Actually ADHD | Medication Strategies & Clinical Wisdom

Jonathan Murphy, PMHNP-BC
  • 5.0 (2)
  • Medicine

Adult ADHD from the board-certified PMHNP behind the YouTube channel Focus Path and the book The Process. Clinical perspective on medication, frameworks, and the conversations the internet hasn't been having.

  1. 6h ago

    Re-introduction & My Holistic Philosophy Regarding Psychiatric Medication

    Jonathan Murphy, PMHNP-BC, on where Focus Path came from, what he's learned building 114 videos, and then the long version of how he actually thinks about psychiatric medication. Part backstory, part media literacy, part clinical framework. In this episode: ▸ Why the practice is called Focus Path ▸ YMYL, Your Money or Your Life, and what it does to creators in health and finance ▸ Why most listeners turn out to be seasoned healthcare professionals ▸ Being reinforced into the outsider role, and what that costs and buys ▸ Self-regulation after 25, and why dysfunctional families dysregulate together ▸ Big tech vs. the old guard: licensing boards, academics, hospitals ▸ Four DEA licenses, four state licenses, board certification — and what that's worth to a platform ▸ 233 days on a health shelf application ▸ Rules for creators in 2026: don't scroll, use a computer, protect the creative energy ▸ The medication framework starts here ▸ Why medication does less than the internet thinks ▸ Florence Nightingale and the immediate environment as the greatest determinant of health ▸ Specialization and why the body isn't actually divided into departments ▸ What medication does: mimic, enhance, or block something already happening ▸ Nervous system, limbic system, and the speed of emotional perception ▸ Attachment needs before and after 25 ▸ High arousal and low arousal, and what sits between them ▸ Emotional maturity as the ability to read your own signals ▸ Alpha and beta states, EEG, and electrical irregularity ▸ Why the early twenties is when things surface ▸ The patient who only wants ADHD medication ▸ Anxiety causing executive dysfunction vs. executive dysfunction causing anxiety ▸ Dopaminergic vs. serotonergic: what each is for ▸ Why prescribers who won't prescribe stimulants get frustrated ▸ The chemical imbalance myth, stated precisely ▸ The Russian doll: mood on the outside, ADHD in the middle ▸ Why you don't start an SSRI in a depressive polar state ▸ The diagnostic quality of prescribing ▸ What medication can do for someone who won't leave a toxic environment ▸ Mood stabilizers, antipsychotics, and who they're actually for ▸ Why medication is never a replacement for boundaries 📕 The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T 📗 Cheat Codes — https://www.amazon.com/dp/B0FMJLQKBW ⚠️ This episode is for educational purposes only and is not a substitute for professional medical advice. It is not a treatment recommendation for any individual. Never start, stop, or change a psychiatric medication without your prescriber. If you are in crisis, call or text 988. Jonathan Murphy, PMHNP-BC | Focus Path Licensed in MA, NH, WA, OR | NPI 1821441965 Board Certified | ANCC 2017007119 CHADD Professional Member | ADDitude Professional Directory 🎥 https://www.youtube.com/@focuspathsystems 🔗 https://myfocuspath.com 🔗 https://www.myfocuspath.blog 📧 https://mailchi.mp/myfocuspath/focus-path-pmhnp

  2. 2d ago

    The Internet Is Not Real Life: Gatekeeping, Social Media Ethics, and the Performance of Authority

    Jonathan Murphy, PMHNP-BC, gets feisty. Media literacy, the performance of authority online, and why he's been documenting everything. Part catharsis, part warning for any clinician thinking about doing this. In this episode: ▸ Why clinicians and social media ethics needs an actual conversation ▸ Representing yourself as your license, and what scope of practice means online ▸ The duty to educate first — and why the goal isn't the money ▸ A LinkedIn exchange about rejection sensitivity dysphoria as an online-origin diagnosis ▸ Neurodiversity as an identity and activism term vs. neurodevelopmental disorder as individual psychopathology ▸ Why you can get a diagnosis, treat symptoms, and meet your goals without joining a movement ▸ Critical theory as a tool, not a conclusion ▸ Psychology as philosophy, and why how you think is governed by schools you may not know you're in ▸ William James, Freud, and the 19th century handoff from religion to science ▸ The Natural History Museum as cathedral, and the secular church ▸ Myth means story, not falsehood — and story is what carries people ▸ Shadows on a cave wall, and the oldest medium there is ▸ The novel, mass printing, and how ideas got cheap to spread ▸ The performance of authority: the white coat, the razzle-dazzle, "look at this study" ▸ Parasocial connection, and why a book feels different from a feed ▸ Why live streams and tips are a structure he won't build ▸ Erikson, generativity, and what the 40s are for ▸ Making content in an empty room for a year without knowing why ▸ The roast video, and why culture commentary is a trap ▸ The pitch underneath anti-psychiatry content: don't go to the doctor, buy my course ▸ Emerson, self-reliance, and taking accountability instead of waiting for utopia ▸ Why YouTube is an entertainment platform and pretending otherwise is silly ▸ Being told to put your credentials in the bio, and not being used to the pedestal ▸ 113 videos, a 224-day health features application, and the documentation ▸ Why ADHD isn't something to identify with ▸ Morbid curiosity, the void, and what the DSM says about screens "The internet is not real life." 📕 The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T 📗 Cheat Codes — https://www.amazon.com/dp/B0FMJLQKBW Referenced: Max Horkheimer and the Frankfurt School — critical theory William James, Sigmund Freud — the origins of psychology Erik Erikson — psychosocial development, generativity vs. stagnation Ralph Waldo Emerson — Self-Reliance (1841) Marshall McLuhan — the medium is the massage Charles Darwin, the 19th century shift from religious to scientific worldview ⚠️ Educational purposes only, not a substitute for professional medical advice. If you are in crisis, call or text 988. Jonathan Murphy, PMHNP-BC | Focus Path Licensed in MA, NH, WA, OR | NPI 1821441965 Board Certified | ANCC 2017007119 CHADD Professional Member | ADDitude Professional Directory 🎥 https://www.youtube.com/@focuspathsystems 🔗 https://myfocuspath.com 🔗 https://www.myfocuspath.blog 📧 https://mailchi.mp/myfocuspath/focus-path-pmhnp

  3. 3d ago

    Why I'd Tell Most Clinicians Not to Start a YouTube Channel

    Jonathan Murphy, PMHNP-BC, on his path from private practice to 113 videos, and why he'd steer most licensed professionals toward a microphone instead of a camera. This one is for clinicians, nurse practitioners, lawyers, bankers, and anyone with a license and an audience they can't reach. Part origin story, part warning. In this episode: ▸ The duality between practicing in the real world and what the scroll looks like ▸ "You need to get this out there" — the thing patients say to every practitioner ▸ Why making content for content's sake is the wrong starting point, and what has to be true first ▸ The wealth advisor question: what are you best at, and how do you leverage your highest-value asset ▸ Shutting off creativity to get through school, and turning it back on in his thirties ▸ Why creativity without structure is disorienting for an ADHD brain ▸ Breaking through on songwriting, and why pen and paper is where creation starts ▸ The first mainstream face of ADHD, and why that representation landed as a gut punch ▸ Why the real problems are cold and boring and don't need coloring up ▸ A 1-point-something GPA, Adderall in high school, and what turned around ▸ Over the rainbow: hyperfocus projecting outward, the Dunning-Kruger effect on steroids ▸ Detoxing social media in 2020 and never going back ▸ The scroll as a slot machine, and the alpha-beta state problem ▸ Marshall McLuhan: the medium is the message, and why every platform has its own constraints ▸ Return on investment of time, and whether you have to interface with the platform to use it ▸ Why Facebook and Instagram are the lowest barrier to entry, and why that's the trap ▸ The market vacuum in adult ADHD medication, and why r/ADHD is proof of the demand ▸ YMYL — Your Money or Your Life — and why YouTube is probably a no for most clinicians ▸ 113 videos, 2,000+ subscribers, 10,000 watch hours, on hard mode ▸ Elite everything, and it still doesn't scale ▸ Why podcasting is the answer for almost everyone who isn't already an editor "The systems designed to elevate voices from the profession are suppressing the very people trying to do it." 📕 The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T 📗 Cheat Codes — https://www.amazon.com/dp/B0FMJLQKBW Referenced: Marshall McLuhan — Understanding Media (1964), The Medium Is the Massage (1967) B.F. Skinner — operant conditioning Dunning-Kruger effect Songtown — songwriting instruction Transistor.fm — podcast hosting ⚠️ Educational purposes only, not a substitute for professional medical advice. If you are in crisis, call or text 988. Jonathan Murphy, PMHNP-BC | Focus Path Licensed in MA, NH, WA, OR | NPI 1821441965 Board Certified | ANCC 2017007119 CHADD Professional Member | ADDitude Professional Directory 🎥 Focus Path on YouTube: https://www.youtube.com/@focuspathsystems 🔗 https://myfocuspath.com 🔗 https://www.myfocuspath.blog 📧 https://mailchi.mp/myfocuspath/focus-path-pmhnp

  4. 6d ago

    Should You Take ADHD Medication Every Day?

    Should you take ADHD medication every day? Jonathan Murphy, PMHNP-BC, answers the most common question he gets in practice, and explains why "as needed" dosing undercuts the thing that actually makes the medication work. Short answer: yes. The explanation is the part that matters. In this episode: ▸ The objection answered up front: no, this isn't telling people to take speed every day ▸ The Stimulation Gap — the distance between dopaminergic stimulation in the brain and what the environment provides ▸ High-stimulation vs. low-stimulation environments, and why both are a problem ▸ What stimulants and non-stimulants are actually doing pharmacologically ▸ Why symptoms have to produce deficits in two or more areas, not just work ▸ The drug is a stimulant. The benefit isn't stimulation. It's focus, calm, and engagement regardless of what's happening around you. ▸ B.F. Skinner, operant conditioning, and why consistency is the mechanism ▸ Raising the baseline instead of rescuing individual days ▸ Why novelty still matters and why your stimulation sources have to change ▸ "It was helpful, but not in the ways I expected" — what patients report at one to two months ▸ Why the people walking into treatment are usually the ones who've tried everything else ▸ Where the benefits actually show up first: social life and IADLs, not the task list ▸ Stigma, shame, and the paradox of accepting treatment ▸ What one, two, or five years of consistent treatment does that going without doesn't ▸ Whether ADHD is cured if you stop, and why consistency now makes coming off more possible later ▸ You don't turn into a pumpkin 📕 The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T 📗 Cheat Codes — https://www.amazon.com/dp/B0FMJLQKBW ⚠️ This episode is for educational purposes only and is not a substitute for professional medical advice. Never start, stop, or change a psychiatric medication without your prescriber. If you are in crisis, call or text 988. Jonathan Murphy, PMHNP-BC | Focus Path Licensed in MA, NH, WA, OR | NPI 1821441965 Board Certified | ANCC 2017007119 CHADD Professional Member | ADDitude Professional Directory 🎥 Focus Path on YouTube: https://www.youtube.com/@focuspathsystems 🔗 https://myfocuspath.com 🔗 https://www.myfocuspath.blog 📧 https://mailchi.mp/myfocuspath/focus-path-pmhnp

  5. Sep 26

    Reacting in Real Time to the Lindsay Clancy Medication List | A Prescriber's First Read

    Jonathan Murphy, PMHNP-BC, reads through the Lindsay Clancy medication record for the first time on mic, reacting in real time as he goes. No script, no preparation, no edits. Just a psychiatric nurse practitioner who prescribes these medications daily working through the list chronologically, from the first Zoloft prescription in September 2022 to the toxicology on the day of the crime. This is a first read, not a considered analysis. Thinking out loud, including the parts where he's unsure. What comes up, in order: ▸ Sertraline (Zoloft) 25mg, September 2022 — why the dosing ladder is clunky and what SSRIs actually treat well ▸ Positive vs. negative symptoms of depression, and why SSRIs hit one and not the other ▸ Low-level mood irregularity and what it looks like when someone can't tolerate an SSRI ▸ Transient first-week side effects and why people quit too early ▸ Lorazepam (Ativan), Benadryl, and buspirone, October 2022 ▸ Why Benadryl isn't the best option for sleep ▸ Buspirone's dosing flexibility and its low-risk profile ▸ Benzodiazepines: Schedule IV, physical dependence, rebound anxiety ▸ Trazodone at South Shore Hospital, November 16 — and why it isn't as benign as people assume ▸ Fluoxetine (Prozac), started and stopped in four days ▸ Ambien, mirtazapine (Remeron), clonazepam (Klonopin), November 25 ▸ Mirtazapine for appetite, including in stimulant-treated kids ▸ Quetiapine (Seroquel) and the increase to 400mg on November 29 ▸ The December diazepam (Valium) string: 12/6, 12/7, 12/9, 12/13, 12/19 ▸ Lamotrigine (Lamictal), Stevens-Johnson syndrome, and the benign rash that gets mistaken for it ▸ The McLean Hospital admission, December 31 to January 5, and what was discontinued ▸ The return to the original outpatient prescriber ▸ Day-of toxicology: diazepam, lorazepam, lamotrigine, mirtazapine, quetiapine, trazodone ▸ What the fill pattern suggests about which medications were actually being taken ▸ Thinking out loud about what benzodiazepines do to anxiety, and why that matters here Everything here is a live reaction to a public medication record. It is educational pharmacology and speculation stated as speculation. It is not a clinical opinion about any individual, not a diagnosis, and not an assessment of anyone's mental state. Nobody in this episode is a patient of mine. Case status: the trial ended in a mistrial on September 4, 2026, after the jury deadlocked. No verdict was reached. The Plymouth County DA has not announced whether there will be a retrial. ⚠️ Educational purposes only. Not medical advice. Never start, stop, or change a psychiatric medication without your prescriber. If you are in crisis, call or text 988. Jonathan Murphy, PMHNP-BC | Focus Path Licensed in MA, NH, WA, OR | NPI 1821441965 Board Certified | ANCC 2017007119 📕 The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T 📗 Cheat Codes — https://www.amazon.com/dp/B0FMJLQKBW 🔗 https://myfocuspath.com 🎥 https://www.youtube.com/@focuspathsystems

  6. Sep 24

    Why the Lindsay Clancy Case Spread Like It Did (It's Not a PSYOP)

    People keep asking whether the Lindsay Clancy case is a psyop. Jonathan Murphy, PMHNP-BC, grew up in Duxbury, and his answer is no — it looks organic. What's worth understanding is why a local tragedy became a national fight, and what that says about how anything spreads now. This episode covers: ▸ What people actually mean when they say "psyop" ▸ Why this one appears organic rather than manufactured ▸ Duxbury, the image of the perfect seaside town, and what sits underneath it ▸ Why the case disappeared from the news and then came back much bigger ▸ The contrast with how Karen Read was covered from day one ▸ Astroturfing and how apparent grassroots movements form ▸ Why the reason behind almost anything now is engagement, and engagement is money ▸ How a story big enough to matter gets steered into men vs. women, left vs. right ▸ The psychological character she occupies — the external perfect life — and why that drives the reaction ▸ Objective truth vs. subjective reasoning, and why the distinction matters for navigating any of this ▸ Why this matters specifically if you have ADHD: impulsive thought, impulsive action, and the need to know your own truth first Where the case stands: the trial ended in a mistrial on September 4, 2026, after the jury deadlocked. No verdict was reached. The Plymouth County DA has not announced whether there will be a retrial. This episode is commentary on media dynamics, not on the facts of the case or the defendant's mental state. Nothing here is a clinical opinion about any individual. ⚠️ Educational purposes only, not a substitute for professional medical advice. If you are in crisis, call or text 988. Jonathan Murphy, PMHNP-BC | Focus Path Licensed in MA, NH, WA, OR | NPI 1821441965 Board Certified | ANCC 2017007119 📕 The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T 📗 Cheat Codes — https://www.amazon.com/dp/B0FMJLQKBW 🔗 https://myfocuspath.com 🔗 https://www.myfocuspath.blog 🎥 https://www.youtube.com/@focuspathsystems

  7. Sep 15

    High Masking Autism: The Most Misunderstood Psychiatric Diagnosis

    Autism spectrum disorder is the diagnosis Jonathan Murphy, PMHNP-BC, sees the most confusion around — from patients and clinicians both. People get evaluated, spend a lot of money, and come back without much. This is what he actually looks for, and what high masking autism looks like from the chair. If you're a late diagnosed adult, or you've wondered whether you're autistic and the evaluation didn't give you an answer, this one is for you. This episode covers: ▸ Why a diagnosis only has to be documented when you need to access something outside the appointment ▸ Autism as one of the rare psychiatric diagnoses where people feel better just by knowing ▸ High masking autism vs. autism spectrum disorder, and why it's about observable signs rather than function ▸ Monotonous tone and speech patterns as an early cue, and why it isn't required for diagnosis ▸ Sensory sensitivity and difficulty processing multiple inputs at baseline ▸ Concrete logical thought sitting on top of and taking precedence over other senses ▸ Why typical neurodevelopment includes a felt social sense that doesn't require thinking ▸ Concrete communication, taking people at face value, and vulnerability to manipulation ▸ The mismatch between deeply felt emotion and limited external expression ▸ Developmental Reinforcement Theory and the eight survival modes ▸ The Strategist as the most common mode on the spectrum, and how it leads to shutdown ▸ The Operator, avoidant cohesion at the periphery, and the path toward OCPD ▸ The General, agitation as protection, and why you can't tell you're dysregulated when you're stuck in your head ▸ Regulate before you navigate ▸ Staying in the job, the marriage, the boiling water, and where meltdowns come from ▸ Why attachment is different from autism, and why autism explains the attachment pattern ▸ Autism and bipolar, and what that co-occurrence usually reflects ▸ What a narcissistic parent does to someone on the spectrum ▸ Social skills training, and checking the environment before assuming the problem is the person ▸ Reading the room calmly versus feeling activated and mistaking it for reading the room On the "fashionable diagnosis" argument: most high masking adults on the spectrum don't identify with internet groupthink at all. Separate what happens online from what happens in real life. Jonathan Murphy is a board-certified psychiatric mental health nurse practitioner specializing in adult ADHD and autism. Licensed in MA, NH, OR, and WA. 20,000+ clinical hours. For educational purposes only. Not medical advice. Consult your own provider for clinical decisions. If you are in crisis, call or text 988. 📕 The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T 📗 Cheat Codes — https://www.amazon.com/dp/B0FMJLQKBW Find the YouTube channel Focus Path | PMHNP-BC for the full clinical education catalog, including the Developmental Reinforcement Theory and Survival Modality series: https://www.youtube.com/@focuspathsystems

  8. Sep 10

    Got Adderall From a Friend? Here's What a Prescriber Wants You to Know

    Is it illegal to share ADHD medication? What happens if you got Adderall or Vyvanse from a friend? Jonathan Murphy, PMHNP-BC, answers both the legal question and the one that matters more clinically: what borrowing a controlled substance does to your relationship with a medication you may eventually need. Covered in this episode: The legal exposure on both sides — giving and receivingWhy ADHD stimulants are Schedule II and what that classification meansThe difference between a drug and a therapeuticWhy "as needed" dosing creates a behavioral problemWhether to disclose prior use to a prescriber, and what a prescriber actually does with that informationWhy people who borrow medication struggle more with long-term treatmentFinding a provider who evaluates adult ADHDJonathan Murphy is a board-certified psychiatric mental health nurse practitioner specializing in adult ADHD, licensed in MA, NH, OR, and WA. 20,000+ clinical hours. This is general education, not medical or legal advice. Corrections and notes: Sharing or distributing a prescribed Schedule II stimulant is a criminal offense in every U.S. state, but the charge varies. Depending on jurisdiction, quantity, and whether money changed hands, it may be charged as a felony or misdemeanor, and federal charges are possible. Consult an attorney about your specific situation. The German military distributed Pervitin, a methamphetamine preparation, to troops beginning in 1938. Mid-century American amphetamine use involved different compounds and regulatory conditions. Related but distinct chapters. The Process: An Adult's Guide to ADHD Medication — https://www.amazon.com/dp/B0H2Z6PM4T

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Ratings & Reviews

5
out of 5
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About

Adult ADHD from the board-certified PMHNP behind the YouTube channel Focus Path and the book The Process. Clinical perspective on medication, frameworks, and the conversations the internet hasn't been having.

Information

  • Creator
    Jonathan Murphy, PMHNP-BC
  • Years Active
    2026
  • Episodes
    29
  • Rating
    Clean
  • Copyright
    © 2026 Focus Path Systems

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