Hyperfocus with Rae Jacobson

Many people with inattentive ADHD feel like something is missing from their diagnosis. That missing piece might be cognitive disengagement syndrome, or CDS: a cluster of symptoms including daydreaming, confusion, daytime sleepiness, and more. CDS isn’t officially its own disorder. But scientists and clinicians are beginning to recognize it as something distinct from ADHD — though it often overlaps. Pediatric psychologist Melissa Miller explains how CDS differs from ADHD, what it looks like, and why it’s linked to anxiety and depression. She also shares early research on treatment, plus the strengths that may come with it.

Fidget toys, like NeeDohs, are sold out and banned in classrooms. Journalist Anna North joins us to unpack how fidget toys went from gag gifts to a generational obsession, and what that shift reveals about neurodivergence, attention, and play. Plus, fidget toys are not just for kids. We look at how they are destigmatizing fidgeting for neurodivergent adults. And we dig into the science behind fidgeting, the history of the fidget spinner, and whether this wave of acceptance for sensory needs will survive.

Last year, Hyperfocus took a field trip to San Diego for an ADHD conference called APSARD, which stands for the American Professional Society of ADHD and Related Disorders (quite a mouthful). A conference of ADHD professionals might not sound fascinating, but it was — and we learned a ton. But there was one person and one talk I really wanted to find: A keynote speech about how ADHD affects women’s bodies by Dr. Sandra Kooij. What Sandra is doing is something so sensible and radical: Looking at ADHD as a whole-body issue. Digging into how it can affect women’s hormones, our health, and especially our hearts. I find Sandra’s research fascinating and was thrilled when she agreed to sit down for a conversation with me. We didn’t waste any time and quickly set up a makeshift studio for this week’s episode of Hyperfocus. Also, a quick note on the audio this week: We had to record this episode outside the conference hotel, on a bustling patio full of ADHD professionals and some noisy birds. So, please forgive the extraneous sounds. Note: We originally published this episode on March 6, 2025. Related resources MissUnderstood: The ADHD in Women Channel Did my ADHD make me more likely to have postpartum depression? ADHD Powerbank: Sandra’s video platform The Head, Heart, Hormones foundation (in dutch with translations) Prevalence of hormone-related mood disorder symptoms in women with ADHD The heart health and ADHD connection For a transcript of this episode and more resources, visit the Hyperfocus page on Understood.org. We’d love to hear from you. Email us at [email protected] As kids head back to school, it's a good time to remember: not every student experiences the classroom the same way. Through My Eyes, a free interactive experience from Understood, lets you step into a day in the life of a kid with ADHD, dyslexia, or dyscalculia. See their strengths and challenges in a whole new way. Try it out here.Understood is a nonprofit organization dedicated to empowering people with learning and thinking differences, like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Today’s episode is a crossover with Understood’s new podcast, Everyone Gets a Juice Box. Host Jessica Shaw interviewed Rae about something she rarely discusses on Hyperfocus: Being a mom to a fabulous kid with ADHD. Even with Rae’s 20 years of experience studying and writing about ADHD, getting help for her child in school has been really challenging. Here’s how she’s supporting her daughter while they wait for school services.

Rae puts on her most uncomfortable pants (on purpose!) to ask a fashion designer and former special ed teacher whether adults can actually get over sensory issues. Julia DeNey, founder of sensory clothing brand Sense-ational You, breaks down why tactile sensitivity doesn’t disappear at 18, what adaptive fashion can (and can’t) fix, and why telling yourself “today’s the day I get over it” is the worst possible strategy.

Our team has been seeing something called “ring of fire” ADHD spreading across the internet. It’s a supposed subtype of ADHD promoted by Daniel Amen, a celebrity psychiatrist with clinics in multiple states and a huge online following. But in reporting this episode, we found that “ring of fire” ADHD isn’t recognized by mainstream science. Nor are brain scans approved by the FDA as a diagnostic tool for ADHD. Our guest today, clinical psychologist Roberto Olivardia, PhD, explains why he believes Dr. Amen’s approach is unethical — and how it may lead to real harm for patients seeking answers.

Last fall, I heard something that floored me: The tests we have for ADHD in adults don’t work very well. As an adult with ADHD, I think about this all the time because our diagnosis is so stigmatized and so misunderstood. It’s overdiagnosed. It’s underdiagnosed. Everybody has it. Nobody has it. If only there were a silver bullet or some test that could definitively say yes or no. So, I asked the two Chicago School faculty members who got me thinking about this after their presentation at the CHADD conference last year: Jessica Rosenfeld, a clinical psychologist, and Reneh Karamians, a neurorehabilitation psychologist. They explained why adult ADHD diagnosis is so difficult, and how new scan technology holds promise for spotting ADHD in the brain.

The ADHD internet is crowded — and not all content is created equal. From unlicensed coaches to miracle cures and viral “hacks,” misinformation spreads fast and wide. The problem is that many prominent voices have little to no formal training. And algorithmic incentives encourage creators to bait their audience. Cate Osborn, known online as @catieosaurus, joins Hyperfocus to explain how the ADHD content economy works. She looks at why grifting thrives and how power, profit, and trust in online mental health spaces affect our understanding of ADHD.

If you have ADHD or autism, research shows you’re at a much higher risk for developing chronic pain — a connection many doctors and patients still don’t know about. In this episode of Hyperfocus, we talk with a doctor who’s trying to change that. Dr. Michael Lenz, a Wisconsin-based pain specialist, explains what the medical community is discovering about the connection between ADHD, autism, and chronic pain, including conditions like fibromyalgia and migraines. He also shares stories from his practice, including times when treating a patient’s ADHD unexpectedly improved their chronic pain symptoms.

One of the most urgent ADHD research gaps has to do with ADHD and trans people. We know there are lots of trans folks with ADHD. But when it comes to understanding how best to treat them, it’s a whole different story. That’s why we wanted to talk to someone who knows this experience well. Ivan Hsiao is the founder of Trans Health HQ. He joined this week’s Hyperfocus to share his own diagnosis story and to talk about what we do (and don’t) know about being trans with ADHD.

ADHD just keeps finding itself in the news. It can feel like a lot for those of us who have it or care for someone who does. Recently, Hyperfocus host Rae Jacobson sat down with a couple colleagues at Understood.org for a livestream to discuss the news and take community questions. Her guests were Dr. Andy Kahn, a licensed psychologist, and Dr. Keona “KJ” Wynne. Together, they chatted about the controversy surrounding Tylenol, what we really know about the cause of neurodevelopmental disorders, and how to talk to your kids about scary or misleading messages in the news. On this week’s Hyperfocus, we’re sharing that conversation in full.

Artificial intelligence has cemented itself as the latest world-altering technology. It follows the same lineage as electricity, the television, the internet — the list goes on. Depending on who you talk to, AI is the greatest thing ever or the thing that will destroy the world, with lots of room in the middle for discussion and experimentation. But within the bigger AI fascination, there’s a smaller yet critical conversation about how this technology might help or harm people who learn and think differently. That’s why we brought in Dr. Amy Gaeta for this week’s “Hyperfocus.” She’s an AI ethicist and researcher who also has autism, giving her a unique insight that she shares on our latest episode.