is people’s private personal information, and technically it’s nobody’s business, but I would like to see a world where someone like me gets to decide, “You know what? I’d just rather my clients not know that I have ADHD,” or, “You know what? I don’t mind if my clients know that I have ADHD,” instead of feeling like it’s something that they need to hide.

Amy Marschall (31:22):

So I would like it to truly be up to the individual, and I did choose to … My website for my private practice has my diagnoses noted on there, so it’s out there. Not all of my clients see that part of the website. I sometimes have brought it up to them directly, but their appointments are not about me. But for example, I work with a lot of young children, and sometimes … Kids have some sense of what these things are, but they don’t really understand it, and they pick up on that stigma really young.

Amy Marschall (31:56):

And I’ve had some elementary-age kids who, they know that they’re coming to me to be evaluated for ADHD, to be evaluated to see if they’re autistic, and they’ll say, “I don’t want to.” And so I’ll ask them about that, and I’ve gotten a lot of … For example, I’ve had a lot of kids say, “Well, if I have ADHD, doesn’t that mean that I’m stupid?” And it’s actually been a really cool moment there that I can say, “Well, do you think that I’m stupid?” And they’ll say, “Well, no, you’re a doctor.” And misconceptions and generalizations and all that, but they’ll be like, “No, you’re a doctor. Doctors have to be smart.” And I say, “Well, I have ADHD, and if I have ADHD and that doesn’t make me stupid, then that means that even if you have ADHD, then maybe that doesn’t automatically mean that you’re stupid.” And they’re like, “Oh.”

Amy Marschall (32:46):

So it’s been cool to be able to share it in that sense, but I’m not sitting down with each client and being like, “I learned something about myself last …” If it’s relevant, I’ll share it, but it’s not my session, it’s their sessions. It’s not a secret, but I didn’t bring it up unless the clients brought it up.

Amy Marschall (33:09):

And sometimes, for some of them, it is relevant because, I mean, with a lot of the trauma, with being neuro-divergent, living in a world that’s not built for neuro-divergence, or with the way that autism gets treated a lot of the time in mainstream where your goal is to not be autistic anymore, a lot of people want to find a therapist who shares that aspect of their identity. I mean, I think they have the right to do that, that they want to know for sure, okay, you’re also autistic, so you’re probably not going to tell me that the only way I’ll get by in life is if I learn how to stop being autistic. I mean, [inaudible 00:33:51] internalized, all of that stuff. But people will often seek a therapist that shares a part of their identity, and if that’s what they’re comfortable with, they have a right to do that.

Lindsay Guentzel (34:02):

I love the way you put all of that. And I was just sitting over here like, “Don’t cry, don’t cry,” because it is … Well, it’s so hard to hear, and it’s always the people who are yelling the loudest, so it’s not necessarily an accurate portrayal of how many people think that way. But one thing that I hope these 31 stories, one of the goals is to show, one, how different ADHD is when it shows up in people’s lives, and two, how different we all handle it, and what works for every single person is going to be different. And I really appreciate the way you described that.

Lindsay Guentzel (34:48):

I was thinking about a lot of the things that I think back on from my childhood that I now know were connected to ADHD, and had I had somebody I could have confided in who would’ve understood, I mean, I would’ve had to actually tell somebody. I mean, that would’ve been step one. But you are in such a position of power and empathy because they can say things to them that sound, and I hate using this word, but that sound crazy. And so they’re like, “Oh, my gosh, I can’t believe I’m saying this.” And you’re like, “No, I get it, and let me show you, let me talk with you about why.”

Amy Marschall (35:24):

Yeah, because you can only learn so much reading about a condition. And everybody’s, like you said, everybody’s showing up differently and everybody is one-of-a-kind and unique in their own experience and all of that, but it’s one thing to have somebody say, “Oh, have you tried using a calendar?” And it’s another thing to have somebody say like, “Hey, here is the specific calendar system that helped me, as someone whose brain is a little bit more similar to yours than that guy’s.”

Lindsay Guentzel (35:55):

This feels like a great point to transition to where you’re thriving, and it’s a question that I’m asking everyone in this, and so it can be in any aspect of life. We’ve talked a lot about your career. You work in the mental health field, so it feels like there’s probably a lot of gray area. But when I say that to you, like, “Where are you thriving?” What comes to mind?

Amy Marschall (36:18):

Sure. I mean, I think that I’m doing really well work-wise. I’m still working on slowing down, although, my husband’s been helping me with that. As my husband, I can’t diagnose him with anything, but he was my boyfriend all through grad school, so when I was learning assessments, he had to take all of them so that I could practice administering them, and I’ve made him fill out all these screeners. We’re pretty sure that he is neuro-typical, and he’s got no interest in getting an evaluation, which is a symptom of not having ADHD is if you don’t sit around wondering if you might have ADHD and you don’t think, “Oh, I think I want to be test …” Because I asked him when I got tested, I said, “You know, people like me tend to pair off. Do you ever wonder about these things for yourself?” And he’s like, “No.” And I said, “Oh, okay. Well …”

Amy Marschall (37:12):

So, we’re doing a thing right now because one of the ways that my impulsivity plays out is I like to … The new shiny idea, project, whatever, and I’m reaching a point with the advocacy that I’ve done and with the trainings that I’ve done that people reach out to me with projects and I get really excited and I’m like, “Yes, I want to do that.” So we’re trying a new thing, and he doesn’t decide what I do at all, but I ask him. So someone reached out to me yesterday about something, and so I texted him and I’m like, “So-and-so wants me to do this. Can I say yes?” And he doesn’t give me a yes or no. He says, “How does that fit in with your existing schedule?” And in that case, it did fit in, so I said Yes, but for a couple of other things I’ve been like, “So-and-so wants me to do this. Can I say yes?” And he’ll be like, “Does that fit in with your schedule?” And I’m like, “No, it doesn’t.”

Lindsay Guentzel (38:12):

He is the voice of reason, the pause that-

Amy Marschall (38:16):

Yes. Well, not even though, because he’s not telling me not to do it. He’s being my slow down, stop and think before you commit to things, because my brain doesn’t have that.

Lindsay Guentzel (38:28):

Yes.

Amy Marschall (38:29):

So, we just have a thing in place, and it was my idea completely, like I was like, “Can I start asking you permission before I take on projects?” And he was like, “That’s weird. I don’t tell you what to do.” And so he’s like, “Just make sure that if you’re telling people about this tactic that they know I’m not controlling what you do.” But I was like, it’s been really helpful to just have somebody that is … And we just have an understanding, because I tried doing that for a friend and I’m terrible because they’d be like, “Can I do this?” And I’d be like, “That sounds awesome. Do it.” And then I’m like, “That’s not helpful.”

Amy Marschall (39:07):

So it’s just the, he’s like, “Do you have time for it?” And that makes me stop and think, so it’s nice. It’s the part of my brain that doesn’t do the thing, he is that part of my brain for me.

Lindsay Guentzel (39:21):

And I love that you’re at a point in your relationship where you know what you need to be successful and you guys have this relationship where you can go to him and be like, “Hey, I have this kind of crazy thing I want to do.” And he’s like, “I mean, yeah, obviously I will do whatever you want to do, but here are my boundaries with that.”

Amy Marschall (39:41):

Right. Well, he’ll just be like, “Can you?” And then I’m like, “No, you’re right. I can’t.”

Lindsay Guentzel (39:47):

Yes. If only that person was with us when we go shopping or when we’re in the grocery store or all of those things. Yes, it’s the moment of pause to think, “Is this necessary? Do I need this? What will this make me feel like?” All of those lovely things.

Lindsay Guentzel (40:05):

So, I want to talk about all the things that you have done on your own and I know the children’s book because we had talked about it before, so let’s talk about some of those projects because those are things I think are incredibly important. And obviously the people listening to this podcast are people who are interested in learning more about their own mental health and their own journeys, and so what’s out there right now that you’ve created that tells your story, but also is meant to help other people?

Amy Marschall (40:43):

Sure. Well, so I started blogging when I started working from home because everybody went online and I work with a lot of kids, and so I’m in all these groups of therapists who work with kids, and everybody was freaking out because they’re like, “What do you do with kids in a video session?” And I was having a great time because I found all these online versions of games that I did in my office. And everybody’s freaking out and I’m doing fine, so I started blogging just what I was doing in my sessions. So, that has been really helpful to a lot of people.

Amy Marschall (41:16):

And then I pitched that to PESI because they have telehealth trainings, but they at that time didn’t have anything for kids, so I do the Telehealth with Kids training for them, which then turned into the Telehealth and Kids book, which I’m actually writing a second one now with more interventions and everything.

Amy Marschall (41:35):

The initial book has like, “Here’s stuff to consider when you’re setting everything up and then here’s a bunch of activities.” I did get one negative review on Amazon that said the book contained too much reading. I’m not quite sure how to fix that. I’m very sorry to that person. Yeah, I don’t quite know how to make it have less reading, but I did write … Well, technically my cat, Armani, is off somewhere right now, but he’s diabetic, so he wrote a book about getting diabetes treatment. That person might like that book. It’s a lot less reading, but it’s about him getting sick and how he was scared and going to the vet, and he got treatment and he felt better. And that he’s still … It ends with, he is still has diabetes, he still has to get medicine and everything, but that he feels a lot better and that he’s having the best life possible.

Amy Marschall (42:28):

So, that’s actually helped … I mean, it helps for kids who have an illness, but it’s also been helpful for some ADHD kids because they might need medication or they might go to therapy, and they might feel embarrassed about that or like, “Why do I do this and my friends don’t do it?” And so it kind of normalizes treatment for anything. The book doesn’t mention diabetes specifically, I don’t think. I decided to just kind of make it more generalizable. But that can help just talking with kids, and it’s got suggested questions for caregivers that you can ask them. What questions do you have about your medicine? Or, do you ever feel scared when you’re going for treatment? Or, how can I help you better? And stuff like that. So, yeah.

Lindsay Guentzel (43:13):

What is one thing, or a handful of things, that you, as someone who is trained in identifying ADHD and helping people along their journey, but also someone who has it themselves, what is one thing you wish more people knew or understood a little bit better as we work to change some of these narratives?

Amy Marschall (43:35):

Sure. Well, I think that it, because it doesn’t look one way, and you don’t know what’s going on for someone else, and I think that’s true for both. And you don’t know about masking, like you don’t know who’s masking and who’s not masking, and being able to mask is not a compliment. Some people seem to think that it is. It wasn’t related to my work at all, but I was talking to someone and I ended up sharing that I’m autistic and they said, “Oh, you must be very high functioning.” And I’m like … They mentioned it as a nice thing, but I was also kind of like, “What the hell does that mean? Excuse me? You don’t know my life. You’ve been talking to me for 10 minutes. You don’t know what things I struggle with just because … and you’re not a mental health professional, so you don’t know. You clearly don’t know what autism is.”

Amy Marschall (44:28):

So just don’t make assumptions. You just, you never know, and don’t question people’s diagnoses. I hate that, “Oh, everybody’s a little bit ADHD,” and it’s like, no, no, they’re not.

Lindsay Guentzel (44:42):

Yes, forgetting things and having a different brain setup is very different.

Amy Marschall (44:47):

Right. Yeah. And that’s okay. And if you do find a lot of the content super relatable all the time, maybe look into getting tested if you have the resources and if you feel comfortable, because there is stigma, there is discrimination, and assessments can get very expensive, so it’s not an option for everybody. But if you find the content relatable, maybe instead of, “Oh, everybody does that,” invalidating, you know, “You don’t really have that.” Just maybe consider, “Hey, maybe I’m part of this community too.”

Lindsay Guentzel (45:21):

Well, Amy, it was such a pleasure to hear more of your story. I know the first time we talked, it really focused in on the work you’re doing, and so to be able to go back and see how it all started and what stood out to you as you sought out your own diagnosis, I’m so appreciative of not only what you shared here today, but the energy you put out into the world and the positivity and the inclusivity, which I think is so important as we work on breaking down these stigmas. And so just thank you so much for your time and your story, and yeah, I just … Keep putting that out there. It’s so needed.

Amy Marschall (46:04):

Thank you. It’s good to be here again.

Lindsay Guentzel (46:21):

A big thanks to Amy Marschall for sharing her story with us on Refocused, Together. You can find out more about Amy, her work, and the books she’s written at resiliencymentalhealth.com. I have that linked in the show notes as well.

Lindsay Guentzel (46:35):

Refocused, Together is a special series created for ADHD Awareness Month with the help of Zach Booker, Dr. Randall Duthler, Tim Gutwald, Keith Brophy, and the entire team at ADHD Online. That includes my teammates, Keith Boswell, Susanne Spruit, Claudia Gatti, Melanie Meyrl, Paul Owen, Kirsten Pip, Sissy Yee, Tricia Mirchandani, and Lauren Radley. Thanks to Kory Kearney and Mason Nelle and the team at DEKSIA, to Cameron Sterling and Candace Lefke. Thanks to Camilla Eden, Lauren Terry, Sarah Gelbard, Phil Rodeman, and Sarah [inaudible 00:47:12].

Lindsay Guentzel (47:13):

Our theme music was created by Louis Inglis, a songwriter and composer based in Perth, Australia, who was diagnosed with ADHD in 2020 at the age of 39.

Lindsay Guentzel (47:23):

To find out more about Refocused, Together or to share your story with me, head over to adhdonline.com and check out the ADHD Awareness Month page, which highlights this project, as well as each day’s episode after they’ve been released. You can also find out more by following along on social @LindsayGuentzel and @refocusedpod.

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Assessment and
Treatment Plan Development**

The patient completes our asynchronous assessment and receives the report from a doctorate-level psychologist within 3-5 days.

The patient schedules an initial appointment with one of our providers to develop a treatment plan through a secure virtual appointment. We provide you and your patient with a copy of our full report. You take it from there.

**If available in your state

Assessment

The patient completes our asynchronous assessment and receives the report from a doctorate-level psychologist within 3-5 days.

We provide you and your patient with a copy of our full report. You take it from there.

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Prescriptions via telemedicine for Schedule II (stimulants) medications are not permitted by state law in South Carolina. Patients can receive prescriptions from our providers for non-stimulant medications.