Ep 22: Studying for GAMSAT with ADHD

Mare Forfa (00:00)
Welcome to our next episode of Nurses Doing GAMSAT. I’m super excited because I’m not here by myself—I have a very, very special guest today! I’d love to introduce you all to Xena. She’s an expert in helping adults navigate ADHD, especially in high-pressure situations like study and career transitions. She’s worked with hundreds of students and professionals to help them really unlock their focus, manage overwhelm, and actually enjoy the process. Because, let’s be honest, that can be a thing, right?

The other thing I love about Xena is she’s a very proud cat owner—just like myself! We were just showing each other… well, I just showed her my cat Gracie, who, if you’ve been following along on the show, features pretty heavily. I’m so, so happy to welcome you, Xena. Welcome aboard!

Xena (00:37)
Mm-hmm. Thank you. I am so happy to be here. It’s an absolute pleasure—and I have to say, it was such a pleasure to meet your cat. Yes, I am a self-proclaimed crazy cat lady. Like, obsessed. Right?

Mare Forfa (01:07)
Me too, yes!
I have this little knit jumper and it has cats on it. Every time I wear it out, everyone’s like, “The cat knit’s out!” And I’m like, look—I love my cat. It’s not my actual cat on the knit, but still.

Xena (01:23)
Oh my gosh, I so need one of those! It reminds me of a funny Christmas gift I got my partner one year—you can get t-shirts made with your face on them, right? I got him some socks with my face plastered all over them. I was thinking, you could probably do the same thing with your cat. Just saying.

Mare Forfa (01:34)
Yeah!
I’m gonna need that website. Tom, if you’re watching this, this is what you’re getting for Christmas this year.

Xena (01:44)
Yes. Love it.

Mare Forfa (01:50)
I love it. I’m so happy to have you here because I know we’re going to talk all things ADHD. Tom and I have been doing this for a long time—about 18 years now—and we get questions all the time about how to study better, how to focus better, especially with ADHD. And I mean this from both a diagnosed and undiagnosed perspective. There are so many people who say…

Xena (01:57)
Mm-hmm.

Mare Forfa (02:17)
…“I think I might have ADHD, but it’s so hard to get diagnosed. It’s so expensive, it takes so long.” And honestly, my personal opinion is: if you think you have ADHD, and the techniques help you focus, then who cares whether you’re formally diagnosed or not? If it works, it works.

Xena (02:26)
Yes. A hundred per cent. I think self-diagnosis is equally valid, right? If you think you probably have ADHD—and as you say, the waitlists are massive, the costs are high—just operate as if you do. What would you do if you were diagnosed? You’d learn more about it. You’d start working with your brain, figuring out how to increase focus, manage procrastination, all that. So yes.

Mare Forfa (02:45)
So tell me—what are some of the ways ADHD can show up in adults, especially in high-pressure situations? Because the GAMSAT can feel like the weight of the world is on your shoulders, and I think it exaggerates who you already are inside. What are some signs people can look out for?

Xena (03:18)
Yes, totally. So the first thing I’d say is when your intentions don’t match your actions—that’s classic ADHD. Like, you intend to study after work every night this week, and then you get to Friday and you’re like, “Shit, I haven’t studied.” That disconnect is classic.

Other signs are difficulty retaining information—maybe you’re reading something or listening in a meeting, but under pressure, it all goes out the window. You forget what you just read or what someone said.

Also, difficulty learning traditionally—like just hearing or reading something doesn’t stick. We often need stories or visuals to hold onto and remember info.

Emotional outbursts are another one. People might say, “I just can’t do this!” They shut down, cry in their car, feel super overwhelmed. That’s emotional dysregulation, which we’ll definitely talk more about.

Then there’s the issue of needing looming deadlines. We’re great in crises. Give us a deadline—we’ll stay up all night and smash it. But without it? Productive procrastination kicks in. We’ll clean the kitchen sink but not touch our study notes.

Mare Forfa (05:28)
We’re…

Xena (05:50)
…also in a constant state of fight or flight. I work with a lot of people diagnosed later in life, and they often say they’ve felt on edge their whole lives—always waiting for the other shoe to drop. That hypervigilance is really common.

Mare Forfa (06:17)
If I had a checklist of what I hear from students all the time, that would be it. “I know I need to do this, but I just can’t make myself do it.” Years ago, in our paid Bootcamp program, we introduced weekly accountability because we realised that having a looming deadline and someone to kick your butt if you don’t do the work actually gets people doing the work. I thought that was just a human thing, not an ADHD-specific thing.

Xena (06:49)
Yeah, yeah. Here’s the thing—ADHD doesn’t create new problems; it makes common problems extreme. Everyone procrastinates sometimes. Everyone has trouble focusing sometimes. But for ADHDers, it’s constant. There’s a saying in the community: “Everybody pees. But if you pee 50 times a day, maybe get it checked out.” That’s ADHD—it’s the frequency and the intensity.

Mare Forfa (07:43)
Yes, 100%. What I’m hearing you say is that it becomes consuming—it’s overwhelming. And that’s super common in nurses and healthcare professionals, and even for those who aren’t. So what can we actually do about it? What are some simple, practical things?

Xena (08:20)
Great question. So ADHD brains have less dopamine, norepinephrine, and serotonin. Dopamine helps us feel motivated to act. Norepinephrine—basically a fancy way to say adrenaline—helps with attention and focus.

If you want to overcome procrastination, you need to boost those chemicals. Exercise is amazing for this. And I don’t mean an hour at the gym—just a 10-minute walk around the block in the sunshine can be enough.

Mare Forfa (09:29)
Ten minutes? Really? That’s it? Can we tell my PT this? Because I can do ten minutes! I love that. Everyone can squeeze that in—even after dinner. It’s good for digestion too.

Xena (09:48)
Exactly. Or even cold water therapy—jump in the ocean or have a quick cold shower. Two minutes is enough. It activates those brain chemicals and supports executive functioning—helps with focus and follow-through.

Mare Forfa (10:17)
I love that.

Xena (10:19)
Another big one is body doubling. That’s when you work in the presence of someone else, even if they’re not doing the same task. It’s a form of accountability. I go to cafés to work—I feel like all the strangers are watching me, so I have to be productive. It also helps to remove distractions—like our phones. ADHD brains are always seeking dopamine, so we go to our phones for a hit. But locking your phone in a box, or using an app blocker, really helps.

Xena (11:47)
Know your distractions. Maybe it’s your phone. Maybe it’s the people walking past your window. If so, get a curtain. Just knowing and limiting those distractions helps.

There’s also a framework I love called NICU—Novel, Interesting, Challenging, Urgent. If a task has any of these four elements, your brain is more likely to cooperate. For example, I don’t love writing, but if I dictate while walking (novel and interesting), go to a café (again, novel), and leave my laptop charger at home (urgent!), I get it done. Get creative.

Mare Forfa (13:26)
100%. We do these live skills drills called acceleration classes in the lead-up to the exam. I always say, “You’ll do more when I’m there than when I’m not.” Just come live. You can watch the recording later, but if you’re there live, you’ll be switched on. We once had students write four essay intros, and the tutor pulled them apart live within an hour. That kind of accountability is powerful.

Xena (13:32)
Ooh, I love it. That’s novelty. That’s challenge. And it’s community.

Mare Forfa (14:22)
I also love seeing what everyone else is doing. That’s the Mrs. Mangle in me. Anyone who watched Neighbours in the ‘90s knows—Mrs. Mangle was always looking out the window, checking on the neighbours. Sometimes a little nosiness is motivating!

Xena (14:31)
Yes! It’s that novel and interesting part—“Ooh, what did they do? How did they do that?”

Mare Forfa (15:00)
When your brain is wired differently, you’ve got to do things differently to light it up and get into action.

Xena (15:04)
Exactly. ADHD brains are wired differently. The goal isn’t to try harder—it’s to try different. You’ve got to do what works for you.

Mare Forfa (15:24)
So many students—well, not my students, but the ones who come to me after a few failed attempts—say things like, “I sat the exam three times. The first time, I didn’t study. The second time, I studied a few weeks before. The third time, I tried again but stuff came up, so I only really studied the last couple of weeks.” And I’m like… this isn’t just bad luck. That’s a pattern.

Xena (15:54)
Yes, 100%. And that’s where something like NICU is so valuable. It’s not just about urgency—it’s about adding interest and novelty too. Mixing it up. And what I love about your program is that it seems to include all of those elements: novelty, interest, challenge, and deadlines. It’s external accountability plus community. That’s exactly what someone like him needs.

Mare Forfa (16:40)
Yeah.

Xena (16:43)
One other thing I want to add when we talk about procrastination is the emotional piece. Often when someone is procrastinating, I ask them: what are you feeling? Let’s say it’s study you’re avoiding—how do you feel when you think about studying? Is it anxiety? Dread?

Mare Forfa (16:44)
Yeah, fun, definitely.

Xena (17:12)
Because our emotions drive our actions. When we feel motivated, we get things done. When we feel dread, we avoid. So noticing those emotions is key. For people with ADHD, regulating those emotions is essential.

Mare Forfa (17:22)
Can I ask a question? It goes back a step, but—how do we know what we’re feeling? I feel silly asking that as a 40-year-old woman, but real talk—how do we actually do that?

Xena (17:33)
That’s such a good question, and I’m glad you asked it. We didn’t learn this stuff at school. I didn’t have a class that taught me how to identify emotions, what they feel like, or what to do with them.

The first step is noticing sensations in the body. For me, when I’m anxious, my chest gets tight, my palms sweat, my thoughts race, I feel on edge. When I feel dread, I shut down—I don’t act. Like when you set a 6am alarm to run and then snooze it every day? That’s dread. So you can look at your physical symptoms and also your behaviours. What are you doing—or avoiding?

Mare Forfa (20:22)
Yes, totally. From work I’ve done, I’ve realised that especially for women, culturally, we’re often only “allowed” to feel one emotion—sad or angry. I was never allowed to be sad as a kid, only angry. So now, as an adult, I have to ask myself: am I actually angry, or am I sad and just don’t know how to be sad?

And sometimes I need to physically get the anger out—punch a pillow, scream under the ocean—and then I realise I’m actually just sad underneath. Sitting with that emotion is hard.

Xena (21:27)
That makes so much sense. If you were taught it was unsafe to feel certain emotions, you suppress them. The messaging we get—“cheer up,” “you’re fine,” “get over it”—teaches us to stuff it all inside. So we disconnect from our emotional experience. Allowing, acknowledging, or naming emotions can feel like a completely foreign concept.

Mare Forfa (22:22)
Especially with dysregulation. And this whole GAMSAT journey can be such a rollercoaster—you do well one day, then feel like you’ve learned nothing the next. How do we manage those ups and downs, especially with ADHD?

Xena (22:52)
Learning emotional regulation is life-changing. It really is.

When ADHDers become dysregulated—say, you’re anxious about the exam or angry about a practice test result—it’s like the power gets cut off to your prefrontal cortex, the part of the brain responsible for executive functioning. We already have challenges there with planning, prioritising, regulating emotions, paying attention. But in that moment, the brain goes into survival mode: “I’m in danger!”

And the trigger can be something simple, like a long to-do list that feels overwhelming. So the first step is understanding what’s happening in your brain and learning how to calm your system down.

Mare Forfa (24:27)
Yeah. That makes sense.

Xena (24:43)
Once you’re aware of that, you can start navigating the rollercoaster more calmly. When you’re dysregulated, you get scattered, jump from one thing to another, don’t finish anything. You seek dopamine—scrolling, Netflix, snacking, comfort shows like Grey’s Anatomy—because it’s familiar and soothing.

So the key is first recognising when you’re dysregulated. Your body sends little alarms. You might start rushing, pacing, getting scattered. Pay attention to those signs. I have clients make a list of their personal “dysregulation signals”—if you track it for a week, you’ll notice so many.

Mare Forfa (26:48)
You’re describing my life! Is this a therapy session for me? Because it’s starting to feel like one.

Xena (26:54)
I’ve been watching you with a hidden camera! I’m kidding.

Mare Forfa (26:59)
Ha! Legit though, I’m babysitting at the moment, and the dog is so soothing. I was feeling really anxious the other day, and I just patted the dog and it instantly calmed me down. Definite dopamine hit.

Xena (27:20)
Yes! That’s co-regulation—when another person or even an animal helps us calm down. It’s incredibly soothing. Cats are the same—when they purr, it has a calming effect on the nervous system. Studies have shown that. A purring cat on your lap is like a weighted blanket. It’s the best.

Mare Forfa (28:06)
That also explains my marriage! My husband is the calmest person I know. When he worked in the emergency department, nothing fazed him. He’d revive someone and then move on to the next patient like, “Alright, all good.” Meanwhile, I’m bouncing off the walls. He’s the calm in my storm, and I bring the spice!

Xena (28:36)
Yes! Same here—my partner is the calm and I am the storm. Life without the ADHD energy would be so boring!

Mare Forfa (28:45)
Exactly. We play an integral role in life. We just need a bit of help with regulation. I’m not diagnosed with ADHD, but everything you’re saying is resonating. So much.

Xena (29:03)
For sure. That brings us to step two of regulation: engaging in activities that help you feel calm and safe. Because when we’re dysregulated, we don’t feel safe—things feel out of control.

Spending time with someone you love, breathing techniques—these are so powerful. I love the physiological sigh: a deep inhale, a little extra inhale on top, and then a long exhale. It tells your brain, “You’re not in danger. You’re okay.” If someone were actually chasing you with a knife, you wouldn’t be able to sigh. So this type of breath communicates safety to the brain.

Mare Forfa (31:00)
Yes, 100%. Years ago, I learned about breathing techniques, but some were 30–40 minutes long. And I’m just not going to do that every day. So I found five-minute breathing exercises on Spotify, and they changed my life. I now do them almost every day—five minutes before bed.

Xena (31:18)
Yes! Five minutes is a win. Love that.

Mare Forfa (31:28)
I feel so good after doing it that there’s no point skipping it. Even now with a cold—I woke up this morning with a tissue stuck up my nose—but because I’m congested, I can’t do my usual nostril breathing, and I can feel the difference.

Xena (32:29)
Yes! That bilateral stimulation where you breathe in through one nostril and out the other—it’s amazing for regulating. Tapping your fingers to count is a great technique too.

Mare Forfa (33:13)
Exactly. I do it eight times and keep count with my fingers. It’s not magic. Anyone can do it. It’s simple, but so effective. By the time I get to six, I feel so different.

Xena (33:16)
Yes! It’s not rocket science—just back to basics.

Mare Forfa (33:43)
And doing extra is fine—it won’t hurt you.

Xena (33:46)
Exactly. And you can do it while driving, on your commute—stack it with something else. No extra time needed. I’m all about those low-effort techniques.

Another one I love for ADHD is EFT tapping—the Emotional Freedom Technique. Are you familiar with it?

Mare Forfa (34:26)
Yes! I’ve never mentioned it on the show, but I’ve taught it before. It feels a bit woo-woo, but I don’t care if it works.

Xena (34:46)
Exactly! The first time I did it I thought, “What the actual fuck is this?” You’re tapping on your face, collarbone, head—it’s weird. But you’re putting words to your emotions while doing something physical, and for ADHDers who need to “do,” that’s gold.

Mare Forfa (35:33)
Yes!

Xena (35:39)
The science behind it is unreal. I just do five minutes at a time. I even do it walking now—I don’t care what people think. I always say: try it. If you hate it, never do it again. But if it helps, then awesome. I’ve never had someone say, “That was terrible.”

Mare Forfa (35:57)
It’s so good. If anyone listening wants to try, just Google EFT tapping. You’ll find diagrams. It looks a bit strange, but who cares if it works?

Xena (36:02)
Exactly. The research supports it—just give it a go.

Mare Forfa (36:23)
In our mindset classes, which we run nine or ten weeks before each exam, we do a guided meditation with our students. Everyone joins in because it’s live and they don’t have to do it alone. I might add EFT this round too—it’s such a good idea.

Xena (36:52)
Please do! I’d love to hear how it goes. It’ll be fantastic.

Mare Forfa (37:18)
Yeah, because visualisation is one thing, but emotional regulation is life-changing.

Xena (37:24)
Exactly. Especially for exam day. You’re going to be nervous. You’ll probably get a question you’ve never seen before. Having these tools helps you dial the anxiety down so you can keep going.

Mare Forfa (38:06)
Absolutely. The GAMSAT isn’t content-based—it’s skill-based. You could read a whole book, and they’ll test you on something completely different. There will always be a question that stumps you. But if you don’t let that one question ruin your flow, you can focus on the ones you do know.

Xena (38:41)
Yes. Yes.

Mare Forfa (39:05)
One of our tutors once said, “You don’t lose marks for getting a question wrong. You only gain marks by getting them right.” He got in the 80s and didn’t even finish the exam—he just made sure every question he answered was correct.

Xena (39:43)
That’s brilliant advice. Expect the unexpected.

Mare Forfa (40:03)
Exactly. And emotions are part of that. Like public speaking—you don’t wake up feeling amazing. You wake up thinking, “Why did I agree to this?” But if you expect those emotions, they’re easier to handle.

Xena (40:22)
Yes! Greet those emotions like, “Oh hey, Dread! I expected you.”

Mare Forfa (40:56)
Exactly. Tom once played Celine Dion and Mariah Carey on the way to a lecture because I was feeling off. Within five minutes, I was singing and in the zone. Music is such a great regulator.

Xena (42:03)
Totally. Movement, music, cold showers—stack those dopamine hits on the day of the exam. Set yourself up for success.

Mare Forfa (42:42)
I once had to do five-minute cold showers during winter for a challenge—hated it! But I timed it with the Cardi B song “Up,” and by the end, I felt unstoppable.

Xena (43:19)
Yes! Play songs that fire you up. I love that.

Mare Forfa (43:55)
I can do Celine and Cardi. Bit of range! Beyoncé’s Formation would work too.

Xena (43:57)
Yes! I do little office dance parties to Katy Perry’s Roar before classes. Gets me pumped.

Mare Forfa (44:17)
So good. Last question—any final exam day tips?

Xena (44:20)
Yes—self-compassion. Don’t treat yourself like an arsehole. Honestly.

Mare Forfa (44:45)
That doesn’t sound familiar at all. Not me with the trash self-talk. Nope. Never. Ha!

Xena (44:51)
Be on your own team. You wouldn’t say to a friend, “Suck it up.” You’d say, “You’ve got this. I’m proud of you. No matter what happens, I’ve got your back.” That’s self-compassion.

Mare Forfa (45:29)
Life-changing advice. And honestly, this exam teaches you more than science or poetry. It teaches you resilience, emotional regulation, self-compassion—all things that make you a better doctor.

Xena (46:30)
Yes, 100%. One more tip: ask yourself empowering questions. Don’t spiral with, “What if I fail?” Instead ask, “What if it all works out?” or “Even if I mess up, how will I take care of myself?” Reframe those thoughts.

Mare Forfa (47:26)
Yes—“How can I walk away from this feeling proud?”

Xena (47:49)
Exactly.

Mare Forfa (47:52)
Tony Robbins says the quality of your life is determined by the quality of your questions. That stuck with me for years.

Thank you so much for being here today. This has been such a pleasure. I’ve had so much fun—thank you for indulging me and listening to my cat stories!

Xena (48:20)
Anytime. Cat stories are always welcome.

Mare Forfa (48:27)
Let us know where we can find you!

Xena (48:27)
Yes! Our website is navigatingadultadhd.com. It’s also the name of the podcast—Navigating Adult ADHD. We’re on Instagram, Facebook, all the usual places. Come hang out!

Mare Forfa (48:47)
Love it. I follow you and see your posts and think, “That is 100% me.” You get me.

Xena (48:53)
Memes are my love language. And I share real moments too—like tripping on stairs with two drinks and wearing my coffee before a meeting. That’s life!

Mare Forfa (49:27)
Oh my god—once I tripped down an entire staircase at a formal event in a ball gown. My friends said, “Don’t worry, no one saw.” But two hours later, I was in the toilet stall and heard girls saying, “Did you see that girl fall down the stairs?” I was trapped!

Xena (49:45)
Now you can’t leave the bathroom! That’s the stuff I post. So relatable.

Mare Forfa (49:55)
Just relived that moment. I need to go regulate emotionally now.

Xena (50:08)
Go cuddle your cat.

Mare Forfa (50:09)
Thank you! This was so fun. Everyone, check out navigatingadultadhd.com, and we’ll be back with more GAMSAT goodness soon. Bye for now!

Xena (50:27)
Thanks, everyone!