Grandma Has ADHD

Episode 49 - The Pressure to be “Perfect”

• Jami Shapiro • Episode 49

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In this eye-opening and heartfelt episode, Jami Shapiro welcomes healthcare professional, patient advocate, and fellow ADHDer Kayva Jha for a conversation that bridges deeply personal experience with professional insight.

From discovering ADHD in her own family to navigating perfectionism, eating disorders, and the healthcare system, Kayva’s story shines a light on the hidden ways ADHD shapes our lives—especially for women. She shares how perfectionism can mask ADHD symptoms, how self-worth often gets tangled in achievement, and why nutrition and mental health are deeply connected.

Jami and Kayva also explore the surprising link between ADHD and chronic health issues, the challenges of compliance with medical care, and the life-changing role of social connection in recovery. Together, they break down how stigma, shame, and lack of awareness can delay ADHD diagnosis for decades—and how self-acceptance can open the door to healing.

Whether you’re living with ADHD, supporting someone who is, or curious about the mind-body connection, this conversation will inspire you to honor your strengths, seek help when you need it, and never give up on yourself.

Thank you for joining us for this episode of Grandma Has ADHD! We hope Jami's journey and insights into ADHD shed light on the unique challenges faced by older adults. Stay tuned for more episodes where we’ll explore helpful resources, share personal stories, and provide guidance for those navigating ADHD. Don’t forget to subscribe and share this podcast with friends who might benefit. Remember, Make the rest of your life the best of your life.

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Have you ever thought, is this just me? When struggling to stay organized, start tasks, or manage time, for those of us over 50, these challenges might not be just aging. They could be ADHD hiding in plain sight for decades. I'm Jami Shapiro, host of Grandma has ADHD, and I'm building a community where your experiences matter.

Whether you are diagnosed, questioning or simply curious. You are not alone. Our Facebook group is filled with vibrant understanding. People over 50 who share their stories, strategies, and yes, even their struggles with plenty of laughter along the way. Ready to find your people. Join our growing grandma has ADHD Facebook community.

Please like and subscribe to the podcast wherever you listen and share it with someone who might need to hear. They're not alone because ADHD doesn't have an age limit and neither does understanding yourself better. Together, we're changing the conversation about ADHD after 50 come be part of the story.

 

[00:01:29] Jami Shapiro: Hi, and welcome to the latest episode of Grandma has ADHD. If you're watching, you're gonna notice that today's cat guest, Kayva Jha, is not a grandma. I mean, I don't think she's a grandma. She looks like she's in in her twenties. but she does work with seniors and she does have ADHD and she does have a family with ADHD.

[00:01:52] Jami Shapiro: And we met in San Diego at one of the many, many events that I attend. And I thought that what she had to share was important to hear. So with that said, I am going to read you her bio. So Kayva Jha is a healthcare professional and patient advocate who's passionate about treating the whole patient, not just their symptoms.

[00:02:15] Jami Shapiro: She currently works as strategic business development manager for a leading mobile wound care company in Arizona where she's building ethical, patient-focused care for seniors with complex wounds. Her mission started at 17 during a high school internship in vascular surgery where she noticed doctors were missing crucial pieces of the puzzle, how behavioral factors, nutrition and mental health.

[00:02:40] Jami Shapiro: Wound, he impact wound healing. Well, that's a good reason to have you on this podcast now, she's developing research on the connection between psychology and physiology, and she founded a nonprofit called Someone who Cares, that helps uninsured patients navigate healthcare and access critical medical care.

[00:02:59] Jami Shapiro: Kayva's big picture goal is inspiring medical professionals to see the full story of each patient, who they are. What shaped them and what they need to truly heal. And I love that Kayva. I don't know if you know this, but I had cancer 20 years ago when I was 34. And navigating that system in a space that I had no idea what I was doing.

[00:03:21] Jami Shapiro: It was a very, very scary process and I was just a number to that doctor, but it was my body. I had young children and it was really, really. Scary. And I also wanna put in a plug that not just for people who are uninsured, but also anyone who struggles with ADHD may often struggle with the maze of the forms and the calls.

[00:03:43] Jami Shapiro: And then do this, and then do this. I was joking with my mom yesterday. She also has ADHD, and I usually say that I won't cook anything that has more than five ingredients. My mom was telling me she just bought a book that was four ingredients or less, so I can't even imagine navigating the healthcare system with ADHD.

[00:04:00] Jami Shapiro: So welcome to the podcast. started. 

[00:04:05] Jami Shapiro: Well 

[00:04:06] Kayva Jha: first off, I need that book because I am right in the same camp. I will definitely not cook anything with more than five ingredients or that takes me more than 30 minutes. So that sounds awesome. Thank you so much for having me. Since the inception of Grandma has ADHD have been dying to know more about this project and get onto this podcast and talk about, my experience even.

[00:04:31] Kayva Jha: Discovering that one of my grandparents very clearly had ADHD. And it really changed the course of my life, getting my diagnosis and changed the course of how I looked at people and their experience and their struggle in navigating their health throughout their life.

[00:04:47] Jami Shapiro: I love that. Before we start on your work work, I always like to hear people's ADHD stories.

[00:04:52] Jami Shapiro: And since you are the grandchild, I think you might be the first grandchild. Is your grandparents still living? 

[00:04:58] Kayva Jha: Yes. So it was in August of 2023. I was visiting my grandparents with my sister and noticing the way that we all interacted. I noticed that my grandfather most definitely had, markers of ADHD, high restlessness, high need to be constantly active, hyperactivity and bouncing from one topic to the other.

[00:05:19] Kayva Jha: Also repetition of phrases that he was not fully aware that he was repeating, which is our favorite. So it wasn't noticing that I realized the lineage and the connection. So did you tell him? So I think. If memory serves me right. I definitely brought it up to him that I think that he and I struggle with the same area there.

[00:05:40] Kayva Jha: And I know that my mom has also probably emphasized it to him as well. I don't know how much it registers, but it also makes him an amazing grandfather who he is over 80, but I mean, I can't even imagine him. Even acting like a day over 50 years old. He is way more capable and energetic than I have ever been.

[00:06:01] Kayva Jha: So I think it also makes him who he is and an amuse 

[00:06:04] Kayva Jha: brand. 

[00:06:05] Jami Shapiro: Definitely. And I definitely can see hyperactivity. My father was hyperactive. My mom is inattentive, my dad's 80, and you can definitely see the gift of hyperactivity in. As you're aging, not so much when you're that little boy that has to sit still in the classroom, but when you're an 80-year-old who can outpace people that are, almost half your age, that's a gift.

[00:06:25] Kayva Jha: Absolutely. 

[00:06:26] Jami Shapiro: So 

[00:06:26] Jami Shapiro: tell me a little bit before we get started. First of all, you are quite impressive and I wanna highlight for everybody that, I just read this long bio of all these things that Kayva has done, and yet she just said, if I have to cook something that's more than 30 minutes or four ingredients, I can't do it.

[00:06:42] Jami Shapiro: So I think that really highlight. The, what it's like to have an ADHD brain. We are interest driven. So if there is something that ignites us or that we're passionate about, it can be the hardest task in the world. And it is like, no problem to get it done, but like, ask me to read an instruction manual or a recipe, huh?

[00:07:01] Jami Shapiro: It is not going to happen. So I like to highlight that when you really get to see it in real life. And I think that there's so many people. Especially, the audience that I am catering this podcast to, which is I've been beating myself up my entire life. I had no idea why I always felt different, or why I felt like I was too much or why I couldn't get it together.

[00:07:22] Jami Shapiro: To recognize, you have your strengths and it's just these new generations that are discovering ADHD and its impact. Get an opportunity to really like, play to those strengths and then farm out the things that we're not good at. Right. 

[00:07:37] Kayva Jha: Absolutely. I'm really happy you pointed that out too because I think something that happens so much with the ADHD mind is, we can have bouts of feeling confident and accomplished in what we do.

[00:07:47] Kayva Jha: But something that I know, just from my research in ADHD is we struggle with that object permanence. So to remember that, this is who we are. When we're also faced with simple, mundane tasks that seem so daunting it's that constant cycle of am I enough going on in your brain?

[00:08:04] Kayva Jha: And I think it's really cool that you pointed that out. Thank you for doing that. 

[00:08:08] Jami Shapiro: Yeah. In fact, one of the things that I learned in ADHD coaching was that a lot of people with ADHD actually have to go back to LinkedIn to see everything that they've done because we're sort of like out of sight, out of mind.

[00:08:19] Jami Shapiro: I'm doing this, it's now or it's not now. And I think that there's also a lot of, imposter syndrome with ADHD. So we feel like we have to accomplish to sort of prove ourselves. And so it's funny, when I read a bio from guests, it's typically like on and on and on, and I'm like, do you realize how impressive this is?

[00:08:36] Jami Shapiro: And yet, I am sure that there are things in your life that you are beating yourself up for. Like, why can't I get it together? 

[00:08:44] Kayva Jha: Absolutely. And you asked me about my story with ADHD, which I think is a huge background that we have to go over to segue into, we'll talk about. And so it really started, I think my mental health journey really started, by the time I was actually nine 10, I noticed that I was different and the fact that I did not have the level of energy that most kids did or like that patience for, behaviors that kids normally engage in. Like, I did not ever wanna go out to play racist. I was like, I would much rather be inside and, and chill out here.

[00:09:20] Kayva Jha: And I noticed when I would go traveling on trips with my parents. I was looking for my next opportunity to sleep as a 10-year-old. Right? So those are things that, I kind of just went through life with by the age of 12 or 13, I. Could tell that there was something where I needed to talk to myself every night and kind of review like what's been going on with me and what got me to this point where I just feel different and sad and like I don't belong.

[00:09:48] Kayva Jha: What happened, and I had this conversation with myself almost every night, like I was my own therapist. Fast forward to when I was 15. I had struggled my entire life with a pressure to keep up an image for appearance. I was. Born and blessed, to have some nice jeans. And that's something that gets noticed when you are young and when you're young and all you hear about is how you should be a model and that you know you're tall and you're skinny, and this is, exactly who you should be.

[00:10:18] Kayva Jha: That becomes your first validator and the first thing you identify with. So if I'm not pretty and if I'm not skinny, then I'm not me, and. Then what? so I remember even from the age of three, looking at myself in the mirror and saying, if I don't stay underweight for my whole life, then I failed then.

[00:10:36] Kayva Jha: Like, I can't not be underweight, right? By the time I was 15, I had never gotten to a point where I was overweight at all. In fact,I was a beautiful, curvy 15-year-old girl, and I just felt inadequate. I felt inadequate with my intelligence. I really wanted to be on honor roll and I wasn't at something that I was as a kid.

[00:10:58] Kayva Jha: And then I also felt like I had outgrown that, Willowy wispy body that I originally had, and those two things made me feel very out of line with myself. I remember the date, the night that I made an actual promise to myself that I will do anything it takes to lose 15 pounds and get to X number so that I am happy.

[00:11:22] Kayva Jha: Right. And I almost knew what I was doing. Like I almost knew that I was. Diving into something that was going to be a process, right? From that point, I became extremely obsessive about dieting, exercising, and getting everything perfect. And when I found out the whole calorie and calorie out relationship started losing weight really fast, and I started getting compliments all the time and.

[00:11:51] Kayva Jha: The thing that I noticed the most though, was all of a sudden everything was organized. Like I could get my schoolwork done on time. My time management was impeccable. I, was not constantly getting the comment. You have so much potential. I still can't. Stand the word potential because of just how much we heard it growing up.

[00:12:11] Kayva Jha: And I remember I was at a point that grading period where I was so exhausted that I would have to have my dad pick me up in the middle of school. I would miss the classes that I was like, I'm good on these ones, and then come back later in the day for the classes that I knew I needed to be in class for.

[00:12:28] Kayva Jha: I needed guidance on, because I was just that exhausted and I told myself, if this impacts my grades, I'm done. it's been great losing this weight and everything, but my grades are most important. And what ended up happening was like, I wanna report part back, and I was on honor roll and now this.

[00:12:47] Kayva Jha: Established something for me that I could not kick for six years, that all of a sudden everything that I failed at in life is now succeeding and it's only succeeding because I've become a perfectionist with my body and my exercise routine and nutrition. And so when, as long as I have that, even though I know it's extremely unhealthy, I knew within one to two months that I was not in a good place.

[00:13:10] Kayva Jha: As long as I have this, I have success. And so this was what pushed me into that issue. By the time I was in college, I had developed very severe bulimia. And it had gotten to a point where I had been in group therapies. I had so much knowledge and self-awareness around eating disorders and what was driving it.

[00:13:33] Kayva Jha: I just couldn't apply the solution. And. When I was 19, I was looking into research papers about what medically can we do about these eating disorders? Because I used to pray every night if there was a pill to take, to just take this all away, I would do it in a heartbeat. And I remember coming across one research paper out of hundreds.

[00:13:59] Kayva Jha: Where at the bottom it said the combination of an antidepressant anti-anxiety or psychotic with the combination of a stimulant and a mood stabilizer has been shown to be very successful in treating individuals with binge eating and bulimia. I then at the same time came across a DNP psychiatrist who within five minutes of talking to me was like, okay, hold up one second.

[00:14:26] Kayva Jha: So you've been a psychiatrist for six years, but no one's ever told you that you have ADHD. And I was, what? Me? I have ADHD. No, I'm such a focused student and I'm always behaving and perfect about my behavior. And he was like, no, no, no. this is clear cut. ADHD having developed into an eating disorder.

[00:14:47] Kayva Jha: And the very first thing we need to do if you don't want to get checked into a hospital by the time we're at next week, is we need to get you on a medication plan. And then in that appointment and the next 10 minutes, I had my prescriptions for my stimulant and my antidepressant, anti-anxiety mood stabilizers, sorry.

[00:15:07] Kayva Jha: And within the next five minutes, I had my first normal meal in six years. 

[00:15:14] Jami Shapiro: Wow. Well, I have to say, we hear that perfectionism can be a trait of ADHD and it's so opposite of when we think of ADHD because we think of the clutter and but I have heard that it is a way of masking and so I'm so sorry that you had that journey, but I'm.

[00:15:32] Jami Shapiro: So appreciative that you're sharing that. I know that wasn't what we were supposed to talk about, but we're still gonna get there. But I would love to hear a little bit more from you about perfectionism because as I've said, it's not my ADHD experience but I know that it is. there was a podcast that I actually listened to when my, Youngest child was diagnosed with ADHD at the age of 16, and here I am studying to be an ADHD coach and I had missed it. And so it turns out that this podcast was, the eight different types of ADHD in girls and one of them is the perfectionist. So I'd love to hear a little bit more about that journey.

[00:16:07] Jami Shapiro: But we're going to take a pause. Because I like to put in a word from our sponsors and take a water break and check in with our guests. So just please hang on to hear more of Kayva Jha's story.

 

Are you tired of feeling like you can't get it together? Struggling with clutter that overwhelms you despite your best efforts. Wondering why organization feels impossible while others make it look so easy. You are not alone and it's not your fault. Hi, I'm Jami Shapiro. Host of the grandma has ADHD podcast and I understand exactly what you're going through.

I combine my years of hands-on work as founder of Silver Linings Transitions, a move management and home organizing company, together with ADHD coach, training and help adults 50 and over connect the dots between ADHD and lifelong struggles. Whether you are downsizing, decluttering, or simply trying to create systems that work for your ADHD brain, I provide virtual and in-person coaching for those in the San Diego area.

Together we'll develop practical strategies that honor how your brain actually works, not how you think it should work, ready to trade. Shame for understanding. Visit Grandma has adhd.com. Or call to schedule a discovery session at 7 6 0 6 0 7 7 3 7 7 because it's never too late to finally make sense of your story.

 

Ever wondered why helping a loved one declutter feels like speaking different languages? I did, especially with my mom. It wasn't until I founded Silver Linings Transitions helping San Diego seniors organize and move for over a decade that I discovered why we all experienced clutter differently. And for those of us with ADHD, it's a whole other world.

If you are listening in the San Diego area and feeling stuck with moving. Paperwork, photos or home organization. Our team at Silver Linings Transitions gets it. We understand ADHD's unique challenges and we won't just help you get organized. We'll create sustainable systems that. Finally stick Schedule a consultation with our team today at 7 6 0 5 2 2 1 6 2 4.

That's 7 6 0 5 2 2 1 6 2 4 or find us@silverliningstransitions.com.

 

[00:19:01] Jami Shapiro: We are back with Kayva Jha, and we are exploring a topic that I have not yet explored in. The grandma has ADHD arena and I am so grateful that Kayva brought it to light for us so we could sort of hear about it.

[00:19:15] Jami Shapiro: Before I continue with the interview, if you are enjoying this interview and you are getting content or you're relating to the content or you think somebody else will, I would love it if you would like the podcast and share it. So that is how we are growing and that growth means that we can.

[00:19:32] Jami Shapiro: Finally destigmatize, ADHD, and really all of the mental I don't like the word disorder, but, but neurodivergent thinking because, we are not all made to think the same way. So please share the podcast, like it, subscribe to it, and then of course, join us at the grandma has ADHD community.

[00:19:49] Jami Shapiro: Okay, so enough plugs. All right, Kayva, again, I'm so grateful to you. So take me through what you've learned about perfectionism and ADHD. 

[00:19:59] Kayva Jha: Absolutely. 

[00:20:00] Kayva Jha: It was recently that I came across a video. It was last year in the summer. And I highly recommend this YouTuber. His name is Dr.

[00:20:09] Kayva Jha: Alo K. He calls himself Dr. K. And he essentially made it a video about female ADHD and. When I watched this video, I literally felt like somebody had just read me my horoscope or my life story, And I was in tears. He quite literally walked me through every single thing that I went through and that so many girls go through with ADHD growing up.

[00:20:36] Kayva Jha: And so it's marked by That pressure for perfectionism by the age of 11, 12, developing body image issues and also developing insecurities around capabilities like intellectually and socially. And he talked about a very, common development of eating disorders by the time you're hitting your teenage years and then by the time you're getting into college you are developing substance use issues to cope with this eating disorder and cope with the rest of life happening as an adult.

[00:21:12] Kayva Jha: And he goes into the saddest, part of the video where he talks about how females with ADHD I believe are. Six times. And I might be completely butchering the statistics, so I would just double check, but are six times more likely to end up in an abusive relationship. And that part is heartbreaking.

[00:21:33] Kayva Jha: So we see this pattern and it brought me right back to when my high school teachers first started telling me. 'cause they were noticing a difference in my personality and they always said, the light in your eye has gone somewhere. What happened? And they started telling me, you do come from a very high pressure family, perfectionist mother, all of these things.

[00:21:55] Kayva Jha: And I was like, what do you mean? I was a rare kind of Indian girl growing up in America. I had a feminist dad and mom, who taught us career and financial independence over any man or anything in life, I had parents who told me, we want you to be happy. I didn't just wanna become a doctor because I was Indian.

[00:22:16] Kayva Jha: I wanted to be in medicine because it was the only thing I really was passionate about. And. their entire philosophy with me was being open, having a voice And chasing happiness over any sort of success or perfection. So I didn't understand what she meant. I was like, I don't know what you mean.

[00:22:36] Kayva Jha: But now that I can see, the lineage through my family, and that strain of perfectionism kind of comes in with ADHD to overcompensate the incapabilities we feel we have. I understand that they were actually not. Incorrect. And I do have to mention, huge part of my journey and really finding myself and finding my value was also because of these teachers.

[00:23:01] Kayva Jha: I wanna shout out to Jonathan Torres and Adrian Flu Torres. Throughout chemistry and throughout my high school experience, he would literally make me like. Snap a rubber band or take it back whenever I'd say, oh, I'm stupid. And I would just rattle this off like every two minutes within my speech.

[00:23:18] Kayva Jha: And he would remind me, you are not stupid. You are extremely intelligent, you are not stupid. And he did not care how many times he had to say it to hammer into my head. So I do now believe that my mind just works differently, but I do feel that I am a brilliant person intellectually too. 

[00:23:35] Jami Shapiro: Well, I'm so glad to hear that.

[00:23:37] Jami Shapiro: So I always ask my guests this is a tough one to ask given your journey, but I say if you could press a button and your ADHD would disappear your whole life, you would never have had it. I want honest, and there is no, maybe sometime No, it's a yes or no. I would do it all over.

[00:23:53] Jami Shapiro: Have my ADHD or I. No, thank you. I'm a hard pass. 

[00:23:58] Kayva Jha: I love this question and I recently saw a Trevor Noah interview where he was asked this question too. And it was an interesting answer, but for my answer, it's a solid, I would choose this life. I would choose this life. I would still choose the eating disorder that happened.

[00:24:16] Kayva Jha: I would choose this exact journey. Yeah. I don't think I would be who I am without it. 

[00:24:23] Kayva Jha: 

[00:24:23] Jami Shapiro: I mean, I just got chills and I love it. And I think one of the things that I love about ADHD is how resilient we are. And also our sense of justice. And I think that when you have something that happens to you want to help others through that experience.

[00:24:39] Jami Shapiro: And your story is going to resonate with a grandma who is listening to this and is. Thinking of a grandchild and it's like, oh, I didn't recognize the ADHD. And then when we get our brains right, life changes. I wanna go back to something that you said about the six times more likely to be in an abusive

[00:24:54] Jami Shapiro: One of the things that I learned is that negative self-talk, that voice in our heads, very, very common. And I don't know if it's the negative messaging we got growing up. I know for me I got a lot of it like, I was a mess. I was always talking in class and disruptive and, so how much of it were, I'm just mimicking the negative, messages that I was getting versus, and I don't know the answer to this.

[00:25:18] Jami Shapiro: Are we just naturally inclined to be negative? I know that we catastrophize and, the anxiety comes from all of the things that we think, 'cause our brains are just going, going and running scenarios. But what I have learned as a result of this, as a result of this podcast is how many women ended up young, pregnant women marrying the wrong person.

[00:25:39] Jami Shapiro: So I don't think you're wrong. I don't know that the number six times is, is right. I will look it up and put it in the show notes. I'm also going to put into the show notes. I wanna understand Dr. K. So I will get that from you. So if you are listening to the podcast, we will put it in the show notes and you'll be able to look that up.

[00:25:55] Jami Shapiro: I wanna make sure that we cover what you do with wound care and how that will relate to our audience. 

[00:26:03] Kayva Jha: 100%. And so, which, which one's your first question? Sorry, I got a little lost track there. 

[00:26:10] Kayva Jha: You can totally ADHD all over me. I wanted to know about wound care and how it, relates to the audience, 'cause you mentioned specifically the impact that mental health has on wound care or, so I'd like to hear a little bit more about that.

[00:26:26] Kayva Jha: Absolutely. 

[00:26:27] Kayva Jha: So to begin with. My entire reason for getting into medicine was I love patients. I love people, and I love getting to know them. I would not be happy in a medical career where I do not get to see patients every day understand their story and get to know them. When I was entering the field, as we call it, and wound care, that means you are going to hospitals, clinics, you are seeing patients.

[00:26:50] Kayva Jha: You are in the field, right? You're not like an outside. Kind of. Manager or something. When I started getting into the field and meeting patients, I came across so many amazing diverse individuals who had lovely personalities and were extremely entertaining and very hard for me to rip myself away from.

[00:27:13] Kayva Jha: Once I was in conversation with them, and that's when I would notice that, oh, a lot of these patients. Are presenting with ADHD like symptoms or depressive like symptoms or OCD or PTSD. And those are the most common comorbidities I even see part of the intake team at my clinic that. We are seeing in our patient charts, there is a comorbidity of major depressive disorder or generalized anxiety, O-C-D-P-T-S-D.

[00:27:44] Kayva Jha: That's why we have a huge veteran population with wound issues. A lot of times they do have PTSD associated within their comorbidities. And then I started making a link between. The fact that these behavioral conditions can lead individuals to patterns of behavior that are linked to substance use, self-harm and self-destruction.

[00:28:08] Kayva Jha: I notice my own pattern with being a self-sabotage and that I noticed that I had That kind of issue where I would go to extremes of things. I was either perfect or I was not, I was either, going out for like an all-nighter or I was not. So this is where I started seeing, that.

[00:28:27] Kayva Jha: Did these patterns really start because of a mood disorder or dysregulation in their childhood? And the biggest link I made was with my binge eating disorder development. Because what I found out about. A lot of eating disorders is that we typically associate the image of an eating disorder with somebody who is malnourished.

[00:28:47] Kayva Jha: But what you will actually end up finding is that a majority may be at a completely normal weight or overweight, and this is because. Eating disorders come in all shapes and sizes too. It's not just anorexia and starvation. It can absolutely be anorexic, bulimia where you are anorexic, you're starving, then you're binging, then you're purging or whatever combination it might be.

[00:29:12] Kayva Jha: And even for myself going through an eating disorder, I think I am presented as a normally healthy looking individual. And so it was also hard to equate that, oh, this person is going through something. And what I would notice now is, okay, so the biggest issue that we see with wound development is a lifestyle characterized by poor nutrition choices, poor physical activity just overall in general.

[00:29:40] Kayva Jha: Poor lifestyle choices, which can also be characterized by substance use and self-destructive behavior. 

[00:29:46] Kayva Jha: Which also by the way, correlate with a lot of people with ADHD. So huge. 

[00:29:52] Kayva Jha: Yeah. And that was a relationship I discovered in college and did a lot of research on because I was just curious about why are certain people, drawn to these behaviors.

[00:30:03] Kayva Jha: But that was the first thing I noticed. Okay. So I had a patient that. I could tell, and this is what I see with a lot of my wound patients. They starve themselves a lot. They don't eat at all really. And then they will get hungry. So they will eat something that is easy and accessible. You don't have to cook, you don't have to think about it.

[00:30:24] Kayva Jha: You know, if it's like a one of those packets, like a hoho or like a, quick microwave dinner, that's the way we're gonna go. And that's how we're gonna get our nutrition. And so this is when we see a huge disparity of health and a decline leading into issues such as diabetes, atherosclerosis, vascular medical conditions, peripheral arterial disease.

[00:30:48] Kayva Jha: I can go on. But what we're seeing there is it starts with that nutrition factor. And. One thing that I also learned recently was nutrition is highly linked to ADHD improvement. So the more whole and clean foods you do eat, the cleaner, your brain kind of works. And I saw this happen with me with my eating disorder.

[00:31:10] Kayva Jha: That is why I felt so laser focused and so disciplined and on target when I was. Actively obsessing over every ingredient in my food and getting my workout in. 

[00:31:22] Jami Shapiro: Ben, she says, stop.

[00:31:33] Jami Shapiro: I can't control when he barks. Oh. I thought I paused, but you know, now you guys are getting to hear what my real life is with Benji, the dog. but I know you're not able to hear the podcast. So. Benji was absolutely in agreement and, instead of saying squirrel, I have to say dog the term squirrel.

[00:31:48] Jami Shapiro: Right? when we get distracted. So I am going to apologize that I probably missed the last minute. So if you wanna go back and if you remember Yeah, 

[00:31:58] Kayva Jha: that's the next part. I was like, I actually don't even know, but 

[00:32:02] Jami Shapiro: we were talking about nutrition and you said that you saw the impact when you were managing your nutrition and your exercise.

[00:32:07] Jami Shapiro: that was sort of when I lost. 

[00:32:09] Kayva Jha: Yes. Yes, exactly. So I saw this relationship and I want to quickly go back into a personal experience as well where, when it came to kicking the eating disorder it was my first addiction, And it was my safety blanket, and I had to.

[00:32:30] Kayva Jha: Genuinely choose to get better from it and to leave it behind because my biggest fear was I was going to lose the actual perfection, the actual ability to do amazing things and be so disciplined and hit every target. I knew that it meant that I was going to reintroduce chaos into my life. But what ended up happening was because of the medications I was on.

[00:32:55] Kayva Jha: the chemistry of my brain literally changed. And so therefore I was not able to partake in those behaviors anymore. And that's a really big part of this journey. And something I want to touch on on this podcast when we're talking about overall population health, is that when we're going through a mental health issue, I don't think a lot of us are recognizing that this may be controversial, but that sometimes therapy.

[00:33:20] Kayva Jha: Is not the only thing that's going to fix it. 

[00:33:24] Jami Shapiro: I'm gonna pause. I totally agree with you 100%. But I have to be super sensitive to my audience because when you are aging, you're probably dealing with other occurring conditions that are going to take priority over your mental health, which is unfortunate, but 

[00:33:40] Jami Shapiro: that's the reality. And so I've been very clear when I do a podcast that I recognize that medication cannot be for everyone. Right? And so I steer away from it just because I'm trying to really appeal to my general audience. And having said that. I think anybody can benefit from putting tools in place and scaffolding and understanding your brain better.

[00:34:03] Jami Shapiro: Even if medication is not on the table for you. So I just wanted to kind of put that out there. 

[00:34:08] Kayva Jha: No, absolutely. And again, this is a huge part of. What we're talking about when we're talking about mental health within physiology is that every patient is so diverse. So what may have worked for me may not work for somebody else.

[00:34:23] Kayva Jha: And that is the biggest part. I even remember writing in my medical school application that. I want us as doctors to start believing that not every patient is a formula. we have to derive a new equation every time we meet a new person. it's not one size fits all. And so going back to the fact that when we're treating the whole patient for wound care, we do need to be addressing the fact that there are mental health issues that can be keeping them from compliant behaviors.

[00:34:55] Kayva Jha: And what we. Classify as compliance in the health field is, actively taking the steps and the measures to not only. Bolster your care, but to make sure that it actually, the treatment and the journey works, right? Because for example, a lot of patients don't know that smoking while you're getting wound care, is basically canceling out every single thing that we are doing when we are providing wound care,You're cutting off oxygen and access. to those arteries. And that is why that wound has developed. It did not have enough oxygen to support a healthy skin system around it. And that's why your skin integrity has decreased. 

[00:35:37] Jami Shapiro: So The compliance also, because I noticed that even with myself, I remember going to an integrative doctor, a holistic doctor, and they gave me like all of these pills to take at different times of the day.

[00:35:49] Jami Shapiro: Again, before I understood the impact of ADHD, and I could not do it. I could not. So now I'm very clear, like if you give me too many things, it's not going to happen. I have to set an alarm to remember to take my Synthroid every morning. I'm, 55, I can't imagine as I age if I am not putting those tools into place to be compliant.

[00:36:09] Jami Shapiro: And that's not even mentioning poor habits like smoking and, that kind of thing. 

[00:36:15] Kayva Jha: 100%. And like you said, I mean. I had this, eating disorder, this obsession. I used to cook so much because of how obsessed my mind was with food. And I am still struggling.

[00:36:28] Kayva Jha: I cannot find out how to build that routine, how to build that consistent. I am going to exercise, not because I wanna look a certain way, but because I want to. Feel good in my body. And now that I'm in a field where I see exactly how much the lifestyle choices we make, even at this age impact, our future health and what, where we're gonna end up as seniors, I still struggle so much to.

[00:36:56] Kayva Jha: Eat three square meals a day, not skip all my meals, and then eat a humongous dinner of God knows what, So we can all still be there and be struggling to be compliant. And I genuinely think that it's the depression and the ADHD. That might be underlying for patients that is keeping us from that ability to maintain the compliant routine and actually get better.

[00:37:22] Kayva Jha: So I mean, I'll take a pause there. What I will go into next is more about the research I'm trying to get into, but before I do that, just wanted to see if you had any questions or. 

[00:37:32] Jami Shapiro: No, it just makes so much sense to why you would've wanted to be on this podcast, because, I mean, they really go so hand in hand.

[00:37:40] Jami Shapiro: You're going to have more issues with your health and problems that need to be addressed if you're also having, for whatever reason, the compliance issue. and so again, I'm really glad we're bringing this information to the audience. Okay, so the research, and I wanna be mindful of the time just because one of the things that I notice with ADHD is that I'm going to lose interest in something past a certain point.

[00:38:02] Jami Shapiro: So let's ADHD it down and give everybody, what they need to take away. 

[00:38:08] Kayva Jha: Absolutely. One thing I will touch on right before getting into research is the social impact of wounds. What we see with these patients. The number one thing I would also notice is that these patients lacked a support system.

[00:38:22] Kayva Jha: A genuinely consistent support system of either family or friends. And as we probably know, these mental health, issues can lead to relationship issues. We're maintaining consistent relationships is something that might come naturally to people. I tend to notice that these patients are quite often alone, and that might be something that further.

[00:38:45] Kayva Jha: Triggers the inability to be compliant is you don't have people who love you or a support system reminding you and nagging you to take care of yourself. I know for me, if I didn't have my mom to call me three times a day to make that dang doctor's appointment, I would not make it. and that's why I do what I do with the patient.

[00:39:04] Kayva Jha: That I'm with, and I remind them as many times as I need to because I know that when it comes to who we are ourselves, even if we don't have ADHD, it's much harder to take the steps to take care of yourself rather than to take the steps to take care of somebody else. 

[00:39:20] Jami Shapiro: So 

[00:39:21] Jami Shapiro: that highlights, social connection and how important that is to our health as well, whether we have ADHD or not.

[00:39:27] Jami Shapiro: When we don't have that connection, then that's where we get depressed. And it's also, again, chicken or the egg. So, exactly. 

[00:39:34] Kayva Jha: So creepy. You said chicken or the egg? 'cause that was my next part about the research. This is how I got into that. Okay. You're absolutely correct. One thing that I always say when we're talking about wounds is it is a bio-psychosocial condition.

[00:39:49] Kayva Jha: It's biological, it's psychological and it's social. And the fact that whether or not you have the behavioral health condition before the wound or maybe after, that, or let me rephrase this. It may turn out, that the patient gets the wound and then develops a behavioral health issue or a mood disorder because of the conditions they're in.

[00:40:13] Kayva Jha: So when you have a wound you have decreased mobility when the wounds are getting infected and they're kind of stuck in that phase of we're healing, we're getting infected, we're healing, we're getting infected. they can start to smell and this. Can be embarrassing for people. This is why they don't go and show the wound to a doctor because they're too embarrassed to even step out of the house with it.

[00:40:36] Kayva Jha: And then lastly, as behavioral health can also relate to dementia or Disorders where we're losing memory which has now been shown to have an actual relationship with neuropathy. Meaning that if you have neuropathy, you might not feel pain or some sort of pressure that has occurred on a certain part of your skin.

[00:40:58] Kayva Jha: This can happen in the legs and the extremities. And so then we see patients who will develop a wound and not even know it's there because they're not hurting. This is huge in dementia patients. So going now into the research it turns out that the surgeon that I worked with the most closely when I was in high school actually had an interest in understanding the relationship between cognitive diseases such as Alzheimer's and vascular health.

[00:41:26] Kayva Jha: And. What my idea was bringing back to him that, a little more different from where you're kind of coming from. But I am curious about what's the chicken or the egg, is it the behavioral health issues that lead patients to have certain behaviors and patterns habits that then lead them to poor health outcomes that can develop, chronic wound issues?

[00:41:49] Kayva Jha: Or is it that the patient. Has gotten a wound and has now developed, depression because they're isolated a lot or anxiety because they're embarrassed about the condition they have. Which one comes first and what do we do about that? So that's where the research is kind of going. And I'll take a pause there.

[00:42:10] Kayva Jha: 

[00:42:10] Jami Shapiro: I think we're gonna have to have you come back and really just dive into that. So I would just say that I wanna schedule another appointment. If you are listening to this podcast, we are going to have Kayva back. We do not wanna leave you with a cliffhanger, but we're gonna leave you with a cliffhanger.

[00:42:26] Jami Shapiro: This was such an amazing conversation and thank you all for listening. Thank you, Kayva, for being so vulnerable and sharing your story with our audience. And you we'll definitely be invited back so that we can get more into. the research behind the wounds and the chicken and the egg and all of that.

[00:42:44] Jami Shapiro: So thank you so much for listening to today's podcast, Kayva, any final words? I promise I'm making a commitment in front of everybody that you will be invited back. 

[00:42:53] Kayva Jha: Absolutely. The last thing I just want people to know, whoever might be listening, is despite where you are in your relationships with your family, despite who you have in your life or if you're alone and what you've done.

[00:43:06] Kayva Jha: Whatever your past is, you are a person. I want you to take the focus off of whether you're good or you're bad. You're a person. You are doing your best every day, and you deserve to get better. You deserve to be healthy, whether that's on your own or with your family. You deserve it. Don't give up on yourself.

[00:43:27] Jami Shapiro: Wow, what a great message. Okay. One more thing that I just realized is that if anybody wants to reach out to you, how do they find you? 

[00:43:35] Kayva Jha: Absolutely. Well, that's a great question. Honestly, you are welcome to email me at any point. I will share it right now. It is just my first name, last name, that's Kayva Jha.

[00:43:48] Kayva Jha: So K-A-Y-V as in Victor, A-J-H- A@icloud.com. And Jami, I'm sure you can include this in your link or in your notes. So please feel free to reach out. And I'd be happy to share more contact pathways with you so that we can get in touch and talk. 

[00:44:09] Jami Shapiro: I love it and I love your message. don't give up on yourself.

[00:44:13] Jami Shapiro: you matter. So thank you so much for listening to today's episode of Grandma Has ADHD. 

[00:44:20] Kayva Jha: Thank you. 

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