Episode 34: Is It Mom Brain… or Is It ADHD? with Dr. Fiona Kehoe

Episode Description:

If you’ve ever wondered whether your forgetfulness, constant overwhelm, or racing thoughts are just part of motherhood—or something more—this episode is for you.

Dr. Fiona Kehoe, a Connecticut-based licensed psychologist with over 25 years of experience, joins us to unpack the truth about ADHD in women and moms. We dive into the signs that often go unnoticed, how hormonal shifts can unmask symptoms, and what getting a neuropsychological evaluation really looks like.

From understanding the three main types of ADHD to distinguishing “mom brain” from true attention issues, this conversation sheds light on what so many women experience but rarely talk about.

You’ll learn how ADHD can present differently in women, why it’s often misdiagnosed, and the supportive steps—from therapy to medication to coaching—that can make daily life feel more manageable.

Whether you’re navigating motherhood, midlife, or just trying to stay on top of it all, this episode will help you see your brain through a more compassionate lens.

💗 Pink Spotlight
Each week, we highlight a moment, product, or practice that’s bringing us joy.

✨ Christina: Investing in a Reformer Pilates machine for her basement gym and streaming the Pilates by Leah app. Leah, a friend and former guest on the podcast, has her own Pilates platform—and Christina loves that she can now squeeze in workouts on her own time and see an ROI by year’s end compared to studio passes.

✨ Kristina: Listening to podcasts on 1.25x or 1.5x speed. It’s a small shift that saves time and helps her get through her favorite shows faster (and yes, we even recommend listening to Pretty in Pink Again on a faster speed since we can be a little long-winded).

✨ Dr. Fiona Kehoe: If you think of a small task that can be done right away—do it. Writing it down can sometimes drain more mental energy than just getting it done, and you’ll free up brain space instantly.

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Don't forget:  Leave us a written review on Apple Podcasts, DM us your address, and we’ll send you a light pink beaded bracelet with a gold pink flamingo charm—just to say thanks for being here. 💕

Transcript

0:00

I'm Christina and I'm t and this is the Pretty and Pink Again podcast where Motherhood meets rediscovery. Welcome, Dr. Keho. Hello. Thanks for having me. How are you? I'm good. I'm happy to be here. We are so happy to be here. We're on the road. Yes. You and I have taken our show on the road a couple of times. We're so excited to be in your office today, and we're really excited to get into this topic because we've like playfully joked about it. We've talked about just, I guess in our kind of complaining and like related, we hide behind humor a lot. Yeah, we do. We've thrown around terms, which we shouldn't, but. I feel like sometimes my mind just doesn't operate how it used to. And I'm starting to question if it ever operated at a stellar level. But all of this is just coming and we're titling this episode. Is it mom brain or is it a DHD? Like, could this have, Could some of our, mental hurdles as moms were they masked as children and maybe they were forgotten or maybe they were misdiagnosed and this is why we're having this issue. Or there maybe weren't resources then maybe things have progressed and so things maybe 30 years ago we didn't uncover them. But we wanna unpack this with an expert and talk about this because, and we had been talking off air just about. You were calling it the tracking of all of the things that as moms we have to do. I like that word. I don't think as women used it, I think as women too, not just as mom. I think as women, yes. All the mental tracking.'cause we always call it the mental load, but it really is, it's mental tracking.'cause it's not just a load that you're carrying, it's the tracking of everything. So I liked that word. Now that's gonna be my new, that's gonna be my new thing that I use when I think of a tracker. I think of if I had an air tag following me around all day and then at the end of the day you looked to see where it went. I'd be like, what did I do? I just went in a whole bunch of circles. Round and round. But yeah. So I'll give our listeners a little bit of a backstory. So Dr. Keho and I met a few years ago because you are my son's doctor and she saw my middle son Vincent. Just quick backstory for our listeners, why I think this topic has really hit home to me is I have four kids. Two of my boys have a DHD one has attention, what is it called in atten? Inattentive, predominantly inattentive type. Inattentive type. And then my younger son has more of the hyperactivity. So my middle son was seen by Dr. Keho. She did a full neuropsychological evaluation on him. He has since now had a lot of support in school, at home medication, and both of my boys are thriving. And during that process of uncovering all of this information about my kids, I'm like. I'm filling out the evaluations for them with them, and I'm like checking all these boxes that pertain to myself as well. Yeah. Or maybe did when I was a kid. Maybe some things I grew out of, some things you learn how to work around. So here I am now as a scatterbrained mom and insert this important conversation. Yeah. So yeah, I don't think, I think that's not uncommon that sometimes going through that process of having a child evaluated a parent will look at and as we're talking about symptoms and think, that's me. We're talking about me not to make it about me, but this is me. Yeah. Those are the same challenges I had and so it's, it can be eye-opening for the parent too, that explains it. That's why that was so hard for me. So let's get into it. So what is A-D-H-D-A-D-D? Like what exactly is this? Dr. Keo. Okay. Starting point. Okay that diagnostic label comes from our DSM five now. Diagnostic and Statistical Manual of Mental Disorders were on the fifth edition. So earlier editions would had two different distinction. There was an A D, and there was an A DHD. And more than 10 years, now it's all under this umbrella of A DHD. It's all called A DHD. And then we specify the subtype. So it's the predominantly inattentive presentation or the predominantly impulsive, hyperactive presentation, or it's the combined type. It's confusing to a lot of people who are, no, I'm a DD, but it's it's all now, it's all the same age. Just, we just specify the type. It's a neurodevelopmental disorder. So it's a condition that makes it hard for someone to focus, pay attention. They may have difficulty, motor overactivity, being fidgety, being impulsive and they're not just occasional lapses. You wanna see that these are ongoing challenges for an individual and it that it's affecting their life at school, socially, out in the community. You wanna see that it impacts them in two, two settings, not just one, and you wanna see symptoms before age 12. So in this case, when we're talking about people getting identified later, it's neurodevelopmental, you wanna be able to say, it can be traced back. And it's hard to do that sometimes because you are not talking to people in real time. I'm talking to you about something that happened, 30 years ago. What do you think? And so it can be tricky, which that's where talking to parents and other people that you knew you at the time may be good informants for currently, when you are questioning, does someone in the family have an issue like this teacher is a really good partner in this because we as parents might think we're comparing perhaps two kids and one looks really inattentive compared to the other. That's an N of two. You really want the teacher's gonna be able to say in a classroom, your kid is totally within normal limits. I wouldn't be worried at all. Or they'll say, I think you're right. I think they're having trouble here that we probably need to, evaluate. So that's why when you have your child evaluate, they have multiple people fill out these forms because you want, you said several different perspectives, maybe perspectives and environments. So maybe like the coach fills out one, the parent fills out one, the teacher fills out one. Yeah. You want to make sure that it's happening across settings. Now, it may not be, but it gets tricky, right? Because let's say we're talking about sports. Maybe my kid loves sports and that's what they're all about. And whatever an attention is there, it's not really visible because, okay, they missed the play, but they saw three kids ahead of them do the play. So it may not be as obvious in some settings as others. It's probably not one size fits all too. And like you're saying, if something, if you're more into something or if something comes more easy to you, then maybe that's not the area that you would struggle in, but maybe in school if something is more difficult. So it probably could vary, which I'm sure makes it very tough. Yeah. And I feel like this has come such a long way because t and I are the same age. We're 39. It was that it was a DD when we were kids. And so you're saying it has progressed so much in 30 something years? Yeah. From where we came from. Yeah. It is it can present differently in different sense. Yeah. And so then maybe, okay, it didn't happen in sports, they're the rockstar out there, but it might be, oh, but they can't sit through church. Look at all the other kids in class are able to, or whatever other setting you wanna look at. There's other settings to look at there. The family reunions place. It's not just our home. They're a standout in that setting too. And the important thing to do too is to make sure this is not something else. Having troubles with concentration and attention. That's on the list of symptoms with depression. That's gonna happen with anxiety. Someone's ruminating they're not able to pay attention'cause they're worrying about things. So what would be a, like a core symptom in all types? So for the inattentive type, there's two blocks here. So the inten inattentive symptoms, and then there's the hyperactive impulsive symptoms. So examples of what's on the inattentive list fails to give close attention to details or makes careless mistakes. Doesn't seem to listen when spoken to directly, doesn't follow through on instructions, fails to finish things. For the hyperactive and impulsive side of things. It's fidgeting with your hands, leaving your seat, and other situations in which remaining seated is expected. Runs around or climbs too much at times when it's inappropriate, difficulty playing quietly. So some of these, they're biased towards the younger kid. Yeah. So if I see a teenager, they're unlikely getting out of their seat and climbing. But they might fall into the fidgety not finishing assignments. They might fall into some of these other things. Talking too much feeling on the go. Blurting out. Blurting out answers. Yeah. Interrupting those type of difficulty waiting turns. Yeah. So those are the types of symptoms that are listed here. And they're more behavioral. These don't always tap into perhaps the internal experience of the kid who I can't pay attention because behaviorally it may not look that way to the observer. I suspect we will be talking about that.'cause we're talking about mom, so that's a key. So a lot of people that I do see are teenagers. And later in the game early on, it's a bit easier. Let's say, especially with the combined type, the teacher's trying to catch'em with a butterfly net, nobody questions it. It's yep, we got the diagnosis. It was easy. We did a teacher checklist, a mom checklist, done by the doctor. That's what it is. But you get a kid that is quiet, behaved, no signs of the hyperactive side of things, and often seemingly look like they're paying attention, those kids may not be recognized till much later. And it's usually them trying to tell people I can't pay attention, okay. It's actually coming from them. Like I spent four hours in my room and I was probably productive for one. I can't keep my mind on this. And again, these are teenage years, so you wanna make sure this is not something else. This is not. Something's going on at school and I'm upset about you. You want this to be a persistent right issue I'm sure that it's become more thorough as this has been studied more and I feel like the labels are changing and so it's a little bit more thorough now. But was this missed a long time ago? Was this easier to miss?'cause you're saying sometimes things aren't flagged. If the kid maybe was not hyperactive, some of these things were getting missed until they were teenagers. Is it possible that this got missed, like entirely? Yeah. I often think the kids that are the externalizers that are, bouncing in their seat. Sometimes they're luck are like, okay, they got flagged immediately. And then you'll find kids that like struggled a long time and Oh, I went an extra 10 years before anybody realized. But in terms of as a whole, all of us go back in time. Lots of things were missed. Course, of course. There's, I think, increased tolerance for the whole range of things. Lots of people with dyslexia would've been so you can, in any family, when I meet families with any condition, it's Oh yeah, we think so and so. Mm-hmm. had it, grandpa, grandma, but it wasn't formally diagnosed. It's often it was, we think they had it never formally diagnosed. I don't think that many people were formally dosing. Yeah. Diagnosed in the past. So is this hereditary then? Is it something that is passed down? There's a hereditary component, yes. Okay. So that's interesting that I'm sure now that people are starting to be flagged, it'll be easier to track things. But like you're saying, if there was generations where this was completely missed, That's a great question. My, when my kids were going through this, my dad was like, oh, what are you going through all this for? Back in my day, if you had ants in your pants, you would get a job where you were boots on the ground. You would get a job in construction or at an office setting. You would give your body what it needed. Basically. It's so Vincent's just a kid that has ants in his pants. Great. And so and I think one way to look at it earlier on, people probably would remember people weren't trying to go to school for so long, so it would be, okay, so you go to eighth grade instead of 12. May not have a big bearing on your life, given what people used to do. Might be like, okay, school's not for you. That's okay. Yeah. That's I think what he was trying to That's a good point.'cause now everything became you have to stay in school for so much longer. Maybe school ended around high school and now it's like mostly everybody goes to college. And so graduate school you really have Yeah. Graduate school after continuing education. So it's like if you want to quote unquote Thrive now in a school setting, if you need higher education to do the career path that you want this, you're, you really are in the school setting. You could be in it until you're in your mid late twenties even. Yeah. So yeah we see'em as a society, right? So life has changed dramatically so much so not just are we pursuing educational for much pursuits for a much longer period of time, but just our environment, this could be a whole other topic. All the things that were hit with, all the electronics, all the things that, that wasn't in that life before. That was a much quieter time. Yeah. Probably the threshold for seeing some of this stuff would be higher. So it's part of the talk always is are people really having this diagnosis more or it's right. Just the other way of looking at, it's our lifestyle is revealing it more because we're putting people to the limits of what they can do all the time. Yeah, that's a really good point. Just one of the things that I was supposed to do with my son before school was I was supposed to have him move before school, so I would have to play catch with him or have him throw a ball up against the wall or get some of his energy out. And my dad was like, this is ridiculous. I used to walk to school three miles every day and then I'd walk home three miles every day. So that was my movement the day, which did that. Your son doesn't have a three mile walk. Exactly. So his point was that I had this too when I was a kid, but my lifestyle was so different that it didn't impact me as much. So things have changed so much and also coupled with all of the new research and professionals like yourself, so we're able to diagnose and recognize this more in our youth. And so now I wanna pivot to us as moms who fell into this. Undiagnosed generation, but still are living this life where you're constantly toggling between things back and forth and you're constantly tracking things and things are being pinged, ping pinged at you. And even somebody that maybe has a very sound mind, how do you stay focused? Yeah, always a question. We always say, sometimes we ask the questions, and then we know there's really no hack, there's no, it's just, it's hard. We're just posing it out in the world. So just on the front end of it, so much to look at, which is, thinking about how people kind of land in sometimes in these roles that they didn't necessarily. Sign up for, it's just the natural development of a couplehood. Are you working? Are you not working? Are you working? But are you still absorbing, the bulk of the childcare? Are you still doing the bulk of this inside the house stuff? We think a lot of moms end up falling into situations where perhaps they realize they've taken on way more than they can really handle. So that's part of it, that's part of the lens to look through before you even think about could this be a DHD is or is what you're doing even reasonable for anybody to do. It may be that you've taken on way more than you can do, then anybody can do. So the answer is yes. Yes. The answer is yes. So if that's the case, and I love that you brought that point up. Yes, I agree. Because, some of us are just, we've gotta do it all and gotta do it perfectly. So you've got, all moms, I think having their heart, I want the beautiful, nutritious meal. They came from Whole Foods with all the food. That's my plan for every day. And there's some moms that I'm gonna do that I don't care, you know what else doesn't happen, but that's gonna happen. And then you've got the moms who are gonna be like, okay, 40 a week we're gonna have a good meal. And the other three, we're all gonna, we're gonna be fine with mac and cheese, or whatever it is. And so people are gonna push themselves differently. And those that I think have that perfectionistic, get rigid about the rules that they want things to go, they can perhaps sometimes struggle a little more, get a little more frustrated. So that perfectionistic and maybe anxious is not a DHD. Those are very different things. So that's why I say like that, the starting point probably may be to say, okay, what are you doing? Could anybody do this? Realistically, and just trying to look at the range of what you're doing. And I think we were talking about before, just the amount just parcel out the child management stuff. Just, their schedules, getting that stuff into a calendar, managing this stuff that can't get into a calendar. Talk about the diaper bag. Having to remember, did I put fresh diapers in there? Do I have white, that whole ongoing dialogue you have in your brain about that darn diaper bag and is it ready to go? And it just stays online, right? You just have that mulling around in your brain a lot. So there's just the demands for a parent. They're just a lot. Yeah. They just are. It's probably like brain fatigue because your mind is always on, especially when your kids are very young, and I'm sure even as they get older you're just thinking constantly. Like it's so much preparation. We've talked about that, but we never talked about how exhausting that can be. Like sometimes you wanna prepare yourself so that you're organized so that things go well for you so that you know the day goes well for you. But that is constant it's like being online all the time and you never shut down your brain. So it's just all day and how fatiguing that can be on a woman. So it, even when they get older, it's, and let's say it's more scheduled it's still do I feed them, two hours before they go to that practice? Yeah. I feed'em, just give'em a snack. It's just trying to manage minutiae of everybody's life. Yes. They can't do it yet. And then if you have teenagers that are a DHD or, and they are still not managing, you're still doing it. You're still providing a lot of support and trying to figure out how to give them support. That's a whole other, topic. Topic Yeah. Is you're trying to model for your kids and teach them to do things and talk to them a certain way and and then you're like, your mind is going constantly. You're always trying to balance, giving enough support, but not too much support and wanting to help them be successful. So it's tricky. But if you, in all of this, if you are a parent who really is doing all this with an un undiagnosed A DHD, yeah. I would it's harder. It's harder. You mentioned in, in the under 12 population and in your teen population, some of the differences of things that you're seeing. What are some of the commonalities that you would see in our age population? It's the same list. Same list. It's the same list. When you're an adult, you, instead of needing, say, six of the inattentive symptoms, you need five. So they just take one off, but you're still looking at those same symptoms. But as I say, so if you look at the hyperactive and impulsive ones, we'll probably, again, we're not talking about getting outta your seat and climbing. Okay. You may be talking too much, you may be interrupting and it's that mom who just got back from the playground. Did I say that? Why did I say that? Oversharing just not putting the brakes on. When you're stretched to the limit of what you can do, you're not as good at compensating or masking some of the symptoms that you would be. Able to do normally. That's really interesting. So is this missed in women a lot? Especially with moms, a lot of the, like even for tea, you've been so open with, you didn't really start experiencing anxiety until you had kids, until your kids started to be a little bit older and you were managing all of the things and that came out as like more of an anxious behavior. Mm-hmm. But is this missed in women? Because I feel like with women, it's very common for moms and women to just like express anxiety, to express they're doing too much. We're trying to keep track of too many things. I feel like we are in this generation where it's like easy to express that and everyone's yeah, me too. But is this missed in women? I don't have a huge end to tell you. Yeah. Because I think a lot what we're talking about that experience of, oh yeah, that explains me. But the number of people that then are pursuing it, saying, I really gotta find out now if I have, that's not everybody, but I would say it very much. The quiet, well-behaved right. Teenage girls that I see who are the ones telling people around them, I can't pay attention. No, nobody would've identified them. It's them saying I can't pay attention. So I would liken it to that person. But if you imagine that kid didn't say anything and just went on with some inefficient strategies, put their crash helmet on, did it got through high school and got through college, and maybe that motherhood is the next big hurdle in their lives where I've met my match. I can't compensate for this. This is too much. For me to do. So yeah, I would think there's lots of people that's gonna be the next point in their life that they could be work but this could be another place. Yeah. So maybe some of it was manageable before motherhood, but motherhood, I like that you said it's like a, it's the next big hurdle of your life where it's, you have to. Function, you have to function. And some of the things that you might have done prior, again, I've mentioned like the kid who's procrastinating, then taking care of it with an all nighter, I got it all done. You can't really do that as a parent. Like you can't go without sleep like that. That's not an option. You've gotta sleep when you can. So some of the things that you might have done before aren't gonna work in this situation. Yeah. It's like all of it bubbles up and then it's just at the surface now because there's no time for your brain to go offline. There's no time to re rely. Like you can't mask it any longer. So you gave some examples here about forgetting appointments, starting a project, not finishing them, the mental clutter, maybe the obvious physical clutter of your home, the guilt that's associated with that. The blurting the oversharing. Let's just click all the boxes. Yeah. You've clicked all of the boxes. Where do you go from there? So there's a couple of things I would say.'cause we did talk too about, you know what there's burnout and there's mom brain. And in fact, it's true. Due to hormonal changes and sleep deprivation. Those early on, I wouldn't be running for an eval because early on everybody knows nice clinical term, you feel a little worked, your brain is not working. That's science fact. So I wouldn't be running for the doctor if, I'm still in that, that pregnancy to infancy, I'm in that phase of motherhood. Yeah. This is, I think that would be normal to now to be forgetful and Okay. Attract things. So you'd wanna see it again, persistence through every phase of childhood. Now I'm really not able to do. The mothering tasks as easily as I would've expected. So you've checked all of these boxes now. Yeah. And you are really thinking, I have this. And you've come out of the very little kid stage where maybe your hormones have started to regulate again. Yeah. You are getting better sleep at night. That fog has lifted, but yet you are still struggling daily with flirting things out, remembering tasks. You're forgetting to take your kids to certain appointments. You're that mom that always needs the last minute reminder. Oh, did you hand in the assignment? You are now, that mom, what would you encourage somebody to do then? So part of this is looking at, it's disrupting my life. And I think that's what you're getting at. Yeah. It's now disrupting your life. This is real. This is not fun. I'm, this is. Think it's time to get evaluated. I may end up being encouraged to pursue a neuropsychological evaluation. Would you explain to our listeners a little bit about what a neuropsych evaluation looks like? So this is instead of asking you about how you use your brain, it's having you show us how you use your brain. Okay. So it's a sit down face to face. A testing that happens one-on-one. So it starts with a thorough interview, a look at developmental history. It might involve if available, talking to other people in your life that may be able to speak to how things went for you as a younger person and your husband, whoever might be a good later resource. And it's asking you to use your brain. So looking at all different cognitive domains, looking at intellectual functioning, verbal skills, non-verbal skills, executive skills in that, and come back to, yes, new learning and memory, academic skills. And with an adult, maybe we're just screening that and then your emotional and behavioral functioning. So you're looking at all those domains and you're putting a profile together because even though our question might be, I really just wanna know about my attention, you can't really look at that in isolation. You have to be able to look at that across a whole profile and be able to say that it's a weakness. You have to look at it against other skills. So the executive skills is an important one that I just mentioned, and people aren't familiar with that. That is the part of our brain. It's the front of our brain, frontal lobes that mediates our executive skills. And while most of our brain, about 90% of the brain is fully developed by the time we're four or five, the exception to that is the frontal lobes, which is continuing to grow up through like our mid twenties, so when kids are little, they don't have much in the way of executive skills yet, right? There's, and then there's growth spurts along the way. Middle school age, that's a big time for a growth spurt. And then there's there's growth spurts up through that early adulthood. And you can see with life demands, how that tracks because okay, middle school comes, these kids are expected to switch classes seven times. Keep track of yourself across seven classes. We used to keep a locker. I don't think they do so much anymore, but you. Keep track of a lot of this stuff. Keep track of what you need for your sports. Someone's usually not hovering over you anymore to do that stuff. Make sure you have your water bottle on and on it goes. And so we're expecting these kids to become increasingly independent through high school, certainly by college. And, kids are gonna accomplish that at different speeds. And for the kid that has a DHD that phase, that middle school phase is another marker. Another time that you might see some kids come to clinical attention because it was just a lot for them to do. They're not ready to do it yet. And so if you try to imagine taking this back to the mom, so if I'm a mom, let's just say I have this undiagnosed condition, and so my executive skills are not great. And by executive skills, management skills. So that's things like, planning organization tracking things, keeping track of two things at the same time. Speed, making sure I'm doing things at the right pace so I'm not making mistakes. Attention is under this umbrella. And so if I'm a bomb, that's my area of weakness, but now I'm taking care of little ones who don't really have their executive skills. You have to imagine that's a lot of tracking to do. So for a person who, that, if that's my weakness and now I'm taking care of everybody's executive skills, that can be very overwhelming. And so anyway, so you go through the eval, we get a profile and we get a clinical opinion. What does this mean? And it's very important, again, like we're ruling out other things too. It's to call it a DHD, you wanna be able to say, this is not depression, it's not anxiety. And it's tricky even there, honestly, because somebody might have some of those symptoms, but it's more, it's secondary to the A-D-A-D-H-D stuff. So hard. It is making me sad. It's making me anxious'cause I'm not doing it well. So you gotta tease things apart versus the person who was already depressed, already anxious and now I can't pay attention. But there you can have those symptoms. Also because of the A DH D's driving it. So maybe A DHD could be the root and you've been somebody that has been diagnosed with anxiety or depression, but really it's because you had this underlying condition you've been struggling your whole life with. That's so interesting. And those are things that can be uncovered and teased out during a neuropsychological evaluation. Careful evaluation. Careful evaluation that you perform. Yeah. Wow, that's really interesting. Jumping ahead. What are some of the, then, what would a treatment plan look like? Is it always jumping to medication? Are there executive functioning skills you can put in place for patients? What are the next steps? Yeah, so next steps, right? So there's a whole, just as there is for the kids there's a range of options. So there's, there is that option of medication. Some people may be interested in that, others may not. The next line I would think would be to work with a cognitive behavior therapist to help you develop strategies, skills to compensate for executive weaknesses. Putting compensatory strategies in place, checklists, getting routine, getting your life with some routine is important. You just talked about cognitive behavioral therapists and we had a therapist come on our podcast months ago, one of our early on episodes, and she talked at length about CBT. Yeah. And so I'd love you to expand a little bit more on that, especially as it pertains to this. Yeah. It could be CBT, it or it could be an executive coach. You wanna find somebody who says, this is in my wheelhouse, this is stuff that I do. I'm gonna help you get organized, or let's, and you want someone to meet with you and say, this is where I'm struggling. This is the part that's hard for me. Is it keeping track of five schedules, coming up with strategies. How are we gonna do this? Am I keeping one calendar? Am I keeping two? Figuring out what's the best way to, to organize all that I have to organize. And just, I think putting routines in place is really important. Studying reminders, using the apps on our phone for that, using checklists. Sticky notes, whatever it is coming up with strategies, but it's a personalized thing. Somebody talking with you about, where I'm struggling with in my life, this is a thing I keep, this is a repeat problem. Finding strategies for that. There's always the standard lifestyle changes too, of just healthy diet, exercise, making sure we're getting good sleep. Those things are important for everybody, but they're gonna really be important if you're also trying to manage this. It might be that I even feel like, oh, I want a support group. Finding a group of other adults that are struggling with A DHD could be something to be pursued. Finding family members or friends that are good supports. It might even be able to provide some instrumental support. This is really hard for me, but you have somebody who I'm just gonna give you my meal plan I'm using for the week, with my kids. It'll work for you. It might lessen your load a little bit too, if you have other people around you that are giving you. Tools that you can then implement. You don't have to do the research to find it. Or you might just say let's alternate weeks. You do the meal plan for both our families for week one. I'll do it for week two. No, it's just something like this like that for somebody that may be a big deal, deal changer of that part's really hard for me. So yeah. But it's, again, it's just very needs to be personalized personally. We're not talking about school anymore. We're talking about we're talking about your life. Yeah. We're talking about management of life, management of kids and it's hard. Can you speak to medicine at all? There are, there's a lot of really good medications out there. We used to be offered, I think one back in the day, it was, would you like Lin? There's a lot. I think for folks that feel. Worried there's a lot of options. A lot of them are the classic stimulant medications. Some of them are the non-stimulant. But it may be worth the some trials to see what works best for you. And that's something that once you've performed this neuropsych evaluation and have presented that information to the patients, is it psychiatrists that would prescribe this, or would it be your primary care doctor? Or how do you go about that? Yeah. Yep. So this is interesting.'Cause with the kids these days, the pediatricians would become frontline, right? They usually are comfortable and say I'll do it. It's okay. You don't have to go to a separate psychiatrist. But if you're an adult, I think it depends on your PCP and how comfortable they feel with this. They may say, I'd rather you work with a psychiatrist first, get you stable on a medication, then I'll take it over or. I want you to just do this with psychiatry. So it really depends on your pcp It's a talk with your doctor. I guess when there's other things associated with this, like anxiety and depression. Yeah. If it starts to get messy and it's I also need treatment for these other things. I think they're definitely Psychiatrist so we talked a little bit about mom brain. I think that I was the one that was throwing that out. Like we've talked on podcasts and I think it was just me and t on a podcast and we've talked about just. I'm like a big need to label things. Like for internally, I'm somebody that if I see, especially like we've said like the TikTok doctors and the Instagram, there's so much information out there right now, and so I will see something. And I'll be like, that sounds like me. Maybe I have that. That's a classic Christina internal dialogue. And so I think I had thrown out the, okay, am I just experiencing mom brain or is this something further? And I've talked openly just about how I've struggled with anxiety and depression within motherhood. Some of these things I do think I had before, but I think motherhood has just sent them through the roof. And so some of these things seem like they overlap with things that that are going on in my brain, but I don't really know, is it mom brain or is this something further? Is this something that was misdiagnosed? My mom swears it wasn't, but I'm like, even misdiagnosed, maybe undiagnosed, i it just wasn't found. But I'm also just curious, is this just something that I am in the thick of motherhood right now. I'm in the transition where we're going from little kids to now we have, one of my kids is starting school and we're a lot more active. We're entering that activity phase where now it's a lot of things to manage, but. Most of it was just me at home managing schedules, who's eating what? There are two different kids, so two different schedules, and trying to manage myself in the middle and trying to be a working mom who works for herself. So some of it I just, I have to try to give myself grace and say, it's just a lot to freaking manage. Yes. You need a trophy. Yes. Rather than say this is a problem like, whatcha doing? Doing wow. That's amazing. It's a lot, it's just a lot to manage. So I think sometimes I, you said that to her. Yeah. Sometimes it's just nice to hear that you have to just give yourself some grace and give yourself some credit that this is a lot, this is a lot for anybody to manage. You said this at the beginning of the episode, it's just a lot to do. It's a lot for anybody to manage. But I guess when do you know where's the line, yeah. So that mom brain you refer to? Yeah. Not a clinical term, but we all, no, we all say it. We say it in, but we do know there's, there are issues, cognitive issues that come after actually from pregnancy. And they hormonal. We've got hormonal, we've got sleep deprivation, and we're managing, early parenthood demands. So that's a big cognitive load right there. So I would, I think we are talking about, getting us through infancy and I think you said your youngest is one and a half, I think one and a half, a little bit over going towards the tail end of just in terms of those actual physical changes For sure. That could be causing problems. Yeah. I'm probably right in the line of where, okay. I we have babies that sleep. It's the hormonal aspect should be wrapping up. It's like, when do you flag it as I'm still struggling with these things, yeah. And we're talking about you, Christina, right now, but really we're talking to our listeners for sure, who are also you Yes. Who are listening to this right now. We've heard that, who are waiting with bated breath to hear what you have to say. Because you hate it, because, you keep going back to I'm just tired. I'm not sleeping. I'm in brain fog. My hormones are still shifting all over the place. Nothing feels consistent yet, but then for me, I've been in this space where it's okay, everything has been a little bit more manageable. So when do we flag it as I still don't feel right. Like that's, yeah, that's a great question. And I don't know that I have the exact line for you. Yeah, I just, off the, I would say, gee, wanna give yourself maybe two years, but yeah, that is, I'm just putting that out there. But, you, again, the key word is persistent. You'd wanna see. This didn't go away. E even when it's in the rear view mirror and you can say everything's regulated now, this is not an issue. I'm just keeping it. And if you're still saying, and yet I'm not able to manage these, mom tasks associated with childcare and all the rest of this and I still can't do this. I think then yeah, you're saying this is persistent now. Yeah. I think that's good. I think even if it's not completely accurate, it's'cause it's different for everybody. But I think just having a timeframe in your mind of being able to say, okay, after two years, if this still seems off, if it's persistent. Yeah. That's a great, it's just nice to know.'cause I think a lot of the times you can just stay in that place you know of. My kids are little and I have a lot going on, and you just you don't get yourself to the next step. Do you feel like it interferes with your life? Because that was another thing Dr. Keho said with like the kids is it really interfering with their life day to day? I guess that same question, it's to yourself. Yeah. I don't think it's interfering. It's just, to me it's annoying and I've always considered myself like a type A person, but I come at Type A. And that verbiage from like a perfectionist standpoint. Yeah. I like things done by way, which she used those words earlier in our conversation, but I've never actually been a hyper organized person. So I think I teeter on yes, I like things done my way. I have expectations of things and if they don't go the way I want them to go, I'm very hard on myself. It's a disaster. It's a disaster. It's terrible this week because we had McDonald's one day. Yes. Shut. Yes. So it's like the way I frame myself and the way I thought that I was gonna be this type of mom and now it's shifting and I'm having to let things go and roll with things. But I've never been a, it's very hard for somebody very hard who prides themselves on perfectionism. Yeah. But I've also never been like a super hyper organized person. I did well in school. I didn't do great in school. I wasn't like a stellar academic person, so I think I like teeter on some of these things. Some of them seem in line, but I don't know if I would hit all six or all nine, like you said. So I think some of it just could be overlap with anxiety and that's just how my brain operates. I need the checklist. Yeah. Should we read again? Read, because checklist. I wanna read the checklist. Yeah. Because I don't think we fully read them. Christina. Christina and I have no shame in our game. Oh no. But I will gladly say yes or no. Okay. Okay. Fails to give close attention to details or makes careless mistakes. Check for Christina Bon tempo over here. Okay. I think that I could, that could be me now. That could be me now. Really? You? Yeah. I think you always double check our work and make sure it's perfect. See, I disagree with that for you. Okay. But you tell yourself that I would know. Okay. But we've got the collateral informants right here. There we go. Yeah. So she, yeah. That's why it's important for a second person. But you said you have it. I'm the work wife has difficulty maintaining attention and tasks or play activities. That's like for a kid. But for me, I would say yes, but because I could be on a task, I always say, I'm like a browser, my brain and I have 50 tasks open at a time. And sometimes even for work or for, if I'm trying to schedule an appointment for one of my kids and I'm like, okay, I have to go on and then I gotta log in here and my brain, it's like I could be like, log on, make the appointment, do this like step by step and then something else will shift my attention. One of your kids and then I'm like, one of your kids I might hear, yeah. But like even still, I might be like, oh, you know what? That reminds me that I need to do this. And then I shift away from that and I'm like, why did I go on the computer? Do the original task? That's so that never really happened to me before. This is like something that's new because I think that there's just now so many more tabs that are open. So it's so many diversions away. So that's okay. So number three does not seem to listen when spoken to directly. I don't think I have that issue. I don't think I have that issue there. No, I don't think you have that issue. Does not follow through on instructions and fails to finish things. That's me. It depends on what the instructions are. If they're auditory instructions, I'm on it. Okay. I have to read something and I'm a more visual person. I, you lost me. Yeah. I still think they only have one fail to finish things is me all day long. I don't make decisions very easily. So like I will get so far down in a task and then I'm like, I'm out. I don't, I'm overwhelmed and I just stop. So that's me. Has difficulty organizing tasks and activities. I would say me sometimes, but I can usually organize tasks is just getting them done. No, for me, I'm okay with that. Yeah. Okay. With that, I'm okay with that. Avoids dislikes or is reluctant to engage in tasks that require continued mental effort. Who likes to do things they don't wanna do? I know that's tricky. It just don't, most people wanna take the path of what's resistance, but I don't loses things necessary for tasks or activities. For example, school assignments, pencils for me, it would be like, I have to go somewhere. Where are my keys? You know what I mean? It's what bag are they in? I can't go until, so that's been, again, something that that happens to me all the time. I'm glad. Is that the last one that was, is easily distracted by other things going on. That is me and then it's forgetful in daily activities. I think that depends. So there is another category of A DH adhd, which is unspecified. So sometimes you can give that to folks who, let's say you don't fully meet and you're at your age five full, you're at four and a half. You've got enough here, and the impact on your life is enough that I feel like it is captured by a DH, adhd. There is another, yeah. It's not that strict like it has to be. I have to find five. So it might, if we've got enough evidence and don't forget, by bringing in the neuropsychological evaluation, you've also not, you've got quantitative data too to X, right? This is a behavioral presentation. If that's coupled with quantitative data that says indeed attention is hard for you. And it's hard.'cause I like you're saying, you're trying to answer for yourself, but I like that you're saying with the evaluation, it's obviously like someone else is evaluating. Yeah. And you're supposed to be doing like more real life things and someone else can evaluate. This is less about what do you think? And it's show me how this attention is me. Yeah. That makes sense. And so someone could still conceivably get a diagnosis of a DH, adhd, but it's none of those. It would be an unspecified. Okay. That makes sense. I'm curious for our listeners who just heard us go through that list, like how many of them would check some of these boxes? And also I should mention, if you have somebody coming to you, clearly it's affecting their life enough, right? If they're coming into your office. Yeah. So whether they've only checked four and a half of those boxes, or the full five, just their presence here alone, I think tells you that it's affecting their life. It's a magnitude that's problematic. The other big. Key though is to make sure that's what it is, that it is not something else. I think that's very important. That you can tease that out. I know that was something that you had to work when you worked with my son. It was a two day long evaluation. Okay. Yeah. This is expected then. Age appropriate. You knew at the time he was eight years old, you weren't gonna have him sit in your office for six hours. His hyperactive body, could not tolerate that. But it was amazing the things she was doing with him so we could figure out how could he access the curriculum best. Interesting. And have that implemented into when we worked with the behavioral specialist who made this color coded schedules for him. Like how will his brain digest this? Not everything is just a pill and a diagnosis. Yes. And a box. Yes. Some of this is, all right, Christina, you're having trouble with forgetting where you're keeping things. You're gonna keep your keys now here every single time. That's gonna be your new CBT. That's gonna be what you do next. And I think that's very helpful. Like I think just that some of those like behavioral lifestyle changes Yes. In a season where you just have so much going on, you have to simplify and try to organize yourself. And so some of those are Yeah. Routines. Tea have to go here. Yep. The baby bag upon entry Yes. Has to be restocked. Yes. I can't be doing that when I'm trying to walk out. I can't. Do it at that point. And I do that stuff well if I give my, if I allow myself enough time and if I'm in a good mental space at that point. Yeah. When I'm like trying to go somewhere, that is not the time to do that stuff. But that seems to be when I remember that I need to do those things. So I do think some of it's routine and I think that as we grow out of the baby phase, where not a lot of things are routine.'cause that's what I struggled with was the lack of routine. And now that things are getting a little bit more, okay, here this day we go here and this day we do this. Yeah. You're thriving routine and there's a little bit more structure and I'm starting to find that okay, even though it's a lot more to manage, like schedule-wise and who has to go where I do better with the structured routine so that it's like more of a habit. We do this day. Okay. So then I know this the day before we have to do this, so I'm coming back to it a little bit more. So it's helping both of us. It's helping. Yeah. But this was great. I think was so helpful. This was a great conversation, was helpful. And then you have me, the mom who's you know what, there's a CVS nearby. If I forget it, eh, I'll just go by it. It's just a very healthy way to think because as long as it's not cleats. Yes, exactly right. Oh, you know what? I'll tell you. We forgot my son's cleats and I insta carted a pair of cleats to the field. Yeah, okay. When there is a will, they're way, you have to just be resourceful. So you have to be resourceful. I love it. Yeah. You have four kids or two kids, or any kids. You have to be resourceful. That's so impressive. That's really impressive. This was so great. So we close all of our episodes with a pink spotlight, which is a person, place, tip thing. Anything that you wanna share that makes life a little bit better for you or easier for you. So it could pertain to what we talked about. It could be completely out of left field and something that you just wanna share. But do you have a pink spotlight for us today? I can think it just comes from what we were just saying. Okay. And because this is true in my own life. Yes. It's just so much easier to when you see that thing on the counter that needs to be put. Just do it now. Yes. Just do it now. Just do it now. It just ease up your brain. It's just nice because I don't have to now store that and remember I have to go and do that. It's just, I like that I've tried to do that, but I like the immediate, but I've said if a task takes under five minutes in my head and I'm like, gonna go put it on a list, just do it now. That's but I like that even the quickness of just, you see something like, just do it. Yeah. But you could bring up a good pool. Yeah. I don't mean I'm gonna sit down and do my taxes now. That takes too long. No. But just the immediate just the stuff in your environment, because that clutters our minds, right? Yes. I know, like I still have to bring that stuff upstairs. Just do it. Just do it now. Okay. It gets invited to a birthday party. Rsvp, buy the gift. Do it now. Yeah. Yeah, yeah. Put it in the calendar or stop at CVS on the way to the party. Get a gift card. Great day. Great tip. I like that mantra. Yes. I love that too. Do you have one for us? I have a quick tip for us today. Okay. So I've been listening to podcasts in my audiobook. Not at the speed of one anymore. You can do it at one time, something I like it. Which speeds it up a little bit, but not so much that it's and you're, you can't understand it. So I've been listening to my podcasts and my audio books at speed 1.25. Sometimes I listen to 1.5. If it's like something that I really need to digest quickly, but for the most part, it's for leisure. I like that. And maybe people can listen to our podcast on one point. Sometimes we get very long-winded here. You don't have an hour to listen to us. You don't have an hour and a half. So if you go on a 45 minute walk and you only listen to your thing on your walk and you hate oh, I wanted to finish this, just. Speed it up a little bit. Yeah. Oh, I love that. So that's my tip. Yeah, that's a great tip. That's tip. I love that. And people could do that right now. You can even sample it. You can literally go and hit it now. Once you get used to the speed of people talking that like that it,'cause it sounds fast at the beginning, but then I've even sometimes done like 1.5 or I've done,'cause you get used to it and you're like, okay, I'm I'm keeping track. I can follow this. Yeah. And then you just breeze through your content that you wanna listen to and you don't have set key all the time. Got into, I got into Nick's car the other day and he was listening to a podcast at 1.5 and I was like, oh, you have it on fast. Let me slow it down. He goes, oh no, this was intentional. This is how I listen to things. Like you're in the dinosaur ages of listening to things at once. Yeah, at real time. Who has time for that? Who has time to listen to us for an hour? I love that. So mine this week is, I have been, now I'm. A year and eight months postpartum with my second, and this year has been like my health journey, like just getting myself back healthy, mentally healthy. I really tried to focus on that, but also physically healthy. And what's been frustrating to me is the, like my lack of. Routine exercise wise, and I've, I'm a big Pilates girl. I've always loved to go into Pilates and right now the class schedules just do not work with my lifestyle. And so I've al, we had Leah Ian, who is my favorite Pilates instructor in person, she launched an app and she does a lot of reformer Pilates as well as I feel like I did all her map Pilates and I was like, okay I need more different, I wanna go back to the reformer. And I ended up buying myself a reformer, which was a huge investment for me. But I was like, this makes a lot of sense for me because first of all, I have her app and so I can actually stream Leah, who is my favorite Pilates instructor, and. It's gonna pay for itself within a year. Yeah, because I'm gonna use, you're gonna come over. Yeah. So you, there we go. Now it'll be even less, but it makes sense. But because to go to the studio the amount of times I would want to every single week, these classes are expensive. Per expensive. So I just said, you know what? Dollars a class, I'll pay this off in a year. By the time I like eliminate that. Cost of going to the classes. Yeah. Your RI, my ROI is gonna come back to me within a year and I've been doing Pilates for five years, so I know that I'm gonna actually use it. Yeah. And I ordered a reformer. You have a good foundation. Leah gave me a, Leah gave me the recommendation for the at home reformer that she would recommend, and I bought it and it arrived in a crate in my driveway. And I was at, I was actually at your house. My husband goes, there is a crate in our driveway. Like, how did they, how do we think that we're getting this into the house? But we like opened up. We got it. It was mostly assembled. I know I said we you sorry. As we do hydroco on it. Yes. But it was like pretty assembled. We were surprised. These muscles are just for you. The, we were surprised. It came mostly assembled, which was really nice. I said, that's why there's a crate.'cause it's mostly assembled and we got it into the basement how happy are you? I am like a new human. I'm like, okay, now I know I can wake up. If I wanna wake up before the kids and get this done, it's gonna be part, again, back to the routine and how important that's been for me. I'm like, and then I don't, I could get it out of the way or even if I don't, and it goes a little awry and I'm like, okay, I can't do it before the kids wake up. I know I can squeeze another point of the day in. And so that anxiety of now I'm not gonna be able to work out today is gonna be eliminated because I can just fit it in at another point. In the day'cause it's in my basement. Yeah. And so I, I am feeling very good and optimistic about it. So I'm excited to have that. And I'll definitely film and if I can get a code for our listeners, I definitely will.'cause I love it so much. So I'm excited. Yay. Awesome. Yeah. Good. Cool. This was a terrific conversation. Thank you so much for having us. Where can our listeners find you if they wanna see you themselves or if they have children that wanna see you? Where can our listeners find you? I have a webpage. It's dr keho do com. So yeah, contact information there. Perfect. Okay. And she is in Avon, Connecticut. Yeah, she's terrific. Great with kids, great with adults. Love it. And great with moms. This is great. Thank you so much. This has been so helpful for our listeners. And if you have Pippa's, if you have any questions, you can text that, text us at the bottom of our show notes and we can get some of that answered or follow up questions or whatever. But we're so happy to have you and lucky. No, thanks. Thanks for having me. Thank you. We'll see you guys next week. Bye.