ADHD医生：如何提升专注力、停止拖延、管理情绪并掌控生活

但先别走开。

But don't go anywhere.

我们还有很多内容要深入探讨，我真的希望你能坚持听到最后，因为哈姆达尼医生会带你了解四件具体的事情，如果你觉得这些内容和你产生共鸣，你需要做这四件事，以及如何开始考虑获得你应得的支持。

There's so much more that we are gonna dig into, and I really want you to stick around for the end because doctor Hamdani is gonna walk you through the specific four things that you need to do if you feel like this is resonating with you and how to start thinking about getting the support that you deserve.

所以你会想听这个的。

So you're gonna wanna hear that.

请继续听下去。

Stay with me.

你知道吗，主持这个播客将近四年，有一个话题是每一位健康专家都认同的。

You know, after hosting this podcast for almost four years, there's one topic that every single health expert agrees on.

蛋白质对你健康、长寿和保持最佳状态的重要性。

The importance of protein for your health, longevity, feeling your best.

但问题来了。

But here's the problem.

谁有时间去煮所有这些鸡胸肉、牛肉和鸡蛋呢？

Who the hell has time to cook all this chicken breast and beef and eggs?

这正是我联合创办Pure Genius Protein的原因。

That's exactly why I became a cofounder of Pure Genius Protein.

一口就能摄入23克优质蛋白质。

23 grams of high quality protein in one shot.

搞定。

Done.

蛋白质问题解决了。

Protein handled.

而且它无糖、无脂肪，不含人工甜味剂或香料。

Plus it's sugar free, fat free, and has no artificial sweeteners or flavors.

在puregeniusprotein.com使用优惠码MELT10，享受10%折扣。

Use code MELT10 at puregeniusprotein dot com for 10% off.

三秒钟摄入23克蛋白质，每份不到3美元。

23 grams of protein in three seconds for under $3 a shot.

这才叫简单。

Now that's easy.

欢迎回来。

Welcome back.

我是你的朋友梅尔·罗宾斯。

It's your friend Mel Robbins.

今天，你和我将获得一份关于ADHD的全面指南，由Dr.

And today, you and I are getting a comprehensive guide to ADHD with Dr.

Sasha Hamdani提供。

Sasha Hamdani.

那么，Hamdani医生，我在你的作品中读到ADHD有三种不同的类型。

And so, doctor Hamdani, I read in your work that there are three different types of ADHD.

对。

Mhmm.

我之前不知道。

I didn't know that.

ADHD有哪些不同的类型？

What are the different types of ADHD?

好的。

Okay.

让我给你展示一下。

Let me show you.

好的。

Okay.

第一种，注意力不集中型ADHD。

First one, inattentive ADHD.

我们之前简单提过这个。

And we touched on this briefly.

注意力不集中型ADHD通常表现为爱做白日梦的人。

Inattentive ADHD typically are the daydreamers.

他们往往容易忘事，组织事情有困难，记不住东西放在哪里，开始任务有困难，而且你知道，如果面前有一个大任务，你往往会回避它。

They tend to be forgetful, difficulty with organizing things, difficulty with remembering where you place something, difficulty with initiating tasks, difficulty with you know, if there's a big task coming up in front of you, you tend to avoid that.

通常，这是出生时被指定为女性的人的表现方式。

Typically, this is how females assigned at birth present.

好。

K.

注意力不集中型多动症。

Inattentive ADHD.

注意力不集中型。

Inattentive.

对。

Check.

多动或冲动型多动症。

Hyperactive or impulsive ADHD.

这是多动症的第二种类型。

This is the second form of ADHD.

这也是男性可能表现出的方式之一。

And this is, well, one of the ways that males can present.

这包括身体上和言语上的冲动。

And this is both physically and verbally impulsive.

这些孩子，还有成年人，很难安安静静地坐在座位上。

These are the kids that are having difficulty, kids and adults, difficulty staying in their seat.

他们总是动来动去的。

They're fidgeters.

他们说话很冲动，老是打断别人。

They are impulsive in speech in that they're interrupting.

在谈话中他们会脱口而出答案。

They are blurting out answers in conversation.

他们很难好好参与对话。

They have difficulty participating in conversation.

所以这就是那种多动型的。

So this is this is that hyperactive type.

然后第三种是混合型的。

And then the third type is the combined type picture.

哦。

Oh.

混合型就是这两种特征都有。

And combined type picture is just a combination of both of those features.

所以你可能既有注意力不集中的表现，也有多动的那部分。

So you can have inattentive features, and you can also have the hyperactivity component.

有趣的是。

Fun fact.

我就是这种类型。

This is what I am.

你怎么知道的？

How do you know?

你懂我的意思吧？

You know what I'm saying?

因为感觉这些描述有点笼统，好像每条都能在自己身上找到影子。

Because it feels like it's a little general, like all of it, so you can kinda find situations for yourself.

但你怎么确定自己是哪种类型，而且为什么了解自己属于这三种中的哪一种很重要呢？

But how do you know what you are, and why is it important to understand which of the three you might be?

所以，我的意思是，你一旦做了全面扎实的评估，你就会真正明白。

So, I mean, you really are gonna know once you get a good solid evaluation.

对吧？

Right?

因为我觉得，做一次好的评估，一次非常可靠的评估，一方面是要确认是不是多动症，另一方面也要排除其他所有可能。

Because I think that part of getting a great evaluation, a very sound evaluation, is equal parts, yes, ruling in ADHD, but also ruling out everything else.

我要确保这不是焦虑，不是抑郁，不是双相情感障碍，也不是甲状腺问题或者其他潜在的医学问题。

I want to make sure that this isn't anxiety, that this isn't depression, that this isn't bipolar, that this isn't some thyroid issue or some medical issue underlying it.

所以在评估中，当你讨论多动症时，你会从童年开始，看长期的行为模式。

So there's within the evaluation where you're talking about ADHD, you go from childhood and you kind of look at longitudinal patterns.

因为，再说一次，特别是对女性来说，这很难，因为每个月我们的激素水平都不一样。

Because, again, with women specifically, it's hard because every month we look different hormonally.

所以，在月经周期的不同时间点看你，你可能看起来不一样，表现也可能略有不同。

So catching you at one spot in your cycle versus another spot, you might look different and you might present a little bit differently.

所以你要寻找的是长期的行为模式。

So you're looking for longitudinal patterns.

你能解释一下情绪方面是怎么影响女孩的吗？

Can you break apart how does the emotional side impact girls?

所以，当你观察女性时，她们通常更倾向于注意力不集中的表现类型。

So when you're looking at females, they typically fall into this pattern of more the inattentive presentation.

这些就是那些爱做白日梦的人。

So these are the daydreamers.

她们容易忘事。

They're forgetful.

她们在组织事情上有困难。

They have difficulty organizing things.

她们在建立日常规律和完成任务动力方面有困难。

They have difficulty with routines and and motivation to get tasks done.

所以总的来说，这些人可能是课堂上让人喜欢的学生。

And so these are the people that, in general, can be a pleasure to have in class.

她们一直顺利过关，表现也不错。

They're getting passed along, and they're doing well.

但在内心深处，她们非常非常努力。

But internally, they're working so hard, so hard.

你知道吗？

You know what?

这种情况不会好转。

That doesn't get better.

你熬过了小学阶段。

You get through your elementary school years.

到了青春期。

You get to puberty.

然后突然被激素冲击。

Then all of a sudden, get smoked by hormones.

激素立刻改变了一切。

Now hormones immediately change things.

现在，不是医生的错，再说一遍，不是医生的错。

Now instead of physicians and again, not the fault of physicians.

对吧？

Right?

这是标准的问题。

This is a fault of criteria.

但现在，医生看着这个孩子，不是说‘哇，我们漏了什么’，

But now instead of physicians looking at this child and saying, woah, we missed something.

而是说，你情绪波动这么大，学习吃力，交朋友也难，所有这些。

You're having, like, all these mood swings and school is hard for you and friendships are hard for you and all of that.

他们却说，你是青少年。

They're saying, you're a teenager.

这是荷尔蒙。

These are hormones.

习惯就好。

Get used to it.

就像，这是

Like, this is

这就是一个13岁女孩听到的话。

what you hear as, like, a 13 year old girl.

然后她们只能自己熬过去。

And then they have to get through it.

所以你就忍着，然后上了大学。

So you just kind of bear it, and then you get into college.

你的压力变得更大了。

And your demands get harder.

你开始谈更认真的恋爱。

You start getting into more serious relationships.

然后可能到了要组建自己家庭的阶段。

And then maybe you get into a situation where you're trying to start your own family.

好。

Okay.

现在你又迎来了一波激素的冲击。

Now you're getting hit with another wave of hormones.

实际上，怀孕期间雌激素水平会稍微高一些。

And actually, during pregnancy, estrogen levels are a little bit higher.

多巴胺水平也会高一点，所以你可能感觉还不错。

Dopamine levels are a little bit higher, so you might do okay.

但产后一来，你的世界就天翻地覆了。

But then postpartum comes and rocks your world.

这时候雌激素和多巴胺水平下降，你就没法像以前那样调节情绪了。

And so you get this drop in estrogen, drop in dopamine, so you can't regulate the way you used to.

于是你又去看医生，说情况很糟糕。

And so now you go to a doctor again, you're like, things are bad.

医生就说，这是激素问题。

And they're like, it's hormones.

然后给你开抗抑郁药，因为你抑郁了。

Like, let's put you on an antidepressant because you're depressed.

这就是产后抑郁症。

This is postpartum depression.

所以又被忽略了。

And so it gets missed again.

然后你熬过了这一切，也度过了你的育龄期。

Then you get through all of that, and you get through your reproductive years.

现在你到了围绝经期，情况变得混乱，因为你的雌激素又下降了。

And now you're in perimenopause, and things are chaotic because your estrogen drops again.

你会觉得，出问题了。

And you're like, something is wrong.

出问题了。

Something is wrong.

现在呢，就是，你只是激素失调。

And now it's, well, you're you're hormonal.

比如，再等十年吧。

Like, give it ten years.

我们以后再见。

We'll see you later.

脑雾。

Brain fog.

对。

Yeah.

就是这样。

There you go.

这在围绝经期会发生。

This happens during perimenopause.

你把我的一生都描述出来了。

You've described my whole life.

我知道。

I know.

我产后抑郁，崩溃过。

I had postpartum depression, crashed.

围绝经期时，我开始出现严重的脑雾和其他症状。

I started having severe brain fog and other symptoms during perimenopause.

所以你用了激素，确实有帮助，但对脑雾没什么用。

So you get hormones, which help, but didn't help the brain fog.

对。

Yeah.

而且，就像，之前只是被诊断为焦虑，一直带着焦虑生活，挣扎、挣扎、挣扎，硬撑着。

And again, like, it was just diagnosed with anxiety, living with anxiety, struggling, struggling, struggling, pushing through.

产后抑郁。

Postpartum depression.

天哪。

Oh my god.

喂奶的时候哭得稀里哗啦的。

The sobbing as you're breastfeeding.

就是，感觉自己不像自己了。

Like, just I don't feel like myself.

天哪，然后到了更年期，用那些药膏，然后突然又诊断出多动症。

Oh my, just and then perimenopause, then the creams, then the and then all of a sudden ADHD diagnosis.

然后就想，等等，什么？

And it's like, wait, what?

而且感觉，不仅是我被诊断出来，而且找到了对我有效的药物之后，就好像四十七年后，我突然觉得自己终于回到了自己的身体里。

And it felt as soon as I was not only diagnosed but but found the medication that worked for me, it's like all of a sudden after forty seven years, I felt like I was in my body.

对。

Yeah.

对。

Yeah.

而且这一点常常被忽略，她们一次又一次地被漏诊，因为我们的诊断标准没有涵盖这些。

And that gets missed, and they get missed over and over and over again because our criteria doesn't catch that.

女性如果有未确诊的多动症，是不是常常会导致焦虑和抑郁？

Is it common in women that if you have undiagnosed ADHD that it can cause anxiety and depression?

是的。

Yes.

为什么？

Why?

很多时候，比如你看多动症，可能会有焦虑和抑郁，这是伴随它的另一个问题。

A lot of times, like, when you look at ADHD, there can be anxiety and depression that is a separate thing that travels along with it.

这种情况确实会发生。

That that can happen.

但对很多人来说，因为，再说回多动症的情绪调节问题，这个问题大家似乎都忽略了，而它对全面了解多动症至关重要。

But for a lot of people, because, again, circling back to that emotional regulation part of ADHD that everyone seems to miss and that is so critically important to getting a comprehensive picture of ADHD.

第一，如果你一辈子都觉得你自己有问题，觉得自己不如别人，觉得自己是残缺的，那肯定会让你焦虑。

Number one, if you've gone through your whole life and you've thought that there's something wrong with you and you're less than and you're broken, that's gonna make you anxious.

如果你明明知道自己有能力做某些事，却做不到，那也会让你焦虑。

If you can't do the things that you know perfectly well that you are capable of, that's gonna make you anxious.

你知道吗？

And you know what?

那可能也会让你非常抑郁。

It's probably gonna make you pretty depressed too.

如果你经历这些巨大的能量波动，一会儿能做很多事，然后就像到了极限，接着就崩溃了。

If you're going through these huge moments of this energy dysregulation where you are getting tons done, and then it's like you've hit your max, and then you crash.

你会有一次巨大的崩溃，然后你会觉得，好吧。

You have this huge crash, and then you feel like, okay.

我真的什么力气都没有了。

I have literally nothing left in my tank.

这看起来像是抑郁症。

That looks like depression.

但这些其实都是情绪调节方面的问题。

But these are all emotional dysregulation issues that are happening.

所以这就是为什么你会看到ADHD伴随这些症状。

And so that's why you see that with ADHD.

未确诊的ADHD和饮食失调之间有关系吗？

Is there a connection between undiagnosed ADHD and eating disorders?

有。

Yes.

确实有。

There is.

但我觉得，这同样源于情绪失调，也源于很多ADHD的问题。

But I think that, again, that stems from dysregulation, and it stems from a lot of ADHD.

你没法对某些事情保持正念。

You're not able to be mindful about certain things.

所以有时候，当人们想到饮食失调时，他们想到的是，你知道，一个极端是吃得不够，另一个极端是吃得太多。

So sometimes it's not actually you know, when people think about eating disorders, they think about, you know, on one extreme that you're not eating enough, and on the other extreme, you're eating too much.

比如，在吃得不够的那个极端，很多时候ADHD患者可能没有饥饿感。

Like, for the extreme where you're not eating enough, a lot of times with ADHD, sometimes it can be like, you don't really have hunger cues.

而且这不只是药物引起的。

And and this is outside of the medication.

就是你的身体没有告诉你你饿了。

It's just your body isn't communicating telling you you're hungry.

就我个人而言，如果我沉浸在一件我真正感兴趣的事情里，我可以八个小时不吃东西。

And I know personally, if I get invested in a task that I'm truly interested in, I can go eight hours, and I'm not eating.

也不喝水。

I'm not drinking.

我都不起身。

I'm not getting up.

对。

Yep.

反过来，像暴食症这类情况，有时候你会试图刺激自己的多巴胺。

On the flip side, with, like, binge eating disorder and things like that, there can be a time where you're trying to stimulate your own dopamine.

你试图让自己动起来，甚至都没意识到自己在做什么。

You're trying to, like, get things going without even knowing that's what you're doing.

你会随手抓东西吃，自己都没察觉。

And you're grabbing for things, and you're eating, and you you don't even know.

然后你低头一看。

And you can look down.

你会想，好吧。

You're like, okay.

一整盒女童子军饼干就这么没了。

That was a whole sleeve of Girl Scout cookies.

就像，所以你可以两头都尿。

Like, the so there's like you can pee on either end.

所以，是的，饮食失调在两端都有联系。

So, yes, there are linkages with disordered eating on both ends.

有趣的是，哈姆达尼医生，你再次看到了这种外在表现与内在混乱之间的区别。

And what's interesting is, again, this kind of distinction that you're seeing, doctor Hamdani, of the external presentation versus the internal turmoil.

我的描述是，这就像你的房子外面着火了，而里面也着火了。

How I describe it is it's like the outside of your house is on fire versus the inside of your house is on fire.

感觉就像两边都着火了。

Like, it just feels like both are on fire.

两边都在燃烧。

Both are literally in flames.

我们现在看待它的方式是，我们只关心能否看到火焰。

The way we look at it now is we only care if we can see the flames.

火焰在房子内部燃烧。

Flames are going on inside the house.

你会对那个收到这期节目的人说什么，如果这期节目是关心他们的人发给他们的？

What what would you say to somebody who has received this episode from someone that cares about them?

对。

Yeah.

因为关心他们的人看到了这些模式，然后通过短信把这期节目发给他们，说：嘿，我希望你听听这个，因为这听起来有点像你可能正在面对的问题。

Because the person who cares about them sees these patterns and has sent this episode in a text saying, Hey, I'd love for you to listen to this because this sounds a little bit like what you might be dealing with.

对于那些按下播放键、第一次真正开始思考你所说内容的人，你想说什么？

What do you want the person who's hit play and is starting to really process what you're saying for the first time?

我觉得如果你正在听这期节目，我不想让这期节目把你推向任何一个方向。

I think if you are listening to this episode, I don't want this episode to push you one way or the other.

这期节目并不是为了让你确信自己有多动症。

This is not meant to convince you that you have ADHD.

也不是为了把你推向某个方向。

This is not meant to push you in one direction.

它只是想让你问问自己内心的状态，这样你就可以开始更深入地挖掘，弄清楚是不是有什么问题，或者有什么需要去处理的事情。

It's meant to ask you questions about your own internal environment so that you can start digging deeper and figuring out, is there something here, or is there something that needs to be addressed?

我想重申的是，我认为好的、富有同情心的护理和诊断，源于一个非常不带评判、没有羞耻感的地方。

And what I want to reiterate about all of this is that I think good, compassionate care and diagnosis stems from a very nonjudgmental and shame free place.

所以，只要你能以非常富有同情心和自我同情的方式来看待这一集以及你做的其他研究，我想你就能更好地接收信息，并开始拼凑出关于你自己行为的模式。

And so just being able to look at this episode and and whatever other research you do in a very compassionate and self compassionate way, I think you'll be able to receive information and actually start to put together patterns about your own behavior a little bit better.

那可能是多动症。

And that might be ADHD.

也可能不是。

It might not be.

你觉得关于多动症最大的误解是什么，让人们，尤其是女性，

What do you think the biggest misconception is about ADHD that keeps people, especially women

嗯。

Mhmm.

得不到帮助？

From getting help?

那就是必须用药治疗。

That you have to treat it with medication.

我觉得不一定需要。

I don't think you have to.

有些人服药后，生活发生了翻天覆地的变化。

There are some people that are on medication and it is life changing for them.

所以我绝不会否定药物，就像我之前提到抗抑郁药时说的那样。

And so I'm never going to and even when I was talking about antidepressants before, same thing.

对某些人来说，那也可能是改变人生的。

That can be life changing for some people.

所以我不会收回那句话，因为药物是一种工具，可以非常有用。

So I'm never going to go back on that because a medication is a tool and can be wonderful.

但同时，能够投入时间去寻找有效的治疗方法也至关重要。

But also being able to actually commit time and figure out therapeutic tools that might work, it is also so critically important.

而且有些人根本不需要药物。

And some people don't need medication.

他们通过认知重构和心理咨询就能走出来，这可以非常有益。

They they get through with doing cognitive restructuring and work through therapy that can be extremely beneficial.

非常感谢你的回答。

I so appreciate your answer.

你说的话让我感到安心的是，还有其他方式可以支持自己。

What I find reassuring about what you're saying is there are other ways you can support yourself.

我们接下来会具体谈谈该怎么做、如何获得诊断、你可以采取哪些措施以及有哪些药物。

We're gonna get into that very specifically about what to do and how to get a diagnosis and what are the things that you can do and what are the medications.

我记得当我得到诊断时，那既是一种极大的解脱。

I remember when I got my diagnosis, it was both an extraordinary relief.

对。

Yeah.

同时我也感到很多悲伤和愤怒。

And I had a lot of grief and anger.

是的。

Yeah.

当你终于明白一直以来困扰你的是什么时，感到一种悲伤，这是常见的吗？

Is that common to feel a sense of grief, like, when you finally understand what's been there the whole time?

是的。

Yes.

我在评估别人的时候，其实会跟他们提到这一点。

When I evaluate people, I actually tell them about that.

比如，我不知道这次评估会显示什么，是不是多动症，或者不是多动症。

Like, I don't know what this evaluation is gonna show or if it's ADHD, if it's not ADHD.

但不管我们经历什么，这都只是对你身体里正在发生的事情进行更深入的探索。

But depending on what we go through, this is just a deeper exploration of what's going on in your body.

你可能会觉得这就是答案。

You might feel like this is an answer.

这就是我一直在寻找的东西。

This is what I've been looking for.

我也可能会觉得自己浪费了太多时间，为失去的时间和潜力以及所有那些东西感到悲伤。

And I might feel like I wasted so much time, and I'm grieving that loss of time and potential and all of that stuff.

而我会对他们说，这很正常。

And to them, I say, that is normal.

你可以有这些感受。

Like, you are allowed to feel those things.

这完全正常，应该有这样的空间，因为这是对正在发生的事情的一种非常合理的表达。

That's perfectly normal, and there should be space for that because that is a very valid expression of what's happening.

但我也告诉他们，那段时间并没有浪费，因为你所做的努力。

But I also tell them that in that time, it wasn't wasted because what you were doing, the hard work.

你在建立日常习惯。

You were building routines.

你在构建结构。

You were building structures.

你在寻找变通方法，最终，当你有了合适的工具和支持，这些都会派上用场。

You were building workarounds that eventually, as you have the right tools and scaffolding, those are gonna come in handy for you.

这些会让这个过程变得更容易一些，因为我也看到过另一面，当人们开始服药但没有这些支持时。

Those are gonna make this process a little bit easier because I've also seen on the flip side of things, when people are started on medication and they don't have that scaffolding in place.

然后当他们停药时，就像又陷入了困境。

And then when they're off medication, it's like they're floundering again.

所以我认为这种多管齐下的方法，结合生活方式和行为调整，再加上药物（如果合适的话），会非常有帮助。

So I think this multifactorial approach of doing lifestyle and behavioral modification with medication, if that's appropriate, can be extremely helpful.

对我来说，这改变了我的生活。

It was life changing for me.

是的。

Yeah.

我想谈谈高成就者之间的联系。对。

I'd love to talk about the connection between being high achieving Yep.

以及它如何，尤其是在女性中，掩盖多动症。嗯。

And how that, especially in women, can hide ADHD Mhmm.

尤其是对我们自己。

Especially from ourselves.

是的。

Yes.

所以我要向你介绍‘伪装’这个概念。

So I'm gonna introduce you to the concept of masking.

你听说过这个吗？

Have you heard of that?

在ADHD的背景下没听说过。

Not in the context of ADHD.

所谓“伪装”，就是你有ADHD时，会有意或无意地掩饰自己的症状。

So masking is when you have it it can be conscious or unconscious camouflaging of your symptoms.

而女性在这方面特别擅长，因为我觉得从小我们就习惯了这样做，因为我们不想惹麻烦。

And this is something that women do exceptionally well because I think from a young age, we're sensitized to do this because we don't wanna be in trouble.

我们不想在人群中显得突出。

We don't want to stick out of a crowd.

我们不想引起太多注意。

We don't wanna bring a lot of attention to us.

我给你举个例子，就拿我自己来说。

I'll give you an example with me.

比如，我是混合型表现，所以我以前非常活跃。

Like, I was a combined type presentation, so I was very hyperactive.

比如，我坐不住，特别爱动来动去。

Like, I couldn't stay in my seat, a big fidgeter.

但我学会了，上课不能老站起来。

But I learned I can't get up all the time in class.

我老是被老师批评。

I'm getting in trouble constantly.

所以我会把大腿紧紧压在椅子上，或者抓住椅子底部，试着把自己像吸盘一样吸在椅子上，因为我觉得我必须得把自己控制住，不然就会站起来。

So I would squish my thighs down on the seat, or I'd grab the bottom of my chair and, like, try to suction cup myself to the chair because I'm like, I I need to physically restrain myself from getting out.

从生产力和伪装的角度来看，你还会看到完美主义。

Now from a productivity and a masking perspective, you also see things like perfectionism.

我不想惹麻烦。

I don't wanna get in trouble.

你还会看到过度补偿。

You see things like overcompensating.

比如，我会加班加点，做足准备，把所有事情都安排好，因为我不想惹麻烦。

Like, I'm gonna stay at work extra long, and I'm gonna over prepare, and I'm gonna get things ready because I don't wanna get in trouble.

我知道自己肯定会漏掉什么，所以我要提前预防。

I know I'm gonna miss something, so I'm gonna prevent that from happening.

在人际关系中，你也会看到情绪调节这方面的表现。

You see things like within relationships and knowing that there's, like, that emotional regulation.

很多女性会默默接受一些她们觉得对同龄人来说都不太合适的事情，但她们会觉得可能是自己错了。

You see a lot of women just kind of accepting stuff that they might not think is appropriate for any of their peers, but they're like, I was probably in the wrong.

我可能太情绪化了。

I was a little bit too emotional.

是我把人家赶走的。

I chased them away.

所以为了保护这种情感上的敏感，她们不想陷入冲突。

And so in order to protect that emotional sensitivity, they don't wanna get into conflict.

她们不想吵架。

They don't wanna fight.

她们不想做那样的事情。

They don't wanna do things like that.

所以，有很多不同的方式会直接影响到那些长期戴着这个面具的人，并且对他们造成伤害。

So, I mean, there's lots of different ways that are directly impacting and and harmful to someone who is continuing this mask for a long time.

最终，那个面具会变得太重，难以承受。

Eventually, that mask gets too heavy to hold.

哈姆达尼医生，感谢您和我们分享这些。

Doctor Hamdani, thank you for sharing this with us.

稍后，我们会讲到接下来该怎么做，但我们还有一些内容要深入探讨。

In a little bit, we're gonna get to the steps of what you should do next, but we still have a little bit more to unpack.

所以，我需要快速休息一下，以便听一下赞助商的广告。

And so I gotta take a quick break so we can hear a word from our sponsors.

我想给你一点时间来消化一下这些内容。

And I wanna give you a chance to just digest this for a second.

别走开，因为我在节目稍后承诺过，我们会一步步讲解，一共有四个步骤，你需要去做。

Don't go anywhere because I promised a little later in the show, are gonna be getting to the step by step, there are four of them, that you need to do.

这就是博士……

This is what Dr.

这是哈姆达尼医生的建议。

Hamdani's recommendation is.

如果你或你爱的人对此有共鸣，回来后我们会告诉你获得所需支持的四个步骤。

If this is resonating about you or with the person you love, four steps to getting the exact support you need when we return.

请继续收听。

Stay with us.

欢迎回来。

Welcome back.

我是你的朋友梅尔·罗宾斯。

It's your friend Mel Robbins.

今天，我们请到了精神科医生萨莎·哈姆达尼。

Today, we are here with psychiatrist Doctor.

她将为你免费提供一份关于ADHD的全面指南，你可以为自己和你爱的人使用这份资源。

Sasha Hamdani, and she is giving you a comprehensive guide for free to ADHD that you can use as a resource for yourself and the people that you love.

你可以把它发给你的医生。

You can send it to your doctor.

你可以把它发给你的朋友。

You can send it to your friends.

那么，医生。

So, Doctor.

哈姆达尼，我们继续。

Hamdani, let's keep going.

ADHD是超能力吗？

Is ADHD a superpower?

不是。

No.

每个人都这么问我。

Everyone asks me that.

我很羡慕那些说它是的人。

I am so jealous of the people who say that it is.

我羡慕那些说它是的人。

I'm jealous of the people who say that it is.

原因是，我觉得ADHD确实给我带来了一些东西，如果没有它，我可能不会有这些。

And the reason for that is I feel like there are some things that ADHD has brought me that I wouldn't have otherwise.

比如，能上社交媒体，能去白宫，能拿到出书合同。

Like, being on social media, going to the White House, getting book deals.

这些都是因为我的ADHD。

Like, that is because of my ADHD.

那是因为那种过度专注。

That's because of that hyperfocus.

那是因为我对某件事感兴趣，然后它延伸到了这个领域。

That's because I was interested in something, and it it bled into this area.

但也有一些日常的事情，让我觉得自己受到很大的限制。

But there's also things on a day to day scale that I feel so limited by.

我觉得可以这样比喻：这就像一种我几乎无法控制的超能力。

And I feel like the analogy that I give is it's like a superpower that I have very little agency over.

因为就像，你现在能飞了，这就是你的超能力。

Because it's like, you can fly now and that's your superpower.

但你不能选择什么时候、在哪里。

But you can't choose when or where.

所以你就只能直接冲上太空，在任何给定的时刻。我觉得我喜欢，我喜欢积极重构这个概念。

So you're just gonna blast off into space at So any given it's I feel like I love I love the concept of a positive reframe.

而且我认为ADHD确实有一些非常非常非常美好的地方。

And I think there is some beautiful, beautiful, beautiful, beautiful things about ADHD.

我确实这么认为。

I really do.

但我也觉得有一些事情真的很难处理。

But I think there's also some things that are really difficult to deal with.

而且我觉得当人们不断强调那个超级英雄的说法时，对我来说，它削弱了挣扎的意义。

And I think when people continuously focus on that superpower trope, for me, it diminishes a struggle.

所以我觉得对待ADHD最好的方式就是现实一点。

And so I feel like the best way to approach ADHD is just realistically.

它们很好。

They're good.

它们就像其他任何事物一样，有好有坏，关键在于你如何应对。

They they just like anything else, there's good stuff, there's bad stuff, and it's how you deal with it.

我很感激你这么说，因为我一直觉得那听起来像是毒性的积极心态，对。

I appreciate you saying that because I always thought that it sounded like toxic positivity Yeah.

出自一个没有ADHD的人之口。

By somebody who doesn't have ADHD.

而且当你考虑到，医生，

And when you also consider, Doctor.

哈姆达尼，你所教导我们的，几十年来，医学专业人士、社会、DSM都没有涵盖ADHD的全部范围，尤其是情绪失调。

Hamdani, what you're teaching us, which is for decades, medical professionals, society, the DSM, has not included the full scope of ADHD, especially the emotional dysregulation.

在生活中不断感到不知所措，这没有什么超能力可言。

There is no superpower to feeling constantly overwhelmed in your life.

是的，确实有一些小小的好处。

And yes, there are some small benefits.

我喜欢你那个比喻，就像拥有一个你无法控制的超能力。

And I love the analogy that you said it's like having a superpower you can't be in control of.

比如，我很想能从手掌里喷出火来，但我不想它在错误的时候失控。

Like, I would love to be able to throw fire from my palms, but I don't want it going off at the wrong time.

而且，如果你一辈子都觉得自己不能相信自己，那会带来很多焦虑。

And there's a lot of anxiety that comes with going through life thinking you can't trust yourself.

对。

Yeah.

你不能相信自己能坚持到底。

You can't trust yourself to follow through.

你不能相信自己能准时。

You can't trust yourself to be on time.

你不能相信自己能记住。

You can't trust yourself to remember.

你不能相信自己不会再搞砸。

You can't trust yourself to not screw this up yet again.

所以，我真的很感谢你这么说。

And so I really appreciate you saying that.

在你的实践中，你有没有发现一些令人惊讶的事情，是大多数患有多动症的人都在挣扎，但可能甚至没有意识到的？

Is there something surprising that you've discovered in your practice that most people with ADHD struggle with and may not even realize it?

是的。

Yes.

我们已经谈了很多关于情绪调节方面的事情。

So we've we've talked a lot about the emotional regulation side of things.

对。

Yes.

有一种神经现象，几乎百分之百的多动症患者都会出现。

There is a neurological phenomenon that you see in almost a hundred percent of people with ADHD.

他们都会经历某种程度的拒绝敏感型焦虑障碍。

They experience some component of rejection sensitive dysphoria.

拒绝敏感型焦虑障碍。

Rejection sensitive dysphoria.

那到底是什么意思？

What does that even mean?

这可是个大问题。

That's a big thing.

确实是个大问题。

It's a big thing.

这名字可真够拗口的。

It's a mouthful.

拒绝敏感性烦躁是一种极其强烈的情绪反应，有时还伴随身体反应，但主要是情绪上的，针对的是真实的或想象中的拒绝、批评，或者害怕让别人失望。

Rejection sensitive dysphoria is this incredibly robust emotional response, sometimes physical, but mostly emotional response to real or perceived rejection or criticism or this fear of disappointing someone.

这是一种内在的情绪反应，伴随着神经化学物质的涌流。

It is this internal emotional response, flooding of neurochemicals that happens.

你怎么定义这个东西？

How do you define this, what this is?

从情绪敏感性的角度来看，这是一种神经现象。

It is a neurological phenomenon when you look at emotional sensitivity.

好。

K.

对吧？

Right?

而且如果你是有多动症的人，你就会有这种情况。

And you have Which you have if you are somebody struggling with ADHD.

我是说，这只是人类的一部分。

I'm saying just part of the human condition.

对吧？

Right?

就是一般的情感敏感。

Emotional sensitivity in general.

如果你说这是正常的情感敏感，那你的情绪会有起伏，而且会根据情况做出适当的反应。

You have if you're saying this is kinda normal emotional sensitivity, you have emotions down, emotions up, situationally appropriate.

你正好在中间。

You're right in the middle.

还有一种情况是情感不敏感，就是人们真的没有做出应有的反应。

You have lack of emotional sensitivity where people really aren't responding in the way that they should be.

他们感受不到巨大的喜悦。

They don't feel big highs.

也感受不到巨大的悲伤。

They don't feel big lows.

可能不太符合情境。

Maybe not situationally appropriate.

还有一种人是高度情绪敏感的，他们感受事物又快又深，而且持续时间很长。

Then you have people that are highly emotionally sensitive, and they are the people who feel things quickly and deeply and for a long time.

对。

Mhmm.

我会把拒绝敏感性烦躁症看作是情绪敏感的极端表现，因为当他们感受到某种情绪时，即使事情并未真正发生，只要他们察觉到可能让你失望、被拒绝或不被喜欢，他们的世界就会崩塌。

And I would put rejection sensitive dysphoria as, like, the the ending point of that as most emotionally sensitive because when they feel something, even if it's not actually happening, if they perceive that there is a risk that I'm disappointing you or that there's some rejection or the person doesn't like me, their world caves in.

他们开始向内退缩，神经化学物质和警报化学物质大量涌出，简直让大脑的其他区域都瘫痪了。

They start turning inwards, and it becomes this flooding of neurochemicals and alarm chemicals that are happening that literally paralyze other areas of the brain.

哇。

Wow.

对。

Mhmm.

天哪。

Holy cow.

对。

Mhmm.

你有一本新的畅销书《太敏感》。

You have a brand new bestselling book, Too Sensitive.

我喜欢这个书名。

I love the title.

谢谢。

Thank you.

为什么这个拒绝敏感性焦虑症值得专门写一本书？

Why is this rejection sensitive dysphoria important to dedicate an entire book to this?

因为没人谈论它。

Because no one talks about it.

所以我们没有合适的工具和语言来正确对待它。

So we don't have the tools and the language to treat it appropriately.

你能给我们展示一下这在日常生活中可能是什么样子吗？

Can you show us what this may look like in day to day life?

是的。

Yes.

我可以。

I can.

我可以用你的短信来展示。

I can show you with text messages from you.

哦，天哪。

Oh, god.

好的。

Okay.

这些没问题。

These are okay.

所以团队截了我的手机屏幕。

So the team has screenshot my phone.

好的。

Okay.

请继续。

Go ahead.

其实是截了他们的手机屏幕，还有我说过的话。

Actually screenshot their phone and something that I've said.

好的。

Okay.

如果我们只看这张截图，你回复我说的话，而上面只写着“别担心”。

So if we're looking at just this screenshot with you responding to something that I'm saying, and all it says is no worries.

对吧？

Okay?

对我来说，我脑子里想的是：她是不是生我的气了？

For me, what is happening in my brain is, is she mad at me?

她是不是对我不满意？

Is she unhappy with me?

她还希望我继续上播客吗？

Does she want me on the podcast still?

我一直在胡思乱想，因为在我心里，我感受到了一种不确定性，因为我害怕这背后隐藏着拒绝和批评。

I am spinning because in my brain, I've attached a level of uncertainty because I'm afraid that there is rejection and criticism underlying this.

而对我来说，这直接反映了我自身的价值。

And that, to me is a direct reflection of my own self worth.

所以我会一直纠结这件事。

So I am gonna spin on this.

我会去问别人。

I'm gonna ask other people about it.

我会把手机给别人看，然后问他们觉得这条消息怎么样。

I'm gonna show my phone to other people and be like, what do you think about this message?

而且我会在这上面浪费大量的情感精力。

And I am gonna waste a tremendous amount of emotional energy on this.

现在我能做的就是反复琢磨这件事好几个小时，这正是我喜欢做的。

Now the things that I could do with this is that I could chew on it for hours and hours, which is what I love doing.

而且我通常也是这么做的。

And that's what I usually do.

或者，我也可以选择过度补偿。

Alternatively, I could do things like I could overcompensate.

我可以给你回条消息，说“好的”。

I could send you a text message back and be like, okay.

我只是想确认我们之间没问题。

I'm just making sure that we're cool.

或者说“好的”。

Or, okay.

我想再确认一下我们的计划。

I I wanna reiterate our plans.

然后你可能会说“我很忙”。

And you're like, I am busy.

我喜欢，你知道的，所以那一刻我需要很多情感上的支持。

I like, the you know, so there's there's a lot of emotional hand holding I would need in that moment.

我可能会做这样的事，比如收到那条短信。

I might do things like, I get that text message.

我已经认定你在生我的气了。

I've already decided that you're mad at me.

我受够了。

I'm done now.

这就是我二十多岁时在感情中的一贯表现。

And that that has been my trajectory in my twenties with relationships.

我会过度解读那些中性的互动。

I would read into neutral interactions.

我会把它们看作某种威胁。

I would read them as threatening in some capacity.

然后我会想，我不需要这个。

And I would be like, I don't need this.

我在学习。

I'm studying.

我不需要这个。

I don't need this.

然后我会结束这段关系，因为你不会把我推开。

And I would end the relationship because you're not gonna push me away.

我要先离开。

I'm gonna leave first.

你会看到不同的模式。

You see different patterns.

确实，当你遇到一个在神经和情感上都很敏感的人，这在ADHD中很常见。

And it is truly when you take a neurologically, emotionally sensitive person, which is something you see a lot of in ADHD.

你把他们放在这些日常情境中。

And you put them in these everyday kind of situations.

由于情绪调节障碍，他们很难过滤这些信息，因为大脑中情绪部分在逻辑部分之前就爆发了。

Because of that emotional dysregulation, they have a hard time filtering that information because that emotional part of their brain is popping off before that logical part.

所以他们就是被这些情绪化学物质冲昏了头脑。

So they are just running with this flooding of emotional chemicals.

如果你想想这个，这就是让我夜不能寐的东西。

And if you think about that, like, this is the stuff that keeps me up.

这就是我担心的事情。

This is the stuff I worry about.

这就是我用来检验现实的东西，人们都烦透了，因为我老是去问他们，这正常吗？

This is the stuff I I reality test with people, and they get so annoyed because I'm, like, constantly going and asking them, like, is this normal?

这不正常吗？

Is this not?

有很多，我不想说是失去生命，但感觉就是这样。

There there's so much I I don't wanna say life loss, but that's what it feels like.

我花了太多时间在这上面。

I'm just spending so much time doing that.

我一辈子都在做这件事。

I have spent a lifetime doing this.

所以，尽管如此，我仍然在尽力管理所有涌入的信息。

So if and yet at the same time, I'm just doing the best I can to manage all the inbound anyway.

如果你也有同感，看到这样的消息，你会怎么做？

If you relate and you read messages like this, what do you do?

是的。

Yeah.

而且说实话，不仅仅是消息。

And for the record, it's not just messages.

比如，对我来说，我对语气和语气的变化非常敏感。

Like, it can be things like, for me, I'm so sensitive to tone, to shifts in tone.

我对肢体语言也很敏感。

I'm sensitive to body language.

我甚至能在进入房间之前就感受到里面的气氛。

I can pick up an energy in a room before I go in.

我也是。

Same.

你知道吗？

You know?

所以这就是情绪敏感的一个特点。

It's like so this is one of those things about being emotionally sensitive.

再加上情绪失调，这些感受就会特别强烈。

And then simultaneously being emotionally dysregulated is that those things hit hard.

是的。

Yes.

所以意识到这一点非常重要。

So recognizing it is huge.

我觉得这是很重要的一点。

That's a big thing that I think is really important.

另外，我们还发现，在当下采取一些措施来降低情绪激活也很重要。

The other thing that we see is important are things that work in the moment to reduce activation.

一些简单的方法比如运动。

Some easy ones are things like movement.

而且不一定非得做剧烈的心肺运动或者举重。

And it doesn't have to be, like, do heavy cardio or or lift weights.

做一些能增加含氧葡萄糖输送到前额叶的活动就行。

Do some sort of movement that's going to increase that oxygenated glucose to get to that frontal lobe.

所以你看到那条短信了。

So you I see the text message.

现在我就想，对。

Now I'm like Yes.

我做深蹲？

I do squats?

你可以。

You can.

你可以。

You can.

因为想想你在做什么。

Because think about what you're doing.

就像，一旦你从神经学上理解了正在发生的事情，你面对的是过度活跃的杏仁核和表现不佳的额叶。

Like, once you understand neurologically what's happening, you're dealing with this overactive amygdala and this underperforming frontal lobe.

哦，我明白了。

Oh, I see.

天哪。

Oh my god.

我刚明白了。

I just got it.

所以在那时，仅仅一条短信的输入就像是“是的”。

So in that moment, the input from just a simple text message is like Yes.

然后那会充斥你的大脑。

And that floods your brain.

对。

Yes.

而你的思考者，你的前额叶皮层，就像“我不知道该怎么办”。

And your thinker, your prefrontal cortex is like, I don't know what to do.

我上不了线。

I can't come online.

出了点事。

Something's going on.

所以从神经学上讲，即使一条短信看起来愚蠢又无关紧要，是的。

Like, And so neurologically, even though a text message seems stupid and inconsequential Yes.

从神经学上讲，你的大脑已经乱套了。

Neurologically, your brain is screwed.

你就像看到杀人犯一样在应对威胁。

You are responding to a threat like you have seen a murderer.

当你真正评估威胁时，无论是社交威胁还是身体威胁，你的大脑在那一刻分辨不出区别。

When you are actually assessing threat, like whether it's a social threat, whether it's a physical threat, your brain doesn't know the difference in that moment.

你的身体以同样的方式做出反应。

Your body is responding in the same way.

所以你的神经化学物质在大量涌入。

So you're having this flooding of neurochemicals.

所以你现在需要做的是理解。

And so what you need to do now is understanding.

好的。

Okay.

我的情绪中心已经超负荷了。

My emotional center is overwhelmed.

我的前额叶功能也不在最佳状态。

My frontal lobe is not working as well as it should.

然后你再看那个情况，比如，好的。

And then you look at that situation and whether it's like, okay.

我可以利用运动，这样能给前额叶送去含氧的葡萄糖，让它回到正常状态。

I can utilize movement, and that's gonna get some oxygenated glucose to my frontal lobe where it's supposed to be.

希望这样能让思考能力恢复过来。

And, hopefully, we can get that thinking back on board.

另一个可以做的，就是延迟反应。

The other thing you could do, delay the reaction.

这件事我花了很长时间才明白。

And this is something that it took me so long.

我从神经学上理解了。

I understand neurologically.

我现在情绪很激动。

I am flooded right now.

我知道我想回应这件事。

I know that I wanna respond to this k.

我知道十到十五分钟后，我的感觉会不一样。

I know that in ten to fifteen minutes, I'm gonna feel different.

所以十到十五分钟后，我会重新评估这件事。

And so in ten to fifteen minutes, I will reassess this.

我甚至会做一些事情，比如设个闹钟。

And I will even do things like I'll set an alarm.

我会设个闹钟。

I'll set an alarm.

过十到十五分钟，我回来，哎呀，真是的。

Ten to fifteen minutes, I'll come back and gosh darn it.

我确实感觉不一样了。

I do feel different.

但我觉得重要的是，就像这本书《太敏感》，我不想让你变得不那么敏感。

But I think what's important is that, like, with this book, Too Sensitive, I don't want to make you less sensitive.

我想帮你更好地掌控自己。

I want to help you be more in control.

我喜欢这个。

I love that.

我不想让你变得不那么敏感。

I don't want to make you less sensitive.

我想帮你更好地掌控自己。

I want to help you be more in control.

嗯。

Mhmm.

这句话说得太对了，正好可以接着聊聊你是怎么做到更有掌控感的。

That is the perfect statement for us to then talk about how you feel more in control.

因为我相信，你一直在听或者看，并且真的在吸收医生今天教给你和我的一切。

Because I'm sure as you've been listening or watching, and you're really taking in everything that Doctor.

你心里肯定想到了生活中的13个人。

Hamdani is teaching you and me today, you are thinking of like 13 people in your life.

或者你在想，哇，这说的就是我。

Or you are thinking, Wow, this sounds like me.

那么，如果你觉得你自己或者你爱的人可能患有未确诊的ADHD，你应该采取哪些步骤呢？

So, what are the steps you should take if you think you or someone that you love may be dealing with ADHD that's not diagnosed.

对。

Yeah.

我们来看看这个，因为我觉得有个图表会更有帮助。

Let's go through this because I think a visual will help.

所以我要调出一个图表来。

So I'm gonna pull up a visual.