Brain Power with Dr. Eko

EP. 34 | Understanding ADHD and Autism Comorbidities in Children, with Dr. Marie Dona

• Dr. Hokehe Eko • Season 1 • Episode 34

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Unlock a deeper understanding of ADHD and autism comorbidities in children and teens with insights from our special guest, Dr. Marie Dona. In this episode of Brain Power, Dr. Dona shares groundbreaking statistics and underscores the urgency of early diagnosis and treatment to prevent additional mental health issues like depression and anxiety. You'll learn why children who act out may not be doing so on purpose and how a compassionate, informed approach can make all the difference. We promise you’ll gain a new perspective on these complex conditions, helping you to better support the young ones in your life.

We also explore the often-overlooked aspects of ADHD such as impulsivity and emotional regulation, offering practical strategies for parents to reframe their understanding of ADHD-related behaviors. By recognizing these behaviors as more than just defiance or laziness, you can create a more supportive environment. Additionally, we discuss the significant role of parents in advocating for their children's mental health, especially during the challenging teenage years. From setting boundaries to ensuring proper care from healthcare providers, this episode is packed with actionable advice to help you navigate these intricate issues effectively. Tune in to equip yourself with essential knowledge and tools to support your child's mental well-being.

Connect with Dr. Dona:
donawellnessclinic.com
IG: donawellnessclinic
FB: donawellnessclinic
LI: https://www.linkedin.com/company/dona-wellness-clinic/

Find the full episode on your favorite podcast platform and check out the video version on our YouTube channel!

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If you want to schedule an ADHD/Autism appointment for your child, you may contact Glow Pediatrics:

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Dr. Hokehe Eko:

Hello parents. Welcome to another episode of Brain Power with Dr o. I have an amazing guest today. Her name is Dr Donna and I'm going to have Dr Donna introduce herself, as always. So, dr Donna, welcome to the show.

Dr. Marie Dona:

Thank you so much for having me. I'm so excited to be here. So my name is Dr Marie Dona. I'm a child, youth, adult, reproductive psychiatrist and therapist, but I also got additional subspecialty training in obesity medicine as well. So that was an additional certification that I just got within the last year or so. Yeah and yeah, I have my own private practice in Riverview, florida, but I see patients within my practice all throughout the state of Florida, new York, pennsylvania and Washington DC.

Dr. Hokehe Eko:

Wow, that's amazing. Thank you for coming on here, and it sounds like you have quite the expertise. Oh my gosh, I didn't know you had the obesity and the reproductive.

Dr. Marie Dona:

Wow, yeah, I mean I feel like it's a thing Like when you you know, as doctors, right, you're always wanting to, you're always doing CMEs, continuing medical education, and you're always wanting to learn, and I felt like that was just kind of part of it. So that's when I just kept like tacking things on, but I feel like it's all beneficial and it's stuff that I can apply towards my practice, you know, yeah, definitely.

Dr. Hokehe Eko:

I mean, it makes sense because you're an adult psychiatrist and then you have reproductive, so if you have mummies you can take them, and then the adolescents, too, need reproductive care as well, I mean from a mental health standpoint. So it all makes sense. So, congratulations, I love it. So today we decided we were going to talk about the comorbidities around ADHD and autism, especially in kids and even teenagers. Teenagers is a big one, yes, so let's dive in.

Dr. Marie Dona:

Well, definitely, as a child youth psychiatrist I will say so ADHD and autism.

Dr. Marie Dona:

They are, you know, mental health conditions that definitely I think are very important to be properly diagnosed and treated as young and as early as possible, just because you know, as you just mentioned, the comorbidity like the likelihood of someone eventually having another mental health condition depression, anxiety, you know, mood swings, you know all of the above it just goes so much higher when someone has a diagnosis of ADHD or autism.

Dr. Marie Dona:

So I mean, I can even give you statistics so you know, for someone who has been diagnosed with ADHD, like as a child, the comorbidity of both depression and anxiety can be anywhere from 25 to 50% of them having dual diagnosis. And, as you can imagine, if someone has depression, anxiety as a young child and it goes undiagnosed or untreated for years, like how the severity of that disorder can just continue to manifest and potentially get worse as they're getting older, into teenage years and adulthood years, so that comorbidity actually goes up. Like if you have ADHD or autism and have untreated diagnosis of depression or anxiety, it goes up to like 50 to 75 percent of comorbidity of depression and anxiety. So there's definitely an interplay between those diagnoses and other mental health conditions.

Dr. Hokehe Eko:

Yes, and I think that's important. Those statistics are staggering, first of all. So it's really important for parents to understand it and to recognize that it's not that their child is willfully being well, willfully not listening, willfully not wanting to go to school and just being a brat. No, because all of these things could be happening at the same time. If we don't recognize that, then we're just going to not give them the help that they need.

Dr. Marie Dona:

Yeah, yeah, definitely. So something I hear all the time and I'll give an example for ADHD specifically. So you know, with ADHD, within the DSM it's diagnosed as, like, the inattentive type, the hyperactive type or the combined type. So then you know, when people are thinking about ADHD they're thinking, oh, super hyperactive, or, you know, very inattentive, forgetful, daydreaming, et cetera. But you know, what isn't really talked about as much, or you know people don't find out until later is that behavioral component or the mood component of ADHD.

Dr. Marie Dona:

So when I talk with parents of kiddos with ADHD and they're like, oh yeah, like not pay attention or they're very hyper, but I'll, like I think it's just laziness when they're not listening to me. Or you know they're doing things without kind of thinking about the consequences, like is there something wrong with that? I'm like, ok, well, with ADHD, while there is the inattentive portion and the hyperactive portion, like impulsivity, that lack of impulse control is a huge thing. You know, with the brain, you know the brain connection, like there is that disconnect between, okay, let me actually think through the consequences of my actions, behaviors, or oh, I want to do this or I'm going to react right now, I'm just going to do it, and then that's when it kind of leads to issues. So I like to help parents try to think of it and reframe it as okay, not just forgetful, not paying attention or hyper, but just the way that they can interact with the world.

Dr. Marie Dona:

Like impulsivity, I'm upset, I'm going to throw my toy across the room and it might break the TV. Oh, now you're acting out, you're in trouble, defiant, just behavioral issue. No, there's, it's a little bit more nuanced than that. Just because they are not understanding, like, ok, I need to take a moment to understand where my emotions or anger is coming from to maybe stop from just thinking I'm angry to throwing the toy. And that's where a lot of behavioral intervention comes in when it's coming to ADHD or impulsivity or these types of behaviors.

Dr. Hokehe Eko:

Wow, that's wonderful. Thank you for explaining that. And so what do you tell parents when they come to you?

Dr. Marie Dona:

and their children have these issues so when parents come to see me, I like to really get a good background about their history, kind of how they do things like basically from childhood to current or birth to current, like you know, birth history, medical conditions, family psychiatric history, all of these, all of the above, because these can definitely affect you know a kiddo in their terms of their behaviors. If there is trauma, abuse, these are huge things that can affect you know a kiddo and their behaviors. So I get a really thorough background, information, history, and then, once that's obtained, then I'll kind of ask, ok, like well, what is going on nowadays that's bringing you into seeing me? And I will say, as a child adolescent psychiatrist, a lot of times it's either behavioral concerns acting in a school, acting in at home, or, you know, issues with attention, focus, that it's actively contributing to them having issues with performance in terms of school. So then identifying what that, whatever that problematic issue is, and then seeing how they've addressed it so far, a lot of times they'll be like, oh, haven't really done anything, or screen time. So then that's when I would usually start talking about intervention. So, child adolescent, adolescent psychiatrists I am, you know, an expert in prescribing medicine, but I will always say, I always recommend behavioral interventions.

Dr. Marie Dona:

First, you know therapy, you know PCIT, play therapy, you know other types of things you know to come down to actually find out the root or the cause of the behavior. So that that's where you can potentially, you know, do things like reward charts. Reward systems are things that have a lot of evidence base for being helpful for kids who have been struggling with behavioral management, behavioral regulation, and a lot of times parents just aren't familiar with that. There are things out there like that that can be helpful with their kiddo. So those are all things that I would recommend as first, you know, first-line treatment and then typically when I would start recommending medicines is after they've already tried behavioral interventions and they haven't been working, or it's kind of plateaued or behaviors have really escalated that you know it can progress to like a safety concern, and then that's when medicines really become more of a topic of conversation.

Dr. Hokehe Eko:

Right, right, that makes complete sense and thank you for walking us through that. And so what would you say for parents Like, how do they, how would they handle things at home? How do they talk to their child about what's going on? Because I think that's a big issue that parents have. Yeah, yeah.

Dr. Marie Dona:

So usually I would recommend for parents to just have like an open and honest kind of discussion, Like sometimes parents might not give their kids enough credit to have an understanding of what they're feeling and, like you know, sometimes they might kind of just assume like, oh, they're just angry or they just have issues. But then you know, just actually sitting down with your child, Okay, like is there something going on? Is there something bothering you? Like, are there issues at school? Is someone bullying you? Are you having?

Dr. Marie Dona:

A big thing that I've noticed with kids with ADHD and even autism is that behaviors can manifest when they are frustrated with schoolwork, like they're not understanding how to do the schoolwork, they're not able to focus, they're not able to concentrate, so they get frustrated. And the only way that younger kids are able to, you know, show their, you know show that they're frustrated is by acting out, getting angry, you know, throwing things, breaking things, yelling, screaming, those types of things. And then, yeah, parents might think, oh, my kid is just being a bad kid when underlying. Oh, no, they're actually really having trouble reading for an extended period of time, or they're having a lot of trouble with math. So you know, just, I think you know, I'm really being open to discussing with their kids, like if there is something bothering them, and then taking their cue from there and then, you know, getting input from the school. I think is also really important. Important too, if teachers are having any specific concerns and then, yeah, trying to navigate from there.

Dr. Hokehe Eko:

Right, right and no. Those are really important points, because I think that even a lot of the work that can be done to help the children has to start at home, and so it's really a kind of environment. So when you're talking about teenagers and you ask them how was your day, and they say fine so how, how do you recommend to parents to get past the fine thing, fine answer and get to the, to the real crux of the matter?

Dr. Marie Dona:

so I'm going to say teenage years, pre-pre-best. You know, like pre-teen years are very difficult when it comes to communication with kids. Because I will say honestly and I have this conversation with the parents all the time too and that, like, as much as you want to be that go-to, that person that you know your teenager is going to confide in and talk to, during that time period, it's almost within developmentally normal for friends like that support group, to just kind of top the. You know the teenagers in terms of, like, who they're wanting to open up to or talk to. So this is where, okay, it is normal that you know sometimes your kids might not be wanting to go to you first, but this is where I say willingness to open the door to communication. Okay, like, I know that you might not be wanting to go to you first, but this is where I say willingness to open the door to communication, okay, like, I know that you might be just wanting to hang out with your friends or do this or that, but I'm always going to be here for you if you need anything or you know, just let me know if there's any way I can support you. And I also think you know willingness, yeah, to open the door to communication.

Dr. Marie Dona:

Being vulnerable too, like so, adhd is a diagnosis that there is high likelihood that it's heritable, like genetics. So a lot of times kids with ADHD might have a parent who had ADHD. So if a parent themselves had ADHD, saying, yeah, I've kind of struggled with the same things too. So if this is something you're going through, let us know so that we can try to help you, and just kind of keeping the door open like that, letting them know that they will always kind of have a support. Boundaries are a thing too. So you know as much as you want to be support, like if someone is obviously acting out, et cetera, like there still needs to be boundaries in place. But I think you know, just ultimately letting your teen know, or you know your kid know that you are there to be a help or support if they're needing anything and just trying to follow their cues essentially. But it is a difficult time in terms of communication, I think, just worldwide and during this time frame specifically.

Dr. Hokehe Eko:

Yes, I have one in my house, so I know. I'm a 10-year-old and, yes, I'm like what happened to my kid, okay, but sometimes it's the fine. No, yes, okay, so I get it. And yes, parents, you're not alone. There's resources to help you walk through how it gets to your kids, but just to get them the help they need. But it's so important I think I like what you said about.

Dr. Hokehe Eko:

For me, I like to say it as speaking life to your kid and just reminding them who they are, who you see them as, who you love them, even when it feels like you can't reach them, they are listening and I found my own limited experience, especially when it's like when she, when she's acting like oh, she doesn't need you, she really they still, they still need you yeah yes, and and when you just keep being consistent and telling them that you love them, regardless of the behavior, it doesn't mean you're condoning the behavior, but they still need to know their love, because that's like the bedrock foundation, because if anything is going to pull them out of that, it's going to be that they know their love, because that's like the bedrock foundation, because if anything is going to pull them out of that, it's going to be that they know their parents love them. So I think it's important.

Dr. Marie Dona:

Yeah, definitely. So I've heard, you know, from all ends of the spectrum. So I've actually had families I've worked with that you know. They've gone through the teenage years but then they've seen the other side of it. It's like I've had also patients that themselves like I remember like oh, I actually talked with my mom and I was like yeah, mom, dad, why, I don't know why I didn't talk to you for like four years but like all of a sudden this like light bulb goes off and they're like I have no idea why I didn't want to talk to you for four years, but I guess it's okay now and then now they have a good relationship.

Dr. Marie Dona:

But I would say like this is honestly where I think it is within the realm of normal. But like everything you said, showing that you love, care, support them kind of regardless if they need anything. But you know, also understanding that this is a time that sometimes they are kind of wanting and needing their distance to you. But just know it's not anything that you are doing as a parent, like it's just something that does kind of happen within these developmental years.

Dr. Hokehe Eko:

Yes, and so what would you say to those parents who they go to the health care professional and they're not quite able to get the help or support that they need for their kids? Maybe it's oh, it's just normal, They'll get through it. What are the questions or what kinds of things should they be saying to their providers to get the help they need?

Dr. Marie Dona:

So I guess this is where a lot of times it can be normal but at the same time too, you know, some of these things might not be as normal.

Dr. Marie Dona:

So I know that a lot of times when they when you know kids, teenagers, might be seeing their pediatrician or PCPs, they'll do kind of screening exams like GAD-7 for anxiety, phq-9 for depression, like those types of things.

Dr. Marie Dona:

So this is where you know, taking those questionnaires seriously and if they're scoring high enough on the threshold, talking, you know, having the kid talk with their PCP or their pediatrician about these issues.

Dr. Marie Dona:

And I will say so, I work in a lot of different, so I have my own private practice, but I also did a lot of like emergency, like child, child, adolescent, teen, er work and it's kind of funny how, like sometimes the teens won't want to talk with their parent about the issues but then they will meet me a complete stranger and they'll feel like because this is, like you know, someone who is completely unbiased outside of the relationship that they can be open and honest. So if this is where you know a parent is concerned, they can always I think I would still encourage them, you know, to bring them in for an evaluation and like you know, if they're, you know preliminary screening PHP 9, gad 7, you talk isn't raising any red flags, that's where you know pediatrician, pcp, psychiatrist can provide that reassurance. But you know, if after a conversation with their kid there are additional concerns, that's where it might be worth warranted for a further evaluation and potentially having their kiddo talk with another mental health provider.

Dr. Hokehe Eko:

Yes, and parents, I want you to know that you're the first and best advocate for your child. So, even if there's a screening form and, based on the way you answer it, it doesn't quite, your child doesn't meet threshold. It's important for you to be honest with the doctor and see exactly what's going on, because that's the only way you're going to be able to get the referrals as need. I mean, depending on what's going on, what's your insurance and all of that is to get the help that your child needs. So it's just don't be ashamed of it. It's nothing to be ashamed of you. It's important that your child gets the help they need yeah and like.

Dr. Marie Dona:

so, while you know, while we're talking here, like we are both, you know, medical professionals, right, we're kind of familiar with, like within norman, what's not, but parents, like, it's okay if you don't know exactly what is normal. That's why it's okay to reach out for help, you know, touch base with your doctor, touch base with your pediatrician, pcp, and ask the questions, bring up behaviors, and that's where they can. You know, not every case is the same, right, so there's different scenarios, different situations and that's where your medical professional can advise you one way or the other. Right, absolutely.

Dr. Hokehe Eko:

Wow. So I like to ask all my guests to give us last minute brain health tips for both the parents and the kids. So do you have any you'd like to share?

Dr. Marie Dona:

Last minute brain health tips.

Dr. Marie Dona:

So do you have any you'd like to share Last minute brain health tips? So I'm all about so. Psychiatrists prescribe medicines, but I'm all about, you know, the holistic treatments as well too, like nutrition, like good, you know, making sure that someone is getting healthy nutrition, sleep, sleep hygiene as much as possible. And I'm going to say the teen years are especially hard. It's a conversation I have all the time with my patients and clients, right, and physical activity.

Dr. Marie Dona:

These are all huge, foundational things that there's so much evidence that like and I'm all about homeostasis too that if one of these things are off, like bad nutrition, poor sleep habits, you know, limited physical activity these are all things that will, you know, can impair mental health. Yeah, physical, medical, mental health, brain growth and overall development. So this is where, you know, people are seeking help, behavioral interventions, therapy, medicines. But I always go back to the basics first and like how's your sleep, how's your? You know, how's your diet? Okay, what are things that we can do to tweak here to make them just that much better? And you know, these are things that, like, they might seem so small, and you know, minuscule, but can make a world of difference in overall helping someone with any and basically anything right, Like any mental health condition, autism, adhd, like basically everything.

Dr. Hokehe Eko:

So so that's my basic, fundamental go-to from here I love it so before the listeners, where they can find out more about your practice okay, yeah, so my practice name is uh donna wellness clinic, so you can reach me through.

Dr. Marie Dona:

Our website is www. donawellnessclinic. com. We have a bunch of social media that handles it's all dona wellness clinic likecom. We have a bunch of social media that handles it's all Donna wellness clinic like facebook. com slash Dona wellness clinic. Instagram. com slash Dona wellness clinic. I am physically located in Riverview, florida, but yeah, I'm able to see patients virtually all throughout the state of Florida, pennsylvania, new York and Washington DC, and we are taking new patients now.

Dr. Hokehe Eko:

Yay, wonderful. So thank you so much, Parents, go check out her YouTube page. If you need her services, reach out. And so thank you so much again for coming on here.

Dr. Marie Dona:

Dr Dona, Thank you so much for having me.

Dr. Hokehe Eko:

This was great Everyone until the next episode, have a wonderful day. Please share this with somebody that you feel needs to hear this. Take care.