Talking Simpsons - Brother's Little Helper With Drew Mackie

Like Jessica, I'm also joining the conversation well after the fact as I catch up on the podcast. I've had similar experiences with my child struggling and stimulant medication has been a great tool. Not everyone responds well to Ritalin, and there are a variety of different medications available to help different people. It's not simply micro-dosing methamphetamine. With regards to the question of why stimulants work for those with ADHD, it is believed that it aids in dopamine levels in the brain. Reflecting on my own experiences (and those of family members) I think these kinds of struggles have persisted in the past for many without being recognized. I've found myself doing things like drinking a significant amount of coffee in order to focus on school and work tasks throughout my life.

Also, to correct Henry a tad, I would argue that doctors were NOT better at diagnosing back then. In fact, girls were flat out exempt in many physicians minds and hugely underrepresented or misdiagnosed with bipolar disorder (post-puberty, PMS + ADHD looks a hell of a lot like bipolar! I was treated for years with bipolar meds until I found a doctor specialized in ADHD). Inattentive cases were also underrepresented. Kids who were actually experiencing social anxiety can look hyperactive - “misbehavior often is stress behavior” - that’s an example of someone who should NOT be on stimulants. Their brain is literally too active! Don’t conflate increases in diagnosis with increases in medication. Increases in diagnosis of ADHD ( along with autism and other learning disorders) is a result of improved screening. (Using autism screening as an example, I can look back at things from my son’s first year that indicate autism, but only in the last few years (he’s 12) has then been a consensus about those indicators so it’s neither here nor there. And knowing earlier could’ve given him a head start for independence at school being eligible for the special education preschool in our district. He couldn’t maintain enough control to be successful at general preschools, not that we tried many.) Part of the problem with diagnosing ADHD responsibly is that typical development of executive function skills can be delayed as late as 11-12 years of age, although the average age to master self-regulation skills (wait your turn, did you do your homework?, where is your lunch, don’t pull Janie’s hair, mental flexibility) I’d around 7-8. Some kids start kindergarten just BARELY 5 years old. My daughter is a July baby and we waited a full year to enroll her. Thank god we did - she would’ve started kindergarten the year everything shut down for COVID! At it was, her first 5 months of kindergarten was online. It was f’ing madness, but she was way better off at newly 6 than newly 5. And mind you, she has somehow escaped the EF challenges both my husband and I have (ADHD/ADD) and her brother. She’s as “typical” as they come from a check-the-box perspective. But a perfectly “typical” kid could still be delayed in developing these skills as late as fourth or fifth grade!! Imagine how many kids are diagnosed with development impairments, not b/c doctors are dumb or corrupt, or schools and parents are lazy, but - as Bob absolutely nailed the problem - because our broken education model offers NO OTHER ALTERNATIVES. Responsibly, ADHD shouldn’t be considered until closer to 10, 8 at the EARLIEST. Therefore, curriculum should largely focus on experiential learning (think exploration and projects vs memorization and assessment) and interpersonal skills - especially the latter. Kids who will go on to be great at math or reading may not bloom until 8 years old. If you want to kill a kids love of learning, force one of those kiddos to achieve external benchmarks before their brain will comprehend. If all behavior is communication, think of all the ways their little bodies and voices will resist. It’s heartbreaking really. I am grateful to have two kids so wonderfully distinct in their strengths and weakness - it’s given me a perspective of what’s broken and also how silly it is to reward or build policy around those kids who so easily fall into the round hole. My daughter is smart and talented, but her ability to “do school” with no extra help is not because she tries harder. She does it b/c she CAN. My son doesn’t because he can’t. Less focus should be put on fixing the child to fit the environment and instead see that the environment is what’s broken, not the kid. For proof of this, you just have to witness how a small change like headphones, seating assignments, typing instead of handwriting can fundamentally alter “misbehavior”. It’s the environment, not the child.

Jessica S

Apologies ahead of time for 1) posting two years and some change after this podcast ran and 2) not thoroughly reading the preceding comments before likely restating many people, lol. ADHD is, at least amongst the lead physicians and researchers on ADHD (Ned Hallowell and Thomas Brown are both great places to start to read more on this), being reimagined if you will away from the idea of the child who bounces off the wall or in other words is hyperactive. In reality, what is believed to be happening in the brain is UNDER stimulation and thus the “hyperactivity” is actually a manifestation of poor impulse control, leaping from one thing to another in an attempt to adequately stimulate certain parts of the brain (currently believe to be the prefrontal cortex, which controls our “executive functions”: impulse control, working memory, processing speed, delayed gratification in achieving goal, focus. Impairments here can affect more than just school or work, it even impacts social skills). Hyperactivity is therefore a poor descriptor. Nevermind that there is the “inattentive” subtype, more likely to be the quiet daydreamer that is hopelessly unorganized with a bent towards hyper focus. Except, even that distinction is flawed. A better descriptor for ADHD would be one that captures variable attention. It’s not so much that you CAN’T focus. But when you need to stop focusing on one thing and transition to another, and then to a third, and then return to the first picking up where you left off? Can you do this with little effort, and stay more or less emotionally regulated? (Behavior regulation issues usually flow from emotion dysregulation: all behavior is communication.) Medication *can* help with this but, as with many (most?) psychotropic drugs, it is most effective when paired with strategies to work around these neurological differences. Another thing that would benefit students is Universal Design for Learning. I won’t go into it, you can look it up to read more about it, but it basically offers teachers and students multiple ways to engage, respond and assess learning. Instead of listening to instruction, a student could have a print out of the instructions and begin working right away, without bother those that learn better by listening to instructions first. Kids that don’t work well in groups could instead take on a support role for several groups. And finally, you could prove mastery of materials by traditional means of writing an essay, or you could produce a podcast. UDL practices state that curriculum should be planned with this baked in so that teachers have zero extra prep needed and that any extra staff required must be in place beforehand. If I would’ve had choices like this 20+ years ago, school wouldn’t have been so traumatic. My son is autistic and just started middle school. They are rolling out UDL in addition to co-teaching. He no longer needs a 1:1 aide, which wasn’t developmentally appropriate for him any longer and he hated it understandably, as most of his classes have a teacher with special ed degree working alongside the general ed teacher. He is flourishing for the first time in years. Autism is indeed different from ADHD, but not as much as you might think. Both benefit from alternatives to our old way of schooling kids: “sit here, shut up and listen”.

Jessica S

(Apologies if this is posted twice...I was editing my post and might have deleted by mistake) I've been a fan of the Simpsons since the first short on Tracey Ullman and still watch the new seasons when I get a chance. Still, if there was an episode where I realized the best days were over, it was this one. I loved the episode itself, but the hearing the new voice actor for Maude caused my heart to sink. Sure Doris Grau and Phil Hartman both died but this was the first time a regular cast member was replaced (not counting Chris Collins). I hoped against hope that it was a mistake or hiccup, but fake Maude was in Tree House of Horror too. Reading why Maggie Roswell was gone a couple of weeks later was even more infuriating. This season also saw the first Simpsons song (We are the Jockeys) that make me think "ugh that sucked!" while Kid Rock was the first guest that made me feel truly disgusted. There's still plenty of Simpsons awesomeness ahead, but this was the point where I truly felt Homer had finally put on those proverbial water skis.

Stephen C. Nedell

I took Ritalin from 5th through 8th grade It did wonders, but had a terrible effect on my mood, especially if I missed a pill so I ended up stopping in the summer before high school Ive learned coping mechanics

Kris

agreed, ADHD into adulthood is a topic that needs far more discussion, because event though its a life long illness, much of the focus is on children. As adults, the problems of focus tend to go away, since your often in environments where its not a problem (if youre lucky) but fuck does that poor emotional regulation, depression, and sensory overload just fucking kick you in the teeth some days, for no reason, especially if youre unmedicated (which I am currently, kind) and trying to get by largely on CBT and the like.

Andrew Giachetti

Thank you to everyone who is sharing their experiences with ADHD and medication. Really appreciate the opportunity to learn. While this is completely anecdotal, I have had a few experiences with friends who are pursuing diagnosis/treatment for their children, and in the process, realize that a lot of the characteristics of ADHD actually apply to them as well. I just find it interesting, since the mainstream understanding is that it was over diagnosed in the 80s and 90s, but still there are people who are having "ah ha!" moments in their adulthood, when never it never came up before then.

Scott Scallion

I will always defend "the frame store, you monster" as a good joke and I love it. Also, the ending comment on Ritalin always felt like a "cause of and solution to all of life's problems" joke.

DrKarate

To chime in on the ADD discussion, I am 31 and have ADHD and Depression. I was tested for ADD around the time I was 12 and was very close to taking Ritalin. I do distinctly remember there were a few perceptions about Ritalin at the time. A. It would turn you into a zombie B. If you mixed it with sugar it would actually make you twice as hyper. C. Kids who took it had a strong chance of suicide. My parents decided not to give me the medicine for Reason C and my dad being a superintendent said he saw way worse kids than me who didn't need the medicine. As of now, I have tried Ritalin and 4 other types with stimulants/stabilizers to different effects. If you know anyone with a disorder, you don't know what medicine works for you until you try out cause brain chemistry is too specific to the individual. Though I do think we know far more about ADHD these days then 2 decades ago, it's actually way more severe than people realized as I deal more often with executive dysfunction, sensory overload, and memory loss than problems with focus. This episode is not a good reflection on ADHD, but the King of the Hill subplot is far more true than you would believe. I hope that clears some things up!

SilkiePJ

I love the design changes that Bart goes through this episode as he gets more maniac and paranoid, they're creepy and very well done. Even with the end of the episode really coming from nowhere and kind of amounting to a shrug, and the commentary about educators failing kids/over prescribing problems getting lost, I think this is still a much stronger episode than the Mel Gibson-wank fest from last week. Luckily though, both episodes of this podcast were as strong as ever

Dylan (batmanboy11) Freitag

Great podcast as always guys, and a better episode than I remember! Just to weigh in on the ADHD discussion, my 6 year old son has been diagnosed with ADHD. His description of his symptoms is that his head feels busy and when its at its highest he can't think/see/hear/listen and he will get very upset and usually buries his face in a pillow im guessing to get away from the noise. I'm not sure how things work in the US but in the UK after the doctor diagnoses he starts you off with some ideas/exercises to try to help and then you report back at your next appointment so they don't go straight to meds. After 6 months there wasn't a great deal of difference in him so we and the doctor decided to try the meds, not sure whether its ritalin or not as we don't really do drug brand names here but i think its the same stuff. We've noticed an improvement for the most part however he still has good and bad days but far fewer bad days than before, he's far better at school and he seems much happier and its lovely that he can actually focus now, for example he can sit down and watch a whole film now which was impossible before. We did find as well that before the diagnosis he was simply considered a bad child at school and now he has been diagnosed there is more effort to understand him and help him and also extra funding is given to schools in the uk after diagnosis so he also gets support from a teaching assistant for parts of the school day. Most importantly he's still him, just him on a good day and he's happier

I just came on here to let people know what a “farm team” was. I did not realize this wasn’t a well-known thing, but then again I’m from Michigan and it’s sort of a big midwestern culture thing. Farm teams are like minor league baseball teams. Lots of small towns in MI and other Midwestern states had/have these teams. They used to be a pipeline for players to the MLB. Sort of like a baseball version of the OHL

Whitney Dziurka

I have mostly inattentive ADHD, which is harder to spot. I got diagnosed with ADHD when I was 21 immediately after I graduated college. My doctor that diagnosed me told me this is actually really common because it's when you have your first "real life" experience and, as a non-diagnosed Adhd-er, you find out that you didn't have trouble with school, but with focus. And that won't go away. I really wish I had discovered that I had ADHD so much sooner, but it simply never occurred to me. Im not sure why, probably the stigma surrounding it. In college I got addicted to weed, which in and of itself is something that most people still laugh at as impossible. But i was smoking every day and it was having severe negative impacts on my social life and my emotional stability. I haven't smoked for over two years and am very much happier for it. I wish I could casually smoke now, but that habit has been established in my brain and I know it's not worth the risk. My weed addiction makes sense because weed and adderall have the key similarity of how they affect dopamine in the brain. Of course the other aspects of weed make it not good for working/studying. Also for a time, that i don't remember much of, I was addicted to modafinil. This is because I could only get my work done at around 3am (which knowing that I have ADHD now, this makes perfect sense and is correct, because of the effects of sleep deprivation on dopamine). Also during this time to cope with all this stress (that I wasn't even recognizing as a problem) I was working out 5 days a week. It definitely helped me, but I want to point that out because even though I was in the best shape of my life because of it - it wasn't nearly enough to modulate my attention. All this biography to say that Andrew Giachetti's comment is totally true. But this is such a... Subtle? Issue that I didn't know my undiagnosed ADHD was the root cause of these damaging addictions. I ultimately owe it chance that I fell in love with a girl that had intense hyperactive ADHD that convinced me past the stigma of that I really did have it.

https://www.who.int/mental_health/management/psychotropic/en/

Andrew Giachetti

https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

Andrew Giachetti

https://add.org/undiagnosed-adult-adhd-a-high-cost-for-society/#:~:text=Denver%2C%20December%2019%2C%202014%3A,the%20general%20population%20has%20ADHD.

Andrew Giachetti

Thank you very much for sharing all of this. We tried to make it clear on the podcast we don’t know enough about the subject, and we appreciate you taking the time to inform us. We’re not sure what happened to your previous comment, we just checked the Patreon backend and couldn’t find it, but I promise you we wouldn’t delete an insightful comment like this one on the topic. Thanks again for your help and support

Talking Simpsons

weird, my other comment was deleted. Ill just ask people to read this. Its damaging to suggest in anyway that ADHD is overdiagnosed, when in fact the opposite is true to debilitating extremes. it may be misdiagnosed, but its more likely than not to be missed entirely, especially in girls and women. And while drugs may seem to be an extreme solution, a lot of times the difference between undiagnosed and untreated ADHD and ADHD that had been caught early and treated with medication or therapy is literally jail, substance, suicide, etc. etc. Plus a life time of being told your a speed freak, the association with speed freaks, a misunderstanding of what the drugs are and how they work. I was literally told by a research professor of mental health stigma in grad school that my ADHD wasnt real and I needed to grow out of it. And when I reported it to the school, the said it wasnt a real discrimination case and I should just drop it because they wouldnt waste their time on it. Its literally dangerous to downplay the significance of ADHD/ Attention Deficit Hyperactivity Disorder (ADHD) among longer-term prison inmates is a prevalent, persistent and disabling disorder "ADHD is a common, inherited and disabling developmental disorder with early onset. Most often ADHD persists across the life span, affecting 2-4% of adults [1]. The core symptoms of ADHD are inattention, hyperactivity and impulsivity. Further, deficits in executive functioning are commonplace, such as planning, organising, exerting self-control, working memory, and affect regulation. Therefore, ADHD affects educational and occupational performances, psychological functioning, and social skills. Adults with ADHD are at increased risk for unemployment, sick leave, coexisting disorders, abuse, and antisocial behaviour leading to conviction [2,3]. Nearly 80% of adults with ADHD present with at least one coexisting psychiatric disorder [3,4]. " "The estimated prevalence of adult ADHD among longer-term inmates was 40%. --Only 2 out of 30 prison inmates confirmed with ADHD had received a diagnosis of ADHD during childhood, despite most needed health services and educational support.-- All subjects reported lifetime substance use disorder (SUD) where amphetamine was the most common drug. Mood and anxiety disorders were present among half of subjects; autism spectrum disorder (ASD) among one fourth and psychopathy among one tenth. Personality disorders were common; almost all inmates presented conduct disorder (CD) before antisocial personality disorder (APD)." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016316/ Kind of fucked up my comment calling out harmful information was deleted. Anywhere here is exactly what you need to know about ritalin, its literally not just straight amphetamine. Thats adderall. https://www.drugs.com/methylphenidate.html

Andrew Giachetti

*Genius at work voice* Ken Griffey Jr hit 56 home runs in 1997 so to say nobody came close before Sosa and McGwire in 1998 is incorrect. His production actually declined as he aged unlike Sosa, McGwire and Bonds so Griffey probably hit them without the juice. Also regarding having Major League Baseball be the group spying. I think it was just integration with the baseball rights they purchased. They had a lot of baseball players appear on various shows right after they first got the broadcasting rights for MLB. There were several players that did a guest spot on that one Married With Children Episode. Mike Piazza and Frank Thomas among others. Bobby(Still being paid by the Mets. Google Bobby Bonilla Day) Bonilla was on an episode of Living Single. Those are the only ones I remember, there's probably others.

Alex Forsyth