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Dr. Iris Manor on ADHD, Trauma, PTSD, and Resilience: Risks, Mechanisms, and Treatment

The host interviews Dr. Iris Manor, a child and adolescent psychiatrist and ADHD researcher, about links between ADHD and traumatic stress disorders, including a Denmark study finding children with ADHD are about 11 times more likely to develop PTSD. Manor distinguishes trauma exposure from traumatic stress disorders and describes behavioral risk (novelty-seeking, impulsivity) and shared neurobiology (hippocampus/ventromedial prefrontal networks, inflammatory cytokines), including possible transgenerational effects of maternal trauma. She argues ADHD and traumatic stress are usually separate but interacting diagnoses, and emphasizes resilience through structure, goals, and avoiding helplessness, noting ADHD makes these harder. She warns clinicians often stop stimulants after trauma despite potential benefit, recommends treating ADHD (and parents’ ADHD), and highlights emotional dysregulation requiring treatment (often guanfacine) to enable ADHD and trauma care. The discussion also covers overlap with chronic pain/fibromyalgia and long COVID, autism-related vulnerability, and disagreement with claims that ADHD is primarily caused by trauma.

00:00 Trauma and ADHD Link
03:11 Why Risk Is Higher
04:02 Biology and Inflammation
08:04 Which Comes First
09:49 Types of Trauma Examples
11:52 National Trauma Risk Groups
15:14 Covid and Chronic Pain
20:42 Resilience Rules and Structure
22:20 Treat ADHD During Trauma
26:39 Family Screening and Care
31:12 ADHD Impact on PTSD Treatment
33:33 Emotional Dysregulation Hierarchy
35:51 Guanfacine for Dysregulation
38:36 Autism Risk and

Click here for the YouTube channel

International Conference on ADHD in November 2025 where Dr. Lenz will be one of the speakers.

Joy Lenz

Fibromyalgia 101. A list of fibromyalgia podcast episodes that are great if you are new and don't know where to start.

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...

Text Dr. Lenz any feedback or questions

Abdominal Migraines, Weather, and Early Fibromyalgia Clues: Pediatric Case and Listener Feedback

The episode shares insights on fibromyalgia-related problems with a focus on the role of weather and activity in flareups and how symptoms can begin years before an adult fibromyalgia diagnosis. A pediatric case is presented of a 10-year-old boy with intermittent severe upper abdominal pain lasting hours to a day, nausea without vomiting, reduced appetite, and mild to moderate headaches, with no red-flag symptoms (no fever, diarrhea, bloody stools, weight loss, rash, bruising/petechiae, or joint swelling) and a normal physical exam. Family history includes migraines (maternal aunt), fibromyalgia (maternal grandmother), and restless leg/growing pains (father). The diagnosis is abdominal migraines, and the discussion emphasizes treatment approaches including restoring consistent exercise (noting a drop in activity during winter after basketball season), improving sleep regularity, considering coexisting restless leg syndrome and iron deficiency, maintaining a healthy diet, and screening for stressors and untreated ADHD. The episode also discusses how colder weather and shorter days can reduce activity and contribute to symptom worsening, and recommends tracking steps and adapting with indoor activity or appropriate clothing; it notes that extreme cold or heat can trigger fibromyalgia pain flares. Listener feedback includes praise for a five-part ADHD series with Dr. Dodson and a question about finding fibromyalgia care in Tampa, Florida, with guidance to start with primary care and noting rheumatologists often diagnose fibromyalgia after ruling out inflammatory disease.

00:00 Episode Overview
00:37 Pediatric Case Setup
01:54 Key History Questions
04:43 What Changed This Winter
06:42 Exam Findings
07:45 Diagnosis Abdominal Migraine
08:31 Treatment Basics
10:19 Weather Exercise Connection
14:56 Fibromyalgia Early Clues
15:49 Listener Feedback Q&A
16:42 Finding Fibro Care
17:53 Wrap Up and Goodbye

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...

Text Dr. Lenz any feedback or questions

The Hidden Fibromyalgia Epidemic: How Bias Leaves Millions Undiagnosed—and How AI Can Help

The script explains fibromyalgia as a chronic, long-term condition marked by widespread pain, profound fatigue, cognitive difficulties (“fibro fog”), and related mood issues, affecting an estimated 2–4% of the U.S. population (7–14 million) but potentially far more due to underdiagnosis. It describes how the condition is often missed because it is “invisible,” lacks definitive objective tests, and commonly leaves patients in diagnostic limbo for about five years while being dismissed as stressed, depressed, or imagining symptoms. Although the 2016 American College of Rheumatology criteria rely on the Widespread Pain Index and Symptom Severity Score, the script argues diagnosis often fails at the moment clinicians don’t suspect fibromyalgia—driven by longstanding gender and age stereotypes that frame it as a middle-aged women’s disease. It highlights research showing that unbiased application of criteria yields a much closer gender split (about 59% female, 41% male), and that many more men report symptoms than receive diagnoses. The script centers on a study of over 21,000 pain-clinic patients who completed tablet questionnaires with a digital body map; an AI clustered pain patterns into nine groups and identified a “widespread heavy” cluster strongly associated with fibromyalgia, where patients were nearly 30 times more likely to have a fibromyalgia diagnosis than those with low back pain. Yet more than two thirds of patients flagged by the AI lacked a clinical fibromyalgia diagnosis; an objective “informatics proxy” applying the formal criteria found 66.3% of the widespread-heavy cluster met diagnostic criteria, while only 22.4% were diagnosed. The missed patients were more likely to be male and older, demonstrating diagnostic bias. Extrapolating from these findings, the script suggests the true U.S. population meeting criteria could be 21–42 million. It proposes integrating digital body maps and machine-learning alerts into clinic workflows to prompt unbiased evaluation, while emphasizing existing tools already work if applied. The script also frames fibromyalgia as nociplastic pain (central nervous system hypersensitivity), w

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...