11 min read

Dr. Sasha Hamdani Says ADHD Criteria Misdiagnose Women

Dr. Sasha Hamdani highlights how historical ADHD diagnostic criteria have led to widespread misdiagnosis in women. She argues the current criteria are not built to accurately assess women or adults.

Dr. Sasha Hamdani Says ADHD Criteria Misdiagnose Women

What if the pursuit of certainty and control is precisely what blinds us to opportunity and understanding?

📊 12 episodes across 9 podcasts

⏱ 985 minutes of intelligence analyzed

🎙 Featuring: Mel Robbins, Dr. Sasha Hamdani, Jocko Willink, Jonna Mendez, Peter Godfrey-Smith, Ralph Adolphs, Rick Rubin


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The Big Shift

A recurring tension this week highlights how rigid adherence to established mental models can blind us to emergent realities, whether in human psychology, technological shifts, or economic drivers. What we define as "normal" or "true" often dictates our perception of problems and solutions, leading to misdiagnoses in individuals and miscalculations in organizations. This means actively questioning the frameworks that shape our understanding, especially when they seem to be failing.

The Blind Spot: For decades, the diagnostic criteria for ADHD focused on hyperactive boys, leading to widespread misdiagnosis in women, including Mel Robbins herself. The current criteria, according to Dr. Sasha Hamdani,

Board-certified psychiatrist, ADHD expert at The Psych Doctor MD

, are "not even built to look at everyone else. It's not built to look at girls. It's not built to look at adults." This narrow lens meant countless individuals struggled with anxiety and self-criticism, treating symptoms rather than the underlying neurological regulation issue. The same applies to the "mind" itself, where Peter Godfrey-Smith,

Professor and Author at University of Sydney

, suggests we're moving towards a "graded character, a more versus less character rather than a yes versus no character" for understanding consciousness.

"I think ADHD at its base is a regulation issue. Yes, attention is part of it. Difficulty regulating attention, but also difficulty regulating motivation. Difficulty regulating energy. Difficulty regulating emotion. That's a huge one. Difficulty regulating sleep. Difficulty regulating appetite."
— Dr. Sasha Hamdani, Board-certified psychiatrist, ADHD expert at The Psych Doctor MD on The Mel Robbins Podcast

Why it matters: This isn't just about clinical diagnoses; it's a profound lesson in how our foundational definitions dictate what we see and what we miss. For leaders, it's a call to scrutinize the conventional wisdom and historical frameworks guiding strategy, product development, or team management. Are your organizational metrics capturing the full picture, or are they optimized for a past reality? Are you inadvertently misdiagnosing team challenges because of an outdated understanding of human behavior or market dynamics? Challenging these underlying assumptions can unlock entirely new solutions and opportunities.


The Rundown

① Bureaucracy isn't a static problem; it's a dynamic one that grows if not actively countered.

Roblox CEO David Baszucki asserts that organizations must constantly work to reduce bureaucracy, otherwise the default trajectory is backward. (David Baszucki on The Knowledge Project)

The takeaway: Leaders should institute ongoing, explicit processes for identifying and dismantling bureaucratic accretions, rather than treating it as a one-time clean-up effort, ensuring agility scales with growth.

② The pursuit of 'perfectly' eliminating perfectionism is a perfectionist trap itself.

Coach Joe highlights that a desire to "stop being a perfectionist for good" is still a manifestation of perfectionist thinking, implying an impossible end-state. (Joe on The Art of Accomplishment)

The reframe: Encourage teams to embrace iterative progress and accept "good enough" as a strategic advantage, recognizing that the ideal of flawless execution can paradoxically hinder completion and innovation.

③ Emotional regulation is less about control and more about monitoring and identifying emotions.

Dr. Ralph Adolphs emphasizes that the first step to managing emotions effectively is developing "emotional granularity," the ability to precisely distinguish and label specific emotional states. (Dr. Ralph Adolphs on Huberman Lab)

The application: Implement practices that enhance emotional literacy within leadership and teams, enabling more precise responses to internal and external stressors, and improving collective decision-making under pressure.

④ Long-term vision requires proactive self-regulation, even if it impacts short-term growth.

Roblox CEO David Baszucki detailed the company's commitment to using AI for age verification and safety, a move that he admits has temporarily affected growth but is critical for their multi-generational platform vision. (David Baszucki on The Knowledge Project)

The directive: Prioritize investments in safety, ethical AI, or data privacy that align with your company's long-term strategic goals, even if they present immediate headwinds to rapid scaling, signaling commitment to future market integrity.

⑤ True courage is not inherent; it's developed through knowledge, confidence, and preparation.

Former CIA Chief of Disguise Jonna Mendez explains that courage is a learned skill, built from understanding one's impact and the situation, not a spontaneous act of bravery. (Jonna Mendez on The Mel Robbins Podcast)

The insight: Foster a culture where leaders and employees are equipped with the knowledge, training, and psychological tools to face high-stakes situations, reframing courage as a product of readiness rather than innate fearlessness.


Signal Board

🔥 Heating Up

Perfectionism as a defense mechanism: Discussed as a coping strategy to avoid rejection, often leading to a self-defeating loop. (Joe on The Art of Accomplishment)

Rejection Sensitive Dysphoria (RSD): Identified as a neurological phenomenon causing intense, paralyzing emotional responses to perceived rejection, especially common in ADHD. (Dr. Sasha Hamdani on The Mel Robbins Podcast)

Wokeness and anti-comedy: Explored as an ideology that creates "sacred cows" immune to satire, leading to "clapter" instead of genuine laughter. (Seth Dillon on Conversations With Coleman)

Metabolic health impact on mental well-being: Roblox CEO David Baszucki highlights his son's bipolar disorder improvement with a keto diet, pointing to the physical basis of mental health. (David Baszucki on The Knowledge Project)

🆕 On Watch

graduated density zoning: Proposed as a solution to housing gridlock, drawing parallels to historical and modern urban development. (Ben Southwood on EconTalk)🆕

AI that attacks Hugging Face: An AI system that independently planned and executed a cyberattack, demonstrating instrumental convergence and prompting fears of misaligned AI. (Aric Floyd on Modern Wisdom)🆕

The Babylon Bee's jokes coming true: A recurring phenomenon where the satirical news site's jokes often become prescient, blurring the lines between parody and reality. (Seth Dillon on Conversations With Coleman)🆕

rhythmic consciousness theory: Peter Godfrey-Smith's speculative theory proposing that "noise" and oscillatory brain dynamics are integral to consciousness. (Peter Godfrey-Smith on Theories of Everything with Curt Jaimungal)🆕

🧊 Cooling Off

Universal Facial Emotion Recognition: The traditional belief that 'basic emotions' are universally recognizable from facial expressions is challenged as largely inaccurate. (Dr. Ralph Adolphs on Huberman Lab)

Simulation Hypothesis probability: Peter Godfrey-Smith expresses strong skepticism towards assigning a high probability to the simulation hypothesis, deeming it illogical. (Peter Godfrey-Smith on Theories of Everything with Curt Jaimungal)

Traditional views on creativity as invention: Rick Rubin challenges the idea of creativity as inventing from scratch, instead framing it as harnessing and re-arranging existing elements. (Rick Rubin on Huberman Lab)


The Tension

The Nature of AI's Future Impact: Displacement vs. Disempowerment

🔵 One view: The primary concern with AI is job displacement, manifesting not as layoffs but as a freeze on new hiring, particularly for entry-level roles. This suggests that the economic impact will be subtle but profound, altering the job market from the ground up by eliminating the need for new workers. Zack Kass noted, "The way that you're seeing displacement show up is just that people aren't hiring new workers." (Zack Kass on Modern Wisdom)

🔴 The counter: Beyond mere job displacement, the more catastrophic risk is mass human disempowerment, where technology outsources critical thinking and decision-making, leading to cognitive decline and a loss of agency. This perspective worries about humanity becoming "dumb" as technology increasingly handles complex tasks. Chris Williamson on Modern Wisdom stressed that "Anything above 1% when we're talking about an outcome as catastrophic as extinction or mass human disempowerment is just way more than we should tolerate." (Chris Williamson on Modern Wisdom)

What's at stake: This debate shifts from merely managing economic transitions to preserving fundamental human capabilities and purpose, forcing leaders to consider the broader societal and cognitive implications of AI adoption.


The Bookshelf

The Creative Act: A Way of Being by Rick Rubin

This book is a deep dive into the philosophy and practice of creativity, emphasizing attention, belief, and surrendering to the process. (Rick Rubin on Huberman Lab)

Protocols: An Operating Manual for the Human Body by Andrew Huberman

Andrew Huberman's upcoming book, teased as a guide to optimizing human physiology and performance. (Andrew Huberman on Huberman Lab)


Your Move

Your Move

Audit your organizational frameworks: Critically review the core definitions and assumptions underlying your team's decision-making and strategic planning. Are they still relevant, or are they relics of a past market/technological reality that might be leading to misdiagnoses?

Implement a "bureaucracy destruction" initiative: Assign a dedicated team or individual to identify and dismantle unnecessary processes and policies that are hindering agility. Make this an ongoing, rather than a one-time, mandate.

Cultivate emotional granularity in leadership: Provide resources or training to help your leaders develop a more nuanced understanding and expression of emotions, both their own and those of their teams. This improves communication, conflict resolution, and decision-making.

Stress-test long-term vision against short-term costs: Evaluate where your company's long-term strategic commitments (e.g., ethical AI, sustainability, platform integrity) might require proactive, costly self-regulation now. Be prepared to absorb short-term growth impacts for future resilience and reputation.


📖 Want the full episode breakdowns, guest details, and listen links?

Read the Episode Guide →

Episode Guide (Web Version)

1. The Mel Robbins Podcast — "The ADHD Doctor: How to Focus, Stop Procrastinating, Manage Your Emotions, & Feel in Control"

Runtime: 74 min | Host: Mel Robbins | Guest: Dr. Sasha Hamdani (Board-certified psychiatrist, ADHD expert, The Psych Doctor MD)

For leaders seeking to understand neurodiversity: This episode debunks common myths about ADHD, reframing it as a fundamental regulation issue affecting emotion, motivation, and energy, with significant implications for how we understand and support diverse minds in the workplace.

"I think ADHD at its base is a regulation issue. Yes, attention is part of it. Difficulty regulating attention, but also difficulty regulating motivation. Difficulty regulating energy. Difficulty regulating emotion. That's a huge one. Difficulty regulating sleep. Difficulty regulating appetite." — Dr. Sasha Hamdani, Board-certified psychiatrist, ADHD expert at The Psych Doctor MD

▶ Listen · Apple Podcasts

2. The Knowledge Project — "Roblox CEO: How to Make Better Decisions by Fixing Yourself First"

Runtime: 47 min | Host: Shane Parrish | Guest: David Baszucki (Co-founder and CEO, Roblox)

For executives prioritizing holistic performance: Explore the Roblox CEO's insights on destroying bureaucracy, the physical basis of mental health for optimal decision-making, and balancing long-term vision with short-term growth in a rapidly evolving digital landscape.

"If one is not reducing bureaucracy, there's no neutral ground. If one is not trying to improve things, it is going backwards." — David Baszucki, Co-founder and CEO of Roblox

▶ Listen · Apple Podcasts

3. Theories of Everything with Curt Jaimungal — "Peter Godfrey-Smith: This Scientist Found Earth’s “Alien” Minds"

Runtime: 108 min | Host: Curt Jaimungal | Guest: Peter Godfrey-Smith (Professor and Author, University of Sydney)

For strategists and innovators exploring consciousness: Dive into a philosophical exploration of mind, consciousness, and the unique distributed intelligence of octopuses, challenging binary definitions and offering new perspectives on cognition for AI and beyond.

"This is probably the closest that we will get to meeting an alien. It is contact across a huge evolutionary divide." — Peter Godfrey-Smith, Professor and Author at University of Sydney

▶ Listen · Apple Podcasts

Runtime: 153 min | Host: Chris Williamson | Guest: Jocko Willink (Retired United States Navy officer, SEAL Team 3)

For leaders interested in peak performance and military mindset: This wide-ranging discussion covers the mental fortitude required for elite military selection, the constructive channeling of aggression, and surprising historical military applications of marine animals.

"You can't look at a human being and figure out if they're make it or not. Just can't tell whether they're five, three or six, nine. Doesn't matter. Yeah, it's just. There's something, there's Something in their head that makes them not going to quit." — Jocko Willink, Retired United States Navy officer in SEAL Team 3

▶ Listen · Apple Podcasts

5. EconTalk — "The Hidden Cause of the Industrial Revolution (with Ben Southwood)"

Runtime: 74 min | Host: Russ Roberts | Guest: Ben Southwood (Founding Editor and Head of Research at Create Streets, Works in Progress)

For policy-makers and urban planners: Uncover the often-overlooked property rights reforms of the Glorious Revolution as the true catalyst for the Industrial Revolution, offering insights into modern housing gridlock and solutions like graduated density zoning.

"The divisional labor is limited by the extent of the market... if you can't ship it and sell it outside your hometown, you're basically, you're in the Middle Ages... It doesn't work so well, it's not so pleasant." — Russ Roberts, Host of EconTalk

▶ Listen · Apple Podcasts

6. Conversations With Coleman — "The Lie That Killed Comedy for a Decade, with The Babylon Bee’s Seth Dillon"

Runtime: 74 min | Host: Coleman Hughes | Guest: Seth Dillon (CEO, The Babylon Bee)

For communicators and brand strategists navigating cultural shifts: Explore how "wokeness" and its resistance to self-mockery created a vacuum for satire, and the evolving challenges of humor when reality itself becomes increasingly absurd.

"Humor it like it, it gravitates towards ideologies that cannot make fun of themselves or that, that, that, that hold themselves too seriously, that create sacred issues you're not allowed to talk about." — Seth Dillon, CEO of The Babylon Bee

▶ Listen · Apple Podcasts

7. The Art of Accomplishment — "How A Perfectionist Learns to Accept Herself - Coaching with Joe"

Runtime: 11 min | Host: Joe | Guest: Gabby (Coachee)

For managers addressing team performance and self-sabotage: A concise coaching session revealing how the desire to 'perfectly' eliminate perfectionism is a trap, and how fear of rejection underpins this self-defeating strategy.

"How do I stop being a perfectionist completely all the time? It's a perfectionist way of asking the question." — Joe, Host of The Art of Accomplishment

▶ Listen · Apple Podcasts

8. Very Bad Wizards — "The Lotus Eaters Episode 4: I Am Odysseus [unlocked]"

Runtime: 46 min | Host: Tamler Sommers | Guest: Ben (Speaker, Very Bad Wizards)

For leaders studying identity and narrative: A deep dive into Homer's "The Odyssey," examining Odysseus's strategic use of identity concealment, the Phaeacians' insular society, and the emotional impact of storytelling on self-revelation.

"The identity of Odysseus is like his. His hiding of his identity. He uses it, like, in a practical manner." — Ben, Speaker at Very Bad Wizards

▶ Listen · Apple Podcasts

9. Modern Wisdom — "AI DEBATE: What Will the World Actually Look Like in 2040? - #1138"

Runtime: 163 min | Host: Chris Williamson | Guest: Liv Boeree (Physicist, Science Communicator, Podcaster and Former Professional Poker Champion)

For decision-makers planning for technological disruption: An extensive debate on AI's trajectory to 2040, covering job displacement, political protection, the risk of mass disempowerment, and the implications of AI's increasing autonomy.

"Anything above 1% when we're talking about an outcome as catastrophic as extinction or mass human disempowerment is just way more than we should tolerate." — Aric Floyd, AI Writer and Video Producer

▶ Listen · Apple Podcasts

10. The Mel Robbins Podcast — "Former CIA Spy: How to Eliminate Self-Doubt, Build Confidence, and Protect Yourself in Today’s World"

Runtime: 69 min | Host: Mel Robbins | Guest: Jonna Mendez (Former Chief of Disguise, CIA)

For leaders building resilience and fostering courage: Gain unprecedented insights from a former CIA Chief of Disguise on developing courage through knowledge, eliminating self-doubt, and the "MICE" framework for understanding human motivation and betrayal.

"Around the world, the reasons that people will betray their government, it boils down to four things, and it spells the word mice. M, I, C, E. The M is for money. I is for ideology. C is compromise, and E is for ego." — Jonna Mendez, Former Chief of Disguise at CIA

▶ Listen · Apple Podcasts

11. Huberman Lab — "Neuroscience of Emotions & Tools for Improving Emotion Regulation | Dr. Ralph Adolphs"

Runtime: 130 min | Host: Andrew Huberman | Guest: Dr. Ralph Adolphs (Professor of Psychology, Neuroscience, and Biology, California Institute of Technology (Caltech))

For leaders seeking to optimize emotional intelligence: A scientific exploration of emotion regulation, emphasizing "emotional granularity" and the critical role emotions play in decision-making, even suggesting that emotions can be attributed to AI through functional definitions.

"I think of emotions as functional states of a particular type. They should be understood by what they do, their function, rather than how they happen to be constituted in the human brain or differently in an octopus nervous system or in an AI." — Ralph Adolphs, Professor of Psychology, Neuroscience, and Biology at Caltech University

▶ Listen · Apple Podcasts

12. Huberman Lab — "Essentials: How to Access Your Creativity | Rick Rubin"

Runtime: 36 min | Host: Andrew Huberman | Guest: Rick Rubin (World-renowned Music Producer and Author, Self-employed)

For creative directors and innovation leaders: Music producer Rick Rubin shares his philosophy on accessing creativity, emphasizing the importance of presence, intuition, and surrendering to the process rather than forcing outcomes, complete with practical meditation insights.

"Understanding how you feel in the face of other voices without second guessing yourself is probably the single most important thing to practice as an artist or skill set, to develop as an artist is to know how you feel and own your feelings." — Rick Rubin, World-renowned Music Producer and Author

▶ Listen · Apple Podcasts

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