170: It's Complicated — Mitch Has ADHD

Scot: Hey, Dr. John Smith, when you think of ADHD, what's a typical thing you think of? Like in pop culture, not from your medical experience.

Dr. Smith: Oh. Well, I was going to go to my medical experience.

Scot: Okay. Well, please do then, because you are a doctor, and you did pay a lot for that.

Dr. Smith: When I was a kid, I was told I had ADHD, and then my mom just decided that we weren't going to do anything about it. I was in fourth grade, and I got sent down to . . . they had this pickle barrel that they had that was a resource trailer for students who had academic needs, and I got sent down there one day.

I showed up and I sat down, and the lady goes, "Why are you here?" And I said, "I don't know. Ms. Buchanan told me to come down here." And apparently, during parent-teacher conference, I was disrupting all the other students and so my teacher thought I couldn't read, but it was just that I was kind of a little bit ADHD, is what the thing came down to.

Then they offered my mom to kind of, "Hey, do you want to treat this kid?" And she's like, "No, he's fine." And that's the short story. But yeah, it was one of those where I was like, "Oh, okay. I just . . ."

Scot: Do you feel like you have it? Do you think you have it and just you never were diagnosed?

Dr. Smith: I don't know. I mean, there are times where it's been difficult for me to focus on things, but I think . . . I don't know. I wasn't given any opportunity other than just, "Hey, you probably should learn how to focus. Otherwise you're going to be in trouble later on in life."

Scot: Okay. A lot of times when we do hear about ADHD, it's kind of the cliché, the kid who's really high energy and can't focus. And even I'm guilty of this, and I'm not proud of it, joking around when I'm distracted, "Oh, boy. What, do I have ADHD?"

But I guess it's a little bit more complicated than that, and it can be a little different if you're an adult that has never been diagnosed that's living with ADHD than it is when you're younger. At least we're going to find out.

There are a lot of adults that have ADHD who have never received that diagnosis before. They think about 8.7 million adults in the U.S. have ADHD. And the number of adults receiving their first diagnosis after age 25 is on the rise, according to a 2022 NIH study. And Producer Mitch, it hits close to our home here on "Who Cares About Men's Health," received an ADHD diagnosis last year.

Mitch: Sure did. About a year and a half ago.

Scot: And it's been a bit of a rollercoaster for you.

Mitch: That is a descriptor of it. Sure.

Scot: Today we're revisiting our It's Complicated series by focusing on what Mitch's ADHD diagnosis means for him and what it can mean for you if you think, as an adult, you have it.

My name is Scot. I bring the BS. Well, I should say first this is "Who Cares About Men's Health," with information, inspiration, and a little different interpretation of men's health. My name is Scot. I bring the BS. The MD to my BS is urologist, Dr. John Smith.

Dr. Smith: Howdy.

Scot: And we've got Mitch, the "Who Cares About Men's Health" convert.

Mitch: Hey, there.

Scot: And to help us better understand Mitch's experience, we brought in an ADHD expert, Braun Tueller. He's a physician assistant or associate. What do you like?

Braun: They recently changed it. It's associate now.

Scot: Do you like that better?

Braun: They don't care much what I care for.

Scot: Well, anyway, he has diagnosed and treated ADHD pretty frequently, like multiple times a day. He's with Huntsman Mental Health Institute. Is that the case, really, multiple times a day for adults?

Braun: Yeah, sometimes. It's certainly not every day that I'm actively diagnosing, but I'm certainly treating patients with ADHD multiple times a day.

Scot: And since you started your medical career, have you noticed an increase in that for adults being diagnosed with ADHD that weren't diagnosed younger?

Braun: A massive increase. We joke around, but there's been a marked increase over the past three or four years, really since the COVID pandemic, and there's a direct correlation with social media trending.

So it's been fascinating to see the number of posts and TikTok videos and just all of that, and have that directly roll over into clinical presentation for people saying, "I think I have this. This is something that I've struggled with."

Scot: I know for me, seeing it on social media made me wonder if I have it as an adult, because they give out these symptoms. But I get a little worried because sometimes these symptoms are so broad. It's like, "Well, it could be a lot of different things."

Do you find that people come in that are like, "Oh, man, on social media, I saw that I might have ADHD"? Is that pretty accurate? I mean, do they have a pretty good guess, or is that 50/50? Could you even guess what the breakdown on that is?

Braun: It really depends on the source material that they're basing it off of. There are definitely times where somebody comes in and it's like, "Oh, yeah, this is something that we've missed."

I'd like to think that with my preexisting patients that we have a pretty good screening criteria, and I know them pretty well. So, in those cases, it's usually a case of talking about what other things could be at work that could be compromising their ability to focus or concentrate, impulse control, things like that.

But for new patients, yeah, I mean, it just depends. ADHD has a lot of comorbidity, which is a fancy way of saying other things that are happening at the same time. So depression, anxiety, things like that. And typically, the rule of thumb is if there's something else going on, we try and get those symptoms taken care of first to make sure that that's not impacting the individual's ability to focus and concentrate.

So it just depends. It's all about taking the history and asking the right questions.

Scot: Got it. What was it about COVID that brought out a lot of these diagnoses, do you think, or people suspecting that something might be up?

Braun: Well, it's polyvariable. There are lots of different potential explanations. I think to answer that, you have to understand what the brain is. And essentially, what the brain is, is it's just a really amazing, complex machine, specifically a computer. And computers have processing speeds. The more stress that you place on a computer, the slower it runs.

In simplistic terms, you can think of it like windows. You have so many browser windows open, and once you get to 300 windows, you're like, "Man, why is my browser not running right?" And I think COVID sort of artificially did that to us as humanity.

Scot: Oh, sure.

Braun: It put a ton of stress on us, which automatically compromised our ability to focus and concentrate. But the other big thing that it did was it took us home. It took us home where we don't have that rigid structure, we don't have the oversight of the boss looking over our shoulder, and all of a sudden people have the opportunity to get distracted by kids and animals, and the TV, and, "Do I want a snack right now?" And all of a sudden, it became a lot harder for people to focus.

And so I think that there was a bunch of stuff that sort of weighed into the equation for people recognizing, "Oh, man, maybe I have ADHD. Maybe this is what's going on, an explanation."

Scot: Mitch, what was your situation? What was your story?

Mitch: So leading up to the diagnosis, it's kind of interesting because even as a kid, I was the good kid. I was very, very good at school. I was part of an accelerated program. And even though I had a very, very strong family history, we're talking most of the family has some sort of severe ADHD, we just assumed I didn't because I was doing fine in school. And that carried on through college, etc.

But after I left college, I started to find myself being kind of adrift, jumping from job to job to job. I was getting into some really impulsive, sometimes not-so-great, even self-destructive behavior, from smoking to binge drinking, etc. Going for these more and more intense sensations and experiences, etc.

But then, on the other end, I would sometimes do these weird freeze states where it would be days of just sitting and not being able to do anything, and hours would pass without even thinking about it, right? It was really quite strange.

And it wasn't until I started to get treatment a couple years ago for mental health . . . and I was initially diagnosed with borderline CPTSD and a generalized anxiety disorder. We had been working on it for two years, me and my therapist, put anxiety meds in me, etc., and progress was glacial. It was extremely, extremely slow.

Even my therapist was saying, "Hey, some of these different modalities that we're trying and we keep shifting, etc., we're not making progress." So it was actually him who said, "Something else might be going on. Why don't we go get you checked for ADHD?"

Scot: Is that pretty typical what Mitch described?

Braun: Super typical in a bunch of different ways. So in no particular order, just to address some of the interesting things in there that a lot of people experience and get sort of confused by.

One is success through childhood. So ADHD is a neurodevelopmental disorder, which means that it's present from childhood. It's one of the diagnostic criteria that we use. But that doesn't mean that it has to be impairing in childhood.

So one of the things that we've run into over the past handful of years is the argument about adult-onset ADHD. Is there such a thing as adult-onset ADHD? And the jury is still out.

But what I can tell you is that people, in particular people who have a high emotional quotient or a high intelligence quotient, so IQ and EQ, can sort of mask their ADHD skills through compensatory behaviors.

So, for example, you may have somebody who's very successful in school, but it takes a lot of work. They're highly organized because they have to be. And so the ADHD sort of runs in the background, but they're able to control it with strict compensation.

Mitch: Yeah, one of the things that kind of fell into place for me is when I was working with an ADHD specialist after my diagnosis, they said, "So do you have good time management skills?" I'm like, "Absolutely. I'm the absolute best at it. I have all these calendars, all these skills."

And she stops me for a second and says, "Are you good at time management, or do you have severe time anxiety?" And I'm just like, "Oh, yes. That is probably closer to what it is. It's a system. It's a hyper-fixation rather than an actual skill."

Braun: Yeah. And it's born out of necessity because without structure, everything just unravels, which is one of the reasons why it's so important, especially in childhood, that we get kids who have ADHD on a structured schedule. They thrive with structure, which is ironic because one of the diagnostic criteria is disorganization.

But a lot of times, what'll happen is that the compensatory behavior stuff works just fine until, going back to the computer analogy, too much pressure is placed on the computer. And then all of a sudden those compensatory behaviors are no longer sufficient.

So I'll have people who were straight As through high school, they did well through undergrad, they get into graduate school, and all of a sudden it goes off the rails, right?

Scot: I'm laughing because . . . I mean, it didn't go off the rails totally, but it was a lot of work for me. It was a whole different ball game than school-school.

Mitch: It's funny because my master's degree, same thing.

Dr. Smith: So, Mitch, what did they end up doing for you? And kind of tell us kind of where it brought you to now.

Mitch: Oh, sure. So the next thing was we went and got diagnosed. Because of all these comorbidities, like Braun mentioned, they wanted me to have a formal test. So I did both a quantitative and a qualitative. So I did this interview process with an ADHD specialist and took the most boring test I've ever had to do in my entire life. I hated it, and I just had to sit and do it for what felt like forever.

And what was so interesting was I didn't get the results initially, right? And the specialist actually called me and asked if I'd be willing to redo it because she said . . .

Scot: Mitch failed.

Mitch: Well, that's what I assumed. I'm like, "Of course I would fail an ADHD test."

Dr. Smith: Write in the cheat code.

Mitch: Yeah. But the reason was that she had not seen results like this before. The three major factors, things like . . . What is it? The impulsivity, inattention, hyperactivity, I was in the 90th percentile for all of them, but I got all of the answers right.

And so she was like, "You must have some pretty intense systems that you have in your head, etc., that allow you to have these extraordinarily intense symptoms, but still function, and I'm wondering if all of them are good or not." And that completely changed kind of the direction of everything.

Scot: Braun, this sounds exhausting, having all these systems and all these checks and balances you're constantly running on your computer, if we're going to stick with that analogy, in the background in order just to function in whatever capacity it is. That has to take extra resources as well, which would make it really hard.

Braun: Yeah, it's a massive drain. And it's a chicken or the egg situation, right? So you're spending all this energy trying to stay organized and stay on top of things. And whether you're succeeding or failing, it's a drain, which is one of the reasons why . . .

Like what Mitch was saying, which I absolutely agree with and have seen, I'll have people who come in initially saying, "Oh, I'm depressed. I'm anxious." We try different treatments. It's not working. And then we're like, "Hey, maybe you have ADHD." We sort of hit on that.

And lo and behold, they're depressed because they're not succeeding the way that they want to or feel like they should be. They're super anxious because they're always late and they're never turning assignments in on time, and it's sort of based off of the ADHD piece to things.

Dr. Smith: So how frequently do you find that that happens in patients? And are we asking the wrong questions upfront that aren't getting us to where we may be the most helpful?

Braun: So, yeah, that's the golden question, because the biggest issue right now is appropriate questioning, appropriate screening by providers.

This is just my two cents, but this is not an issue with patients per se. People are trying to figure out why they are the way that they are, and they're just trying to find answers. And so it's really the provider who needs to be taking a thorough history, who needs to be doing a deep dive into, "Why are you feeling the way that you're feeling? When did it start?"

The family history you brought up, I mean, ADHD has a 76% heritability, and that's based off of twin studies, which is super cool. We won't go down that road, but . . .

Dr. Smith: Twins are tough, I'll be honest.

Braun: Yeah. I mean, a 76% heritability is really high. So just getting a family history can give you big clues as to what you might be dealing with.

But yeah, it's one of the blessings and the curse about this field, the field of psychiatry. I would say we're at least a decade or two behind the rest of medicine. It is very much still an art.

Someday we'll have the technology and we'll have the availability to do a brain scan on demand, or to do a blood draw and tell people exactly what's going on and what they need. But where we're at right now, it's very subjective based off of the provider. So it's finding somebody that you feel confident in. It's finding somebody that has a good reputation in the community that you're able to work with.

Mitch: And it's interesting because we were talking about the . . . I mean, Scot, you were talking about it being exhausting, and that kind of moves me to my treatment plan, right?

They were first like, "Hey, we'll get you with a specialist, an ADHD coach, to kind of talk through how you can maybe overcome some of these executive dysfunctions. And also, would you be interested in medication?" And I said, "I don't know about medication. I have all this other brain chemistry and brain chili going on. Why add another one?"

And the psychiatrist I was working with said, "Well, why don't you just try a really low dose of Adderall and see how you feel?" I'm like, "Fine, fine, fine."

And so I took it on a weekend. We were doing some errands, me and my partner, and I had a full meltdown in the middle of an IKEA. I grabbed Jonathan's hands for some reason and run him to one of those fake apartment bathrooms. I had to go somewhere private, and there are all the hanging tags and everything like that. And I just look him straight in the eye, and I'm like, "Is it always this quiet for everyone?"

And I had not realized . . . I just call it static or a storm. When I am medicated, I can hear a voice in my head, right? And when people always talked about, "Hey, you have that train of thought, you have that voice in your head telling you what to do and how to coach yourself, etc.," I just thought that was a metaphor, an analogy of what we should be doing or how the experience should be felt.

But yeah, it really was life-changing to suddenly just . . . I ended up crying and everything, because it was just like, "What the hell is this?"

Scot: Life changing in a good way? I mean, this story sounds terrifying.

Mitch: Oh, yeah. Well, it's ups and downs. Those initial results, the suddenly everything's quiet, suddenly I can feel and be in charge of my own brain, that didn't last forever, right? And so it seemed like every couple of weeks we were trying new meds for about a year. That was a really weird time.

I mean, Scot, you mentioned a couple of times in person, it's like, "Are we on new meds this week?" Because, man, oh man, it was . . .

Scot: Was that not cool, Braun? Should I not have done that?

Braun: No, you're good.

Scot: All right. John, do you think that was all right?

Dr. Smith: I think it's fine. I mean, you've got to find out. And so, Mitch, how many iterations did it take before you kind of settled in and felt like, "Okay, I like where I'm at"? Obviously you coped for 20-some years with the static storm in the background, and now everything changes, and it's almost like you're starting over again. And so kind of run us through that. I'm very curious.

Mitch: Yeah. So actually, the first person I was working with, and I eventually moved to someone else, was very aggressive. We were doing weekly meetings where I was learning more about ADHD and we were talking about my symptoms. We tried everything, and it seemed like every month we were trying something new. New doses of Adderall, switched to Vyvanse or Mydayis, which is some weird new one, and we tried Ritalin, we tried this, we tried that.

And week-to-week, I would feel really, really good sometimes. Other times I would be hyper-focusing. And suddenly, I could not stop myself from needing to deep clean the bathroom at 2:00 a.m. There were other days that I couldn't sleep. I would freeze for days on end, just like I used to when I'd get super stressed in the past.

It was all over the place until about five months ago. And that's after trying about six or seven different medications and really zoning in on stuff, and finding a second opinion to kind of help coach me and guide me in one way or another. I think it's about five or six months now. We found the right cocktail for me.

There are still days that I struggle in one way or another, but I can think straight. I can recognize when I'm starting to spiral down an emotional anxiety hole, rather than just, "Well, buckle up," like I used to. Yeah, it's been quite cool.

Dr. Smith: So, Braun, is that pretty typical where you have to go through multiple iterations of medication to find kind of the right balance for the patient? I'm asking a second question too. And do patients ever look at you and go, "I kind of like the way things were before because I knew how to cope with it"? You know what I mean?

Braun: Yeah. I mean, it's . . . I hesitate to say normal because, really, what is normal? But yeah, it is. Everybody is different. Everybody's biology is different. Everybody's experience is different. And so sometimes it does take trial and error.

We have an algorithm that we follow that's just based off of previous studies and what people have responded to. The data says that a combination of therapy, a specific therapy called CBT, which is cognitive behavioral therapy, paired with medication gives the best results.

Mitch: That's what I did.

Braun: Yep. And because there are always two sides, behavior is always a piece to it. You're going to have bad habits, things that medication have nothing to do with. And so that's why it's recommended to do both at the same time.

And then there are two classes of stimulants that we use, the amphetamines and the methylphenidates. In adults, amphetamines tend to be more effective. They're a little bit more potent both in the benefits as well as the negatives. They have a little bit more risk for side effects, but they work a little bit better than the methylphenidates. So we'll oftentimes start with something like Adderall in an adult who's struggling with ADHD.

But again, everybody's different. Sometimes people will develop tachycardia, an increased heart rate or blood pressure. Sometimes they'll feel super anxious on Adderall, and so we'll have to switch them to either a longer-acting medication or an alternative medication, maybe switch them over to Ritalin, a methylphenidate, to see if they respond to that a little bit better. So it just depends on the person's response.

Dr. Smith: I don't want to hijack this thing too much . . .

Mitch: No worries.

Dr. Smith: . . . but I'm interested. I know the family members that I have who are treated right now, they've had a really difficult time getting ahold of some of their medications. Is that interfering with the way that you guys are practicing right now?

Braun: Yes, massively. So with the explosion of ADHD that's happened over the past three or four years, the demand for these stimulants has skyrocketed, and it's generated an incredible shortage.

I mean, pretty much on a daily basis, I'm having to change somebody to a different pharmacy or change a medication dose or medication just outright purely because of access, trying to find access to the medication.

There are a lot of conspiracy theories out there, but what my understanding is, is that regulatory agencies are very hesitant to increase production of these tightly controlled substances, because the stimulants do have a lot of abuse potential. They're Schedule II controlled substances, which means that they have that addiction and dependence potential.

But because they're not authorizing increased productivity, it's just sort of whatever you can find out there right now. It's really wild and not cool for everybody involved.

Mitch: Yeah, it's been killing me because it's like we've finally figured out the cocktail, and I had four or five months of just feeling great and making a lot of progress and stuff, and then there's a week that, "Hey, we can't fill it." And it's just like, "Oh, okay. So I guess I have to kind of start over or pray that some of these other systems that I've created or these new better coping mechanisms are more effective for the next couple weeks." It's been rough.

Braun: On behalf of the powers that be, I'm sorry that it's something that you've had to struggle with. And you are not alone at all. It's definitely a huge issue right now.

Scot: So, Mitch, compare and contrast then and now. When you actually can get your medication and after you've done some CBT, how is life different? What's it like?

Mitch: It's night and day. A lot of new things have started to happen. I have a brand new appreciation for my not-so-typical brain, and it also allows me to kind of give myself grace for some of the past difficulties, some of the really disappointing moments in my life where I didn't understand what was going on, right? I didn't have the tools and abilities to recognize that I was hyper-focusing, or I was in an anxiety spiral, or whatever.

And so I have a better relationship with myself and my brain. We've been able to actually cut back on my anti-anxiety meds. And just a couple weeks ago, we've gone from weekly therapy at the start, a weekly CBT for my anxiety, down to a once-a-month check-in, which has been really kind of exciting.

And I feel like I'm more, I don't know, present in my life, in my relationships, with my family, with Jonathan, with other friends in my life.

It almost was a reverse of what Braun was talking about earlier, where we had been trying to treat my anxiety, right? We had been trying to treat one thing or another, and there was this other more kind of complicated piece, this ADHD that we didn't realize that I had, that had to get untangled first before there were all these other things that we could do.

Go figure, when we talk stimulation, for me, being anxious and playing the what-if game about all the terrible things that could happen is a really stimulating thing for my brain.

Scot: Oh, really?

Mitch: Yeah.

Scot: Oh, I didn't even think of that. So he was creating his own stimulation, Braun.

Braun: Yes. Probably not a very pleasant stimulation, but yeah, absolutely.

Scot: Yeah, in not healthy ways.

Mitch: No, not at all. And so, yeah, I don't want to blame my mental health guy. I love him to death. He's great. But all of the symptoms were like, "Well, you're hyper-fixating. You're anxious all the time. You have an anxiety disorder. Let's work on that." And it's like, "Yeah, that's part of it, but another part of it is my brain really appreciates those feelings."

Scot: Yeah, so you created those because they were . . . Wow. That's wow.

What about your ability to focus or your impulse control, those sorts of things?

Mitch: Better. Better than they have been. Yeah, there are still days that it's just ugh. I didn't sleep well enough last night and that's why I'm having a "nope" day and my brain is just not going to work with me today, so let's work tomorrow. Or recognizing when my brain is going to work with me today and taking advantage of it and . . .

So it's more that I have better tools to focus when I need to and not beat myself up when I can't.

Scot: Braun, I think it's getting time that we need to wrap this up. It's been a great conversation. If somebody's still listening and they've heard some things that are kind of familiar in Mitch's story or some of the symptoms you talked about, that's great. Are there other symptoms or things that people should take into consideration as an adult to go, "Huh, maybe I should go look into whether or not I have ADHD"?

Braun: Yeah. I mean, one of the things that people get hung up on is the hyperactivity piece. We tend to think of ADHD as the bouncing child that won't stay in their seat and is all over the place. That tends to transition into more impulse control-type stuff, sort of what Mitch experienced and what he described previously.

Adult ADHD is often typified by impulse control issues. So we'll see substance experimentation/abuse, maybe some atypical sexual activity, jumping from job to job, just trying to figure out what's going on, and trying to find a way to be satisfied and stimulated.

Scot: Let's go ahead and wrap this up. This has been a great conversation, very enlightening. Mitch, as always, thanks for sharing some very, very close-to-the-vest, personal information, I would imagine, in hopes that it can help somebody else perhaps find some relief.

John, any takeaways or anything you want to contribute as we wrap this up from this episode?

Dr. Smith: I think this has been great. I got some insight into a few things, and yeah, I think it's great. Mitch, thank you. You seem like you're the guinea pig. Half the shows I've been on, we guinea pigged you as getting on testosterone, and now we're like, "Hey, let's pick on Mitch again today."

Mitch: Yeah, that's fine.

Dr. Smith: So, yeah, let's just get Mitch's journal and go through it and see what else we can pick on him about.

But no, I think it's great bringing awareness to this and that it is a rising thing, but also that sometimes maybe there are some things we can kind of look at and do to try to retrain our brains is great to know.

Scot: Yeah. I think my takeaway is there's so much in this that I need to listen to it again as not a participant, right? As just a listener.

I am a little nervous at times, and I've kind of wondered at times if I have it, and a lot of that is because of the internet. And I feel like as I get older, it's harder to do these things, but it's probably more complicated than just ADHD.

Braun, like you said, COVID came along. I was in graduate school during COVID. Maybe I've had these coping mechanisms this whole time, and I'm just finally burning out. I'm exhausted from running them, and maybe that's part of what's going on.

But I think, as I learned a couple episodes ago, it's not my job to diagnose because I am not the one who has the expertise or went to school for this. So perhaps a conversation with a provider would be a good idea for me.

Where should somebody start? Where'd be a good place to start? Primary care provider? Go straight to somebody like you who's a little bit more of an expert on it? What do you think?

Braun: Primary care. Primary care is a good first stop. If it's a hole in one, just sort of a straightforward scenario, they are more than qualified to diagnose and start treatment. If it's a little bit more complicated, absolutely, specialty services, whether that's therapy, so psychology or seeing a social worker or other associated therapist, or a medical professional like a psychiatrist.

But I do think that primary care is a good starting point, if for no other reason than they typically have a really good pulse on the system and they can direct you where there's availability and who's reputable.

Scot: What I love about the fact you're a physician associate, used to be known as a physician assistant, that is an expert in this is oftentimes people think, "Oh, I've got to go to a psychiatrist or a psychologist." But that's not the case. You've just proven you're very knowledgeable on this because this has been an area of interest for you.

So I think any of those people you brought up are probably a good place to start. You don't have to go straight to the top, I think, is what I'm trying to say.

Dr. Smith: Start somewhere.

Braun: Yep. Again, it's a blessing and curse of where we're at in medicine, but if it's not a good fit, if you don't feel like you're getting the care that you need, you can always get a second opinion and sort of go up the chain of command.

Scot: All right. Mitch, anything else you want to add? I mean, you've already added so much.

Mitch: Well, it's just for mental health period. It's not a failure to go and talk to a specialist. If you're having difficulties, if you're struggling in one way or another with your mental health, start the conversation with a professional somewhere. And who knows what your life might be after you take that avenue.

Scot: It doesn't have to be this difficult, as one of our past guests said. It doesn't have to be this difficult. You can get help.

All right. Do you have a complicated medical condition like Mitch, or do you suspect that you might have adult ADHD, or have any questions or stories you want to share with your experience because you think it might help some other people? All you need to do is contact us, and it's super easy. It's hello@thescoperadio.com.

Thanks for listening, and thanks for caring about men's health.