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Episode 61. ADHD and Our Relationships with Food

  • Podcasts

The New Year can make even the most pessimistic person feel some optimism and if you made a resolution, there’s a very good chance you have one of these — losing weight, eating healthier and exercising more — on your list. They were the top 3 resolutions Americans made this year, according to Statista.com

To get you started on your journey, we wanted to dive into the relationship between the ADHD brain and food. Because it is incredibly complex and we know disordered eating is a comorbidity many people with ADHD deal with. But it goes well beyond that and there are conversations happening right now that explore the connection between what we eat and how our brain works — the gut-brain connection.

These complex conversations are ones Dr. Marylin James is having every day with her patients, through her practice Haven Family Health in Jacksonville, Florida and through her work as a telehealth physician at ADHD Online. Dr. James uses her dual board certification in both family medicine and osteopathic manual medicine to provide her patients with the individualization they need. 

Transcript

Lindsay Guentzel (00:03):

Refocused with Lindsay Guentzel is produced in partnership with ADHD Online, a telemedicine mental healthcare company based in Grand Rapids, Michigan that cares for ADHDers of all ages in towns, cities, and rural communities across the country. Are you self-diagnosed but curious about seeking out an official diagnosis? They can help with that too. ADHD Online provides comprehensive online assessments that are both affordable and easily accessible, and even better, you can take it in the comfort of your own home, at your own pace, in your own comfies, and even get a personalized treatment plan back in around seven days. To find out how the team at ADHD Online can help you on your journey and to see what services are available where you live, head over to adhdonline.com.

(00:55):

Hello, and welcome back. My name is Lindsay Guentzel, and I’m the host of Refocused, a podcast all about attention-deficit/hyperactivity disorder, more commonly referred to as ADHD. It’s a podcast I launched back in May in partnership with the team at ADHD Online, a telemedicine mental healthcare company based in Grand Rapids, Michigan that cares for ADHDers of all ages in towns, cities, and rural communities across the country.

(01:24):

My production team and I are in the midst of an entire podcast overhaul, differences you’ll start to hear as you’re listening, for sure, and lots of changes behind the scenes that I think you’ll be able to see come to the surface over the next few months. And it is so exciting and it has been a ton of work, and I’m so grateful to the talented team of people who have been driving these changes, and I’m even more grateful to you, our listeners, who keep coming back week after week.

(01:53):

If you enjoyed what you heard in 2022, get ready, because over the next 12 months we actually have a plan in place with workflows and job descriptions and responsibilities, and it is like we are becoming a real full-fledged production team. It’s been amazing, and at the same time, equally terrifying, but it is by far the most rewarding thing I’ve ever done. So please know, I mean it when I say thank you for joining us on this journey.

(02:25):

Before I bring today’s guest into the conversation, I want to lay out a bit about what our team was thinking when we started to plan episodes for January. The new year always brings with it a sense of opportunity, of possibility. It brings up conversations around self-improvement and setting goals, and all of that is wonderful, and for the most part, a really healthy thing to do. Growth is incredible, and for so many of us with later in life ADHD diagnoses, it’s something we are without a doubt seeking. But it can be hard to make ourselves the focus, whether we are parents or partners or we hold leadership positions at work or have become caregivers to our parents or our in-laws. Maybe it’s even that we’ve let our people pleasing tendencies take over in an uncontrollable way.

(03:18):

Regardless of where you are right now, it is so important that we remember we have to put our oxygen masks on first. There’s a reason that’s included in every pre-flight instruction, because in order to take care of those around you, you have to first take care of yourself, and it doesn’t make you selfish or oblivious or uncaring. It actually makes you more valuable to those around you, because when you put your oxygen mask on first and you can breathe, you are able to put everything you have into what’s happening around you, emergency landing or not.

(03:53):

And I know that message, put on your oxygen mask before helping those around you, it comes with a pretty heavy level of concern. It brings up the feeling that things are not okay, but that mindset is truly something we need to have front and center, when we wake up in the morning and when we go to bed at night, and yes, as we make resolutions and plans for the new year ahead.

(04:16):

My goal with these conversations you’ll be hearing throughout the month of January is to help set you up for success, for whatever your goals may be. And I’m hopeful that we all hear something that makes us go, “Okay, I could do that,” or, “I could try that,” or, “I’ve never thought about it that way before,” for hopefully so much more than what’s on our resolutions list this year.

(04:42):

So let’s get into today’s conversation, one that felt like an easy topic to touch on in January when so many people have personal wellness on the mind. And yes, while it does feel like it makes sense, it also feels kind of cliché because, well, diet culture and all the damage that can come when we tie our self worth to our looks or the number on the scale or the size of our jeans or how often we work out or, and this is a big one, when we label food as being good or bad.

(05:17):

Today’s conversation with Dr. Marylin James kicks off our look into food and our relationship to it. And when I say our, you know, that big collective our, in this context I’m talking about the ADHD brain’s relationship with food.

(05:34):

Dr. James started Haven Family Health in Jacksonville, Florida where she uses her dual board certification in both family medicine and osteopathic manual medicine to provide her patients with the individualization they need. She is also a telehealth physician with ADHD Online and she does a great job of explaining the complexity of the connections between people with ADHD and their relationship with food. And our conversation is actually the perfect setup for my conversation with registered dietician nutritionist Becca King, who you’ll get to meet in our next episode, although it’s very possible you already know Becca, thanks to her social media account @adhd.nutritionist where she shares her expertise as an adult with ADHD who has worked through her own complicated relationships with food, as well as a registered dietician nutritionist who works with patients who have ADHD.

(06:30):

I struggled with deciding which interview to play first for you guys, sort of a producer chicken or the egg conundrum. But bottom line, it was just so important for me that I give you a well-rounded introduction to this conversation, and I’m so grateful to Dr. James and Becca King for sharing their time and expertise with the Refocused community. Also, I almost called us the Refocused family, which feels a little cultish, and also I should not be the one giving this community a nickname. That just feels very weird. So if you have an idea of what we can call this group we are building, email me at podcast@adhdonline.com. Now let’s get into my conversation with Dr. Marylin James, the first episode of our two-parter looking into the ADHD brain and our relationships with food.

(07:36):

I really wanted to take a step back as we’re talking about the new year and food and diet culture and all of the things that come with that. And I wanted to make sure that we kind of walked through the basics of why we’re having a conversation about ADHD and relationships with food in the first place. So I’m so excited to welcome Dr. Marylin James to Refocused. She is the owner of Haven Family Health in Jacksonville, Florida, where she uses her dual board certification in both family medicine and osteopathic manual medicine.

(08:13):

She received her bachelor of science in biology from Loyola University before moving on to Des Moines University, where she received her doctorate in osteopathic medicine. She’s also a telehealth physician with ADHD Online. And I loved how she summarized her philosophy of care on her website. She said, “Medicine needs to be personalized because every individual is unique. Oftentimes, it takes as long as it took for the disease to manifest to reverse the disease, but it can be reversed because our body has the capacity to heal itself. My goal is to partner with my patients to understand them at a deeper level and to be there every step of the way from disease to ease,” and I am so grateful to have Dr. James sharing her expertise with us on Refocused today. Dr. James, welcome and thank you so much.

Dr. Marylin James (09:00):

Thank you, Lindsay. I’m really excited to be here as well. I’m really impressed that you took the time to read all of that and to learn about me and it’s such an honor to be here. Thank you.

Lindsay Guentzel (09:13):

Thank you for giving me the time, and there’s so many ways that I could go reading your backstory, being raised in India and watching your grandfather take care of his patients and then going back for yoga training. We’ll have to have another conversation because I feel like there’s so much more there that I want to dive into, but I would love to just start by identifying why food relationships is something a person with ADHD might need to address. Take me out, big picture, 10,000 feet in the air overlook, because as you mentioned in your summary of how you take care of your patients, it is so different for everyone, but there are some similarities or some things that we could be on the lookout for.

Dr. Marylin James (09:57):

Definitely. When it comes to food, I feel like it’s a very important and oftentimes overlooked topic because there may not just be enough research to back up many things, and so many providers may even be a little hesitant to really delve into that realm. However, even if there isn’t any solid, very evidence-based randomized control trials backing up many things, it is a conversation we definitely should start with our patients. Not just eating habits and patterns that we may notice in people who have ADHD, but also how there is a very strong connection between the gut-brain axis and what you eat is a huge part of managing your ADHD as well.

(10:46):

So to kind of go into what you were asking me, what kind of patterns we may see in patients who have ADHD, as we know, ADHD is a imbalance in our brain chemistry, especially a few neurotransmitters like dopamine and norepinephrine, and people who have deficiencies in those oftentimes find it very hard to focus, to find motivation to do things, to plan things out, and they may notice it’s hard for them, like others, to eat on time, to be motivated to prepare a meal. They may have all the intention to, but to do the grocery shopping, to decide which recipe and have the patience, the attention, the focus to go through following a recipe to put a meal together, is very tasking for people who have ADHD, right?

(11:42):

So the tendency in those cases is to just order takeout, right? They kind of just hold off till the last minute or they keep procrastinating or they feel overwhelmed because it’s too much effort. They will just either order takeout or just even skip meals, in some case. And so with the pattern of skipping meals over time, people will just develop kind of a very low appetite in general, and sometimes they may skip meal the whole day, and then at the end of the day, just binge eat. And so we see that pattern too, a binge eating tendency towards the end of the day. And the impulse control is very hard when you have dopamine deficiencies, and so that impulse to just kind of binge eat is very hard for them to manage.

(12:30):

We also see the pattern of, I guess what we could call emotional eating, right? Many people call it emotional eating, but it’s actually using food as a way to get that same effect from when you have enough dopamine reserve, because eating a lot of very not nutritionally dense, but like sugar dense, carb, caloric dense food like sweets and pastries and ice cream, they give that same dopamine high. So we may notice that they’re going and reaching for that food that will help them get them full and give the dopamine high, I guess, the dopamine that they need to focus, but then it crashes. They just crash because of all the carbs will just come out of their system, and they’re stuck back at square one, where the same problem of inattention, difficulty concentrating, difficulty feeling motivated, that’s how it was before all of that too.

Lindsay Guentzel (13:34):

I know from my own experience, I was treated for a handful of comorbidities before receiving my ADHD diagnosis about two years ago, right before I turned 35, and one of those was disordered eating. And it’s not perfect by any means of the imagination. I’m not trying to say that in the last two years I have solved all my problems, but addressing the ADHD helped immensely with realizing where my disordered eating was actually coming from. And so it’s just been so eye-opening to me to look back and see all the time where I thought that was the concern, it was really this ADHD that I had no idea was consuming my life, and I know more women are being diagnosed later in life, and so I’m curious, from a provider’s perspective, how do you start those conversations? Because ADHD can infiltrate so many different parts of a person’s life to the point where I think sometimes it’s hard for us to realize that might be what’s kind of the wizard behind the scenes pulling the strings.

Dr. Marylin James (14:41):

Yeah. Having had that experience personally, I’m sure that you may have noticed how long it took, not just for you, but for the providers you worked with to kind of tweeze it apart, so it’s not something simple. It’s challenging. It’s because mental health and many other comorbid conditions related to mental health are very challenging. I guess it’s kind of like what came first, right? And in that case, I think over time we just first of all have to learn how to trust our patients, their symptoms, and have a very holistic approach. So as a DO, we are taught in medical school to look at the mind, body, and spirit. Right? And that’s a holistic approach that I continue to include and I champion for other providers to approach patient care that way as well, because we have to understand the different factors that may go into one presentation, which for a disordered eating patient, maybe that they have a very bad relationship with food, they are avoiding eating all day, and then they binge eat at the end of the day, their appetite is all over the place.

(15:55):

So when we see those things, it’s important to keep the differentials in the back of our mind. Could there be anxiety? Could there be depression? Is there any history of trauma? Is there ADHD? And I will be honest with you, at the beginning of my career, ADHD was not even something I would’ve thought about until over time I started seeing more ADHD patients. I started seeing their pattern of eating, and now I’m more aware of it and I keep it in the back of my mind to screen them for ADHD, to start having that conversation with them, “Hey, how are you with feeling motivated to organize your house? Do you misplace things? How’s your concentration? Do you feel like you’re interrupting others often?” And so that will get them thinking too, “Yeah, I do those things, but I thought it was just part of my personality or who I am,” but then it turns out that they have been living with ADHD their whole life and they didn’t know about it, their providers didn’t know about it, and it just went undiagnosed for a long time.

Lindsay Guentzel (17:02):

You mentioned dopamine and how the connection between a complicated relationship with food and the lack of dopamine in the ADHD brain can kind of be that starting point. What are some things that you recommend to your patients that can also help kind of fill that void of the dopamine response that aren’t food related? Because I think sometimes it’s so important to offer up other ideas for people, especially because I think sometimes when we are grabbing food and we don’t quite know why, and we don’t know that it’s actually filling that void for us, if we can replace that habit with something that gives us an equal feeling but isn’t as complicated or destructive, it’s a great path forward.

Dr. Marylin James (17:56):

Exactly. So that is a reward center in the brain, and we basically are teaching our brain that this action of mine equals this result, the feelings that we get from the dopamine release, happiness, pleasure, satisfaction, focus, energy. So now we have to replace, and it’s not easy, but we have to put the effort into retraining the brain to seek for that same result we get from dopamine, but from a different source, healthier sources, which food can be healthy, but if we have an unhealthy relationship with food, it might be good to step back from that, and then probably doing other things like going outside for a walk or exercising or playing an instrument, engaging in hobbies that you enjoy.

(18:56):

It’s one of the things I have a discussion with at the beginning of any doctor-patient relationship. I ask my patients what brings them joy, what kind of hobbies are they involved in, what kind of activities ground them and is very meditative for them, and I actually document those things as part of my history and physical because I keep going back to that because patients themselves may seek out food because it’s so easy. It is a quick fix, rather than something like exercising or playing the piano or drawing because it’s more time consuming. They may seek out something more immediate. So I go back to that. I’ll be like, “Hey, you remember, you used to enjoy playing the piano or you used to enjoy exercising. Let’s go back to that.”

(19:47):

So it does take conscious effort from the patient’s end, but replacing it with those kind of activities is very helpful. And I also tell my patients, if you have a job in front of the computer, in front of the screen, you’re not spending enough time looking outside or being out in nature, you do need to take some breaks in between your workday where you just spend 10 minutes, go outside, let the sun just warm your skin and just soak up that sunshine. It is so important for your brain, and I call it a dopamine reset of some sorts. There’s no clear evidence behind any of this, but I just think that nature is very important for us, as well as staying active and engaging in hobbies that we enjoy.

Lindsay Guentzel (20:37):

I’d love to ask you a little bit about people who might be using food as their stimulation. We see so many people with ADHD who need to play with fidget spinners or clicking pens. There’s this constant movement. And I’ve heard from a lot of people, and I know from my own experience that sometimes it’s even just the oral stimulation of food in your mouth. And so I’m wondering what your thoughts are for people who might be dealing with that as like, what are some things that they can start to think about if they’re concerned that that might be their way of stimulating their brain?

Dr. Marylin James (21:21):

So if food is their source of coping with the need for stimulation, doing something to kind of divert that towards exercise or something that gives them the same stimulation is very helpful. If they are trying to kind of recover from that oral stimulation, and sometimes we notice people who have ADHD may also have the habit of smoking, vaping, they engage in those things because they need that oral stimulation. I advise them like, “Put a gum in your mouth, a sugarless candy. Try to sip on tea.” I mean, I literally have a cup of tea here right now. I like to show my patients what I’m doing as I tell them what to do to kind of help them understand, like I’m not just giving or throwing advice out there. These are things that I incorporate into my own life and is a healthier habit for us all to try to incorporate. So just having a big kettle of hot water ready in the morning and having different sorts of teas that are not caffeinated, and just sipping on it throughout the day can be very, very helpful for that.

Lindsay Guentzel (22:32):

You mentioned gut health and how that can play a role with managing ADHD symptoms, and I’m wondering if we could just talk about that for a little bit, because I know from my experience as a journalist, I worked on a lot of stories about the connection between our mental health and our gut health, and I, at the time, was blown away by what I was learning. And I don’t know that we are talking about this enough, that we are really diving in, and I’m not just talking about for people with ADHD, I’m talking about human beings in general. I have had experiences where I’ve definitely been eating something and then the wave of anxiety comes and you’re going, “Well, I’m not anxious about anything and everything’s kind of going well, but I wonder where this is coming from?” And then once it happens enough over and over again and you can put those puzzle pieces together, you go, “Oh, maybe it’s what I was eating.” And so I would love it if you could just talk about that and what that might look like for a person with ADHD.

Dr. Marylin James (23:38):

Yeah, this is a world that is very new to us. It’s not something that I was even taught back in medical school. So, a lot of research is coming out on it and it’s pretty new, but it’s very exciting because it helps us understand how the body works as a unit and that we cannot look at one organ or body system in isolation from the other.

(24:00):

So what we eat is what we become, is what we think. What we put into our body, not just in the form of food, but also what we hear, what we see, all of that counts. So food, not just in the form of food that we eat, right? We think about other things, food like for the mind, food for our soul, right? All those things makes more sense. But the food that we actually eat that goes into the gut, it determines a lot of things when it comes to precursors for our immune system, for our hormonal balance, our endocrine system, for our brain health, because a large majority of neurotransmitters like serotonin and dopamine are actually made in the gut, and not many people know that. And in order to help maximize the balance and to have good levels of these neurotransmitters for optimal cognitive function and focus, you need to eat to promote the gut flora.

(25:10):

We have a lot of healthy bacteria, as well as unhealthy bacteria in our gut. And if we eat this very mainstay western food of hamburgers and fries every day, it’s going to feed the unhealthy bacteria and cause dysbiosis, basically an imbalance between the good and the bad bacteria. We need the good bacteria. We need to feed them with food called prebiotics. That is the food for the probiotics, the healthy bacteria, so that they can digest them and give small chain fatty acids and other precursors to help make the dopamine and the serotonin.

(25:52):

So when we eat the wrong things, it promotes the growth of the unhealthy bacteria and can cause byproducts that are more inflammatory, things that can cause more anxiety, anger, mood disturbance, headaches, IBS, and all sorts of other symptoms, versus if we eat food that is more healthy and wholesome, things that have lean meats and things that are more organic, if it happens to have more pesticides in it like corn and soy and things like that, if we can include more fiber rich food and fruits to feed the healthy bacteria, we will be able to help our body produce the neurotransmitters we need for better mental health.

Lindsay Guentzel (26:36):

One of the things that’s kind of going on right now is, with the new year comes all of these resolutions, and we could have an entire conversation on diet culture in this country, but the new year hits and we hear about gyms being … an influx of people joining and starting routines or picking up diets, and I’m wondering from your perspective as a physician, what is that relationship like for someone with ADHD? Because it’s like this, “Oh, I’m going to change and I’m going to do this thing,” and we know the average person doesn’t stick with their new year’s resolutions. And so I’m wondering, what would be something that you would suggest to somebody who is trying to eat healthier or is trying to add exercise into their life, where it’s not an all or nothing approach and it’s something that actually can be manageable and become more of a lifestyle? Because I know from my own experience, anytime it was a diet or restricting or trying to be perfect is when it never ever lasted more than a week.

Dr. Marylin James (27:42):

Yeah. I made new year resolutions maybe up until college, and after that I realized I was just setting myself up for failure. So honestly, even in my clinic, I don’t advertise things like, “Oh, it’s a new year, it’s a new you,” because I feel like it just kind of sets you up for disappointment.

(28:05):

My approach is that of practicality. You have to know that progress means also having some setbacks, and that doesn’t mean failure. You have to know it is going to be a path that is going to be up and down. In the meantime, I advise what’s called an 80/20 lifestyle. 80% of the time, try to incorporate the healthier habits. 20% of the time, just cut yourself some slack because we are human, we’re not perfect. And if something has to be sustainable, we have to embrace that 80/20 lifestyle, because otherwise, it’ll just lead to a lot of frustration.

(28:48):

People who have ADHD would really do well if they can get into a pattern of consistency. But until that habit has been replicated or that pattern has been done multiple times, it’s hard to make it a habit. So I tell my patients, “Let’s talk about three things.” I have them write down, pick the top three things that you’re going to work on over the next month until we follow up. And having that accountability pattern, whether it be a physician or another health coach or your nutritionist, whoever it is, but I mean, not just a family member or a friend, but like a professional who can keep you accountable and give you good guidance and good medical advice or good professional advice, is very helpful for people who have ADHD because that is support. That makes a huge difference.

(29:48):

And then picking two or three habits, or two or three habits to break, or two or three habits that are healthy to incorporate and starting from there would be very helpful. I usually tell my patients, “Okay, you’re not exercising at all. What is an activity you enjoy doing?” You can’t just throw ideas out there that they don’t like to do, because that’s never going to then work. So if someone likes to walk, then I encourage them, “Why don’t you start with just 10 minutes of walking five days a week, starting this week?” And then I tell them, my second thing would be, how about mindfulness? What kind of mindfulness habit would they be able to start including? And the third one would be dietary. What kind of bad habit is there with food? Are they just eating out every day? If so, let’s try doing smarter shopping. Or if they are already cooking at home, if they’re making very unhealthy food, kind of incorporating some fruits or veggies, nuts, legumes into their diet.

(30:55):

So, let’s start with three things. Try to do it 80% of the time. If it doesn’t work out, it’s okay. Don’t beat yourself up. You’re just going to keep going, because that’s all we can do as humans. That approach seems to work, that really helps them know that it’s manageable and there’s no way you could go wrong, because going wrong some days is part of the plan.

Lindsay Guentzel (31:20):

Absolutely. And it’s so important to acknowledge that and to take the shame and the embarrassment and the hard feelings out of that equation, because it’s just inevitable that things are going to go wrong.

(31:34):

Let’s say there’s a person, they have ADHD, they’ve got their diagnosis, and they believe that they might have a complicated relationship with food. What might a treatment plan look like? And I say that knowing that it’s going to be completely different for every single person, but what are some of the things that a physician might walk somebody through? I think one thing for people who have ADHD, when we are trying to do something where there’s no concrete timetable or real way to gauge results, it can be a little hard for us to get started. So I was just throwing that out there as kind of a, let’s give people an idea of what they might expect if this were to be something that they would approach their physician about.

Dr. Marylin James (32:21):

So once we identify that one of the patients has a complicated relationship with food, first of all, we try to understand what all may be factoring into that, right? Maybe they live with family members, all of whom have that habit, and that’s just how this person grew up. And so it would then be more of a family approach and not just talking to the patient they need to make changes, but also about how the family can make changes. It may be rooting from childhood trauma that they had, and then maybe a lot of anxiety, depression, so they may need some good counseling and a mental health provider on board to help them with that aspect. So it’s a multimodal, multifaceted approach.

(33:11):

From my end, once I identify what all could be kind of perpetrating this unhealthy food relationship, we talk about how to manage their ADHD, which oftentimes may include medical management, some supplements that I recommend for them, but I also create parameters for them because people with ADHD, like you said, if they don’t have a definite timeline, if there’s no parameter to things, it’s hard for them to kind of work with that. We need to provide them a solid plan.

(33:48):

So like I was mentioning earlier, I like to discuss with them, “Hey, let’s pick three things. One as far as your activity, another one as far as being mindful, and the third one about your diet,” because all of that is important in approaching a healthy diet. And I discuss with them, “What kind of food do you like? What kind of food do you not like?” And within food that they do like, I try to understand if they are somebody who likes to cook or who eats out often, because we need to pitch it towards the patient in a way that they can practically incorporate it.

(34:24):

I had a patient who loves Chipotle and had Chipotle every day for lunch, and she works, and that’s the only way, if she’s not going to have Chipotle, most likely she’s going to not eat lunch at all, which I’m like, “Okay, well, I don’t want you to not eat lunch.” Lunch is one of the most important meals of the day. It’s the time our digestive fire is at its highest.

(34:47):

And so we had a conversation, “Hey, let’s make healthy swaps with your nutrition.” Right? So of the three goals, one of the goals is the dietary changes, and so we talked about how she will not include sour cream, how she will swap out the white rice for brown rice, and she will reduce the amount of cheese that she puts in it. And that really helped her. That was tremendous. And the mindfulness was when you’re eating, focusing on how the texture of the food is in your mouth and how it feels, creating that mindfulness is so pivotal because when you have ADHD, you are not able to focus or be here in the moment. And food can actually be a meditative process for those people.

(35:38):

And then activity, exercise, it helps to naturally increase the dopamine levels, and then it kind of helps with that cravings that you get for food. So I always start, “Let’s pick those three things. Let’s create a plan that works for you according to your likes and dislikes,” something that is so practical and approachable for my patient. Then I follow up with them in 30 days. I check in with how each of those three areas are going, and if they have all three down, then we start adding few more things, every time. I just pick three things to work on though. It seems to do the trick.

Lindsay Guentzel (36:18):

I love that. I want to wrap up by asking you, what stands out to you as the most concerning part about where things stand regarding ADHD and the acceptance of food relationship issues? And I love that this is where we’re wrapping things up, because you mentioned in medical school this wasn’t even really something that was talked about, the gut-brain connection.

Dr. Marylin James (36:41):

I’m glad you asked me that. Honestly, even before this podcast, even though I have all these beliefs about the food and the brain relationship and there are articles coming out on it, as a physician, I have to be able to quote studies, large studies, and evidence behind this, or up-to-date articles that I can actually share with you, but I couldn’t find any. And I shall say that is the most frustrating thing about ADHD because I believe that food is very important. The connection, not just the pattern of how people with ADHD have different disordered eating pattern, but just starting when you are a child, what you could do, what the mom, the dad, the family can do to help the kid develop really healthy eating habits, how they can feed the kid to help them with their mental health, why food is so important, the gut-brain axis and how that plays into ADHD, how we can use food and what kind of nutrients in it helps to treat ADHD.

(37:55):

There needs to be more studies about that, and I wish that it would become more mainstay in medical school training and in training for different healthcare professionals that food is important in approaching ADHD management. I just, I’m hopeful, but it is very frustrating right now, but it doesn’t hold me back from how I approach the care right now, and a lot of patients are very understanding of that connection. They’re much more open to it, and that excites me.

Lindsay Guentzel (38:28):

I feel very similarly to you in kind of the frustrations about where things stand when it comes to research with ADHD, and then I have to remind myself that it’s a newer thing that we are all dealing with, but I am also very hopeful and I’m hopeful that these last few years and the number of people who have found their own diagnosis and are still seeking that out, I’m hopeful that that will be kind of a good push in the right direction.

Dr. Marylin James (38:54):

Definitely. I’m glad that we’re having this podcast and that way others can hear about this and not just wait for many years or until they’re way into their forties or fifties to get diagnosed by a provider. So, thank you for doing this podcast.

Lindsay Guentzel (39:13):

Well, thank you so much for joining me, Dr. James. I so appreciate your expertise and your thoughtfulness, and we will connect soon.

Dr. Marylin James (39:21):

Thank you, Lindsay. It was a pleasure, and I’m excited to chat with you again. Take care.

Lindsay Guentzel (39:27):

Thank you. A huge thanks to Dr. Marylin James for helping paint a picture of the complexities that the ADHD brain can face when it comes to food. To learn more about the work she’s doing, check out havenfamilyhealth.com.

(39:50):

Refocused is produced and hosted by me, Lindsay Guentzel. Our production team includes Al Chaplin, Sarah Gelbard, Sarah Platanitis, and Phil Rodeman. Support also comes from Keith Boswell, Claudia Gatti, Melanie Meyrl, and Susanne Spruit.

(40:06):

The show’s music was created by Louis Inglis, a songwriter and composer based out of Perth, Australia, who was diagnosed with ADHD in 2020 at the age of 39. To work with Louis, you can find his emails, as well as links to his work, shared in the show notes. To connect with the show or with me, you can find us online, @refocusedpod, as well as @lindseyguentzel. You can also email us directly at podcast@adhdonline com.

ADHD Online will be closed on January 16 in observance of the Martin Luther King Jr. federal holiday. 

Live support will be unavailable on Monday, January 16. Send us an email or leave a message and we’ll get back to you as soon as possible when we return on Tuesday, January 17.

Please note that each clinician sets their holiday hours and may be processing your requests during this time or they may be out as well.

As always, you can still take our assessment at anytime online, whenever and wherever is best for you. 

ADHD Online corporate offices will be closed on December 23, 26, and on Monday, January 2 in observance of the holidays.

As always, you can still take our assessment at any time online, whenever and wherever is best for you.

Please note that each clinician sets their holiday hours and may be processing your requests during this time or they may be out as well.

Happy Holidays from the team at ADHD Online!

Our ADHD Online corporate office will be closed Thursday, November 24 and Friday, November 25 so our employees can enjoy this special time with their families. 

As always, you can still take our assessment at any time online, whenever and wherever is best for you.

Please note that each clinician sets their own holiday hours and may be processing your requests during this time or they may be out as well.

We will resume normal business hours Monday, November 28. Thank you for your understanding and patience as our staff enjoys time with family to celebrate the Holiday.

Behavioral Therapy

  • Florida
  • Georgia
  • Indiana
  • Michigan
  • Ohio
  • Oregon
  • South Dakota
  • Missouri
  • Texas
  • Tennessee
  • Virginia

Assessments

Assessment services are available in all 50 states.

Assessment and Treatment Plan Development & Implementation**

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.

The patient schedules subsequent follow-up visits with our providers for ADHD medical treatment or behavioral therapy.

**If available in your state

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.

Assessments available in:

All 50 states

Medical Treatment available in:

Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky

Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Mexico
North Carolina
Ohio

Oregon
Pennsylvania
Rhode Island
South Carolina*
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
Wisconsin

Teletherapy available in:

Georgia 
Michigan 
Missouri 
New Jersey 

Ohio
Oregon
Pennsylvania
Virginia


*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. 

south carolina

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.