AuDHD Expert: What Female AuDHD Really Feels Like, THIS Trait Makes You Vulnerable!

"Audio HD Neurotype is different to pure ADHD and pure autism, but they are all one lapse with autistic girls and women social communication patterns. We are driven to connect. It can come across us looking quite innocent, having dissonance about how people feel, what they tell you and what they really want. It's not that we do not sense it. It's that we sense so much." Dr Samantha Hugh is a highly specialized female ADHD and autism expert with a PhD in medical science. She's here to give you a detailed crash course in ADHD and help you spot it. With ADHD there is that heightened cue detection. The salient's network trained to pick up stimuli from your environment, but an ADHDer who had been through trauma in their lives, that salient's network then becomes threat detection, more than cue detection. How do you explain how it feels that might help somebody recognize it? First of all if someone's thinking that they might be ADHD, I would. "So sorry to interrupt your hyperfocus for 30 seconds, but you're going to want to hear this. I've been working on an epic side quest. I've just launched the ADHD chatter Patreon, which is where I'll be connecting with my community on a much, much deeper level. I'll be doing live body doubling sessions behind the scenes bonus questions with all of my world renowned podcast guests. I'll be sharing the best most transformative ADHD hacks over there, as well as hosting a private chat between myself and all of you guys. And that's really exciting because it means we all get to hear each other's coping strategies as well as feeling much less alone. The ADHD chatter Patreon community really is the place to be. If you want to transform your ADHD from a place of understanding into one of truly thriving, you can join right now using the link in the description, back to the episode. If someone's listening or watching who has ADHD and they suspect that they might also have ADHD, what could you describe the condition? Yeah, so first of all if someone's thinking that they might be ADHD, I would question what brought them here. With ADHD because of the co-occurrence of the ADHD traits and the autistic traits and I've spoken about this before in a last episode, where it is often a collision of the nervous system of one thing, sameness and also craving freedom and adventure. So for someone who is ADHD, your life would look like on any given day, maybe you just want things to stay the same, but then there is a part of you that really want to do something new. Many people with this ADHD neurotype tend to end up in squiggly careers throughout their lives where it's like you have so many different hobbies and interests and jobs and maybe different relationships. Yeah, definitely that one thing to chop and change just when things are good and stable and secure. I mean that sounds like quite a confusing existence with so many different push and pulls and perhaps contradictions. Can that be quite a distressing experience for somebody living with that too opposing sides of their brain? It is more distressing when we're in the middle of change or when we're at a place where we want change because it's when you feel like your life is stabilized and then all of a sudden you just don't want that anymore and you want something completely different and often it is that middle place that people can feel destabilised and are looking for an anchor. I said at the beginning, "Audio ADHD is such a big conversation within the community at the moment." There are lots of people having conversations on it which is brilliant and I always like to bring the best most credible people onto the podcast. Could you explain your qualifications to the people who are watching and listening? Yeah, so it's interesting because I mentioned this quickly career and if I were to bring the qualification that is relevant to this is that I have lived experience for 44 years going on 45 now and I've lived with a brain that I didn't understand for decades and it was only in my 40s when I was diagnosed that I you know only began that excavation but my career began in cancer research and I studied genes, molecular biology, biochemistry and cancer research so I looked at how people's genes manifest into diseases and I culminated in a PhD in cancer research at the age of 30 and then came out and swiftly landed in 16 different industries or one of which I told you about which is in commercial modelling and acting and for a really long time I was really ashamed of it and it was because I keep hearing from people who said to me "but you have a PhD, why are you doing modelling?" and I did it because part of it was because there was something inside me that really wanted to come out you know I wanted to express myself you know so much of my life, so inward and it was so contained and also the other part was because I was a mom and being a freelance model was something that earned me better wage you know better rate you know at a more flexible timeline and it was hard after I gave birth because I had a period of postnatal anxiety and really low low mood and wondering who I am and what am I doing and I bring the science head and the heart of living as an Audi HD to this and I think that's what people resonate with and you've clearly stuck at and done incredibly well in the field of new university and raising awareness about ADHD I think predominantly but now more so Audi HD what is it you think about this particular topic that has maintained your attention or made you the most passionate that you've I imagine being about any of your different points in your squiggly career yeah so the career really started from trying to figure out what happened to me and what happened to us that's why when I created ADHD girls in 2021 it was very much to try and understand what ADHD looks like in women you know because what we have known is that the assessments that are done for ADHD and autism is very much under bias and because of my own cultural difference you know I also noticed that some of the things that were you know tough for me was highly mask and I wasn't really able to relate to the diagnostic criteria which led to then also difficulty in getting my autism diagnosis which took me seven months you know to I was trying to convince them that I'm autistic and the whole excavation into ADHD let me to then you know speak to the community and people were talking about what it's like to be autistic too and I was like oh my god that's me and they were saying how they could be quite blunt in meetings in workplaces and I've offended my boss in my first week at work when I was working in Imperial College and he pulled me into a room because after we had a meeting and he said that the way I was challenging the way things were done is not how you do things here and it's like you don't talk to people who've been here for 20 years that way and I was like was I rude I didn't even know because all I really wanted to say was the truth and what I saw as the truth but to someone else it looks like I was this rude inexperience person who came up from university well from academia and you know I've got to say the world of academia we're very much like secluded to be academics we look at books and we don't communicate science very well you know so when I kind of went into communications doing that work then yeah people were shocked by the lack of social you know understanding and yeah so that brought me to really excavate into ADHD and it was not only after I was denied an autism diagnosis three times that I've wondered what in the world is ADHD is what is ADHD look like in women you know what why don't I recognize myself in the diagnostic criteria that we're using the ADOS you know and they put all of my challenges down to trauma and because I was going through a lot of trauma in the time when I was going through the assessments but is ADHD different to trauma or is ADHD something that can co-occur with trauma and I ran ahead and did the lift experience research myself I created the first comprehensive ADHD women survey and within a month and a half we have 400 replies it was a very long survey as well so well done you know to everyone who filled that in and we you know then found out that it does look different to what we were assessed on and then a month later Gina Ripon published the book called The Lost Girls of Autism and it she set herself in there that she had been part of the problem that she was trying to solve in that before she thought that there was no gender differences between autistic girls and autistic boys and autistic men and autistic women, but then she realizes that there is and there are a lot of differences in that autistic women can to be more worried to look for social connection and in fact their social connection patterns look like neurotypicals. So what does that tell you then about the assessment that we're doing, you know where we're asking autistic women and girls can you socialize, can you have, you know, can you make eye contact and you make friends and what if we say we can, you know, but we may not be able to maintain them for long, but we can, you know, and perhaps not maintaining it is the most painful part about being an all the HD woman. You said a moment together you were denied an assessment for autism three times. Who denied you and why? I talked about it before and they have since been very sorry about it. There was two clinical psychologists and I went through the NHS route and it only came four years after I first, you know, approached my GP for it because it was on the NHS. So I just thought, okay by then I had really self-identified as autistic as well, but I thought, you know, just go and see what it's like. So these two clinical psychologists who interviewed me over a period of half a day and I very blatantly remember thinking I didn't prepare because I thought, ah, I'll be fine, you know, I know enough about autism. And the first thing I said was, do you know there's a gender bias in the assessment criteria and they're like, yeah, we'll try and ask you a question in different way or, you know, we can also, you know, get you to look at the masking scale, which is quite common for autistic women. And I was like, okay, and then we went through the assessment and yeah, in the end, they put my challenges down to trauma and it was traumatic. The whole assessment was traumatic. It asked so much about the friendships and the relationships and it asked if I was bullied, you know, things like that and could I make friends? When did I have my first friend? You know, and my mom would always say that I was very sociable. I was like a little girl, always had friends. I was very cheerful. And yeah, I was very talkative, which is everything against, you know, what we know about autism. So because of that, they thought that I didn't, you know, I wasn't, and also because my work that I said, I'm obsessed about, they said, but that's what you do. You would be and I'm like, well, I have to be obsessed about it in order to do it. And that was also discounted. But later we know that autistic women tend to have different interests, you know, to autistic men and our interest tend to be more geared towards understanding human behaviors. And that's why so many of us are in the help of profession, very highly empathetic and, you know, really interested in helping people. You think that empathy is what drives you today to raise awareness of ADHD and women? Part of it. Yeah, the empathy helps me. It helps me do the work well. It is the sense of justice, so being underrepresented, that drives me every day. And lately, because I have realized as a difference in how people with different neurotypes, whether it's ADHD and ADHD, respond to treatment and care, you know, that drives me to do this work because I have my own half-crash, two years ago, from being in a period of high stress and everything collided. And, yeah, I then, when, you know, to a very long journey to kind of take myself out of that hole and actually then realize that because of my way of being, my neurotype that is different from what people conventionally know as, you know, ADHD and autism, I respond to medication differently, you know, hormone replacement therapies don't work the same way as people would imagine for me because I'm also hormone-on-esensitive because I have also been through some pretty traumatic times, pretty dark times. That changes how the nervous system reacts to treatment and also people, you know, so everything else has to be tailored to this population in a different way. That hole you mentioned two years ago, how deep did that hole get? And what did that look like? Very deep. It was very painful, you know, I listened to your interview with Dr William Dotson. He talked about RSD and he talked about this woman with one of his patients who, apparently even two years after leaving a relationship, was still experiencing RSD, you know, or what you then asked him, is that CPTSD or PTSD that looked like that? And he said, yeah, he can look like that. And that hole lasted so long because, and that happens so more often that we then we talk about, you know, what really allowed me to do this work is that during the toughest time of my life, I was speaking to a trainee therapist, you know, I was going through the divorce, I was then also dating somebody who was doing a push-pull dynamic with me. And then it was only recently I read an article in Psychology magazine, we talked about the intermittent reinforcement that these women, who was this all the HD women also went through and I resonated with everything. Because the RSD that I got, the PTSD that I got from the relationships wasn't strictly my fault, you know, it wasn't because I was abandoned or I felt like it was unsafe. It was more because someone had let me to think that they were going to be there and then very abruptly disappeared when I started to ask for something that I need, you know, it was that push-pull that lasted over two years. And I allowed that to continue because I would receive that person back, you know, each time they go away and then after they've regulated, they come back to me and I was like, okay, come in. And I never put a stop to it because I wanted connection, you know, I wanted this great love, you know, but it was a form of self-harming in some ways, you know, but it was also a situation where I could not really control and in my period of going through that, I was quite dysregulated when I was speaking to my therapist because it is hard. You know, you come to think about it. You're having a divorce, your ex-husband, you know, blame is you for everything and took no responsibility for what they appeared to be in all the years when you try to make the relationship work. And then, and then you have someone who's who clearly needs you because you can help them, but then has made his promises that they cannot keep and there's this dissonance about what's going on with me. And then I have two children who I need to be there at whole space for. And in that moment of my dysregulation, the training therapist said, it sounds like you have borderline traits. There was just something in me just broke there and I was just like, wow, and she was meant to be a friend. You know she was my neighbor. And she said that and I had a feeling that maybe she was taking sides, you know, as a, of course, the woman who is just regulated is the crazy one, you know, and the man who can appear to be okay and, you know, keep up the facade is, is the calm one. But why is the woman dysregulated, you know, in a relationship? Could it be that she doesn't feel safe? Instead, of telling someone who is in a moment of deep crisis, you're telling them you have borderline traits, would you ask, are you being abused? Are you going through something that makes you think that your reality isn't real? It was constantly being dismissed here and rejected, rejected there, but really was cowardice on the other person's part that I took responsibility for. And no one could really understand where I was and I was in deep, wicked mentality. You know, and I know how hard it is to be so misunderstood when no one is in your corner because no one thinks you need help, you know, and years later someone was saying to me, you know, it's because you are the strong one. I was like, is it true? Is this what the strong ones have to go through? You know, but there was so much in there because when I was going through all that, I think maybe there is some truth that I appeared in tense, but what is autism? But in tense, you know, we are on a spectrum of intensity and women, autistic women are intense, you know, because of the way our brains are wired quite differently to autistic man. And, Yeah, then I. This is related, but it was something I watched recently on a podcast with Dr. Anna Lemke, who wrote the book "Doping Nation." And she's a psychiatrist. She said that people who were in the deep froze of addiction can appear with those borderline traits or narcissistic traits or personality disorders. And in some ways, I don't disagree because when you are in that intermittent reinforcement with somebody that pushpulled dynamic, where someone comes, "Oh, I feel safe. Oxytocin gets released." And then they pull away. You get to be drawable. And over time, when that keeps repeating, you develop a person addiction, not really by choice, but because of that pattern. And so the dysregulation that happens then, when you go to the mental health services, the trauma and mental health services, if you do not have the means to advocate for yourself, you could very easily be sectioned. Like I know people who treat borderline patients in anti-NHS, and they said that these women often have a history of addiction, but there's also quite severe, because they have multiple things that they are addicted to, whether it's alcohol drugs, but often there is a relational connection, some relationship, then work out in their lives, and then in that, the difficulty they end up there. And I asked, "What is the actual thing that helped them? Is it the DBT, the dialectical behavioural therapy that people prescribe to those with intense emotions?" And they said, "It's learning in that group setting and keeping each other accountable, apparently at first they hate each other." There's a sense of competition. But I find that so meaningful, because the feel of psychology and mental health services now, do not see borderline personality disorder as something that is on a surface level. They don't see it as something that we should stigmatize, because they're using a different term now, and it's called this organized attachment. And they're saying, "Please don't stigmatize this organized attachment like we did borderline." The number of ADHD women I know who end up in mental health services and psychiatric units, because they were thought to have EUPD or BPD is really upsetting. I feel personally upset because someone did say that I have to straighten and I'm like, "Oh, okay, but I know myself and I knew that there are times where, even though I'm dysregulated, I can get back to baseline and guess what helped me?" It was a friend of mine who told me, "Sam, you are going through so much in your life right now. Of course you're going to be upset and in distress. You're not this, and for once I'm really grateful that I do not believe in the label." Thank you so much for sharing that. That was a huge monologue. It took me two years to come up with that. Are you okay? Yeah, fine, fine. I've been back and forth and I've got them good. When you're going through that horrendous traumatic period of your life, where were you at with your awareness of your own neurodiversity? Had you had your ADHD diagnosis at that point? I had ADHD diagnosis, but I didn't know what ADHD really meant. Of course I knew what autistic mean, but it was very pigeonholed to the generic consensus. It was not until maybe two years later that I realised that we are an entirely different species. And with the memory of the trauma that your situation caused you, when you did finally get the ADHD diagnosis or the autism diagnosis to accompany the ADHD diagnosis, when you heard those words, "How did you feel in that moment?" Well, it came after seven months of being invalidated and I was crying every session. So I was pretty much traumatising them as much as they were traumatising me. I was like, "Why won't you give it to me?" And I just a bad person. And the fact I was so dysregulated, she probably told them. After that, I just remember the day I received the diagnosis, I thought I wasn't going to get it. And I was thinking, "Why do they even want me to come in if they're not going to give it to me?" So I sat there and I sat to them that I feel like I'm the only person here who have my own back. And they said, "But we're going to give you a working diagnosis." I was like, "What does that mean?" "You don't understand it." "The working diagnosis?" "Is that like a draft diagnosis?" "Yeah, so it's because I never had a developmental witness. I didn't ask my mom to be one because I thought she's only going to say I'm very talkative and things like that. It's not really going to help and her memory is not that great anyway. But as my ex has been to be my developmental witness, which went down so not well." So yeah, a working diagnosis is usually given when there isn't enough evidence in a developmental timeline. But why are they looking at that now? That we know in July last year, in the summer last year at Princeton University came up with this paper where they talked about at least four new subtypes of autism. You know, that looked nothing like what we believe autism to be, and two of the classes at least do not have developmental delay. We appear neurotypical until later in life when whatever life happens in this population tend to have a higher rate of mental health conditions. My sincerest apologies for interrupting your hyper focus, but a quick word from our sponsor. Like many in the new year, we want to turn over a new leaf, looking to be more productive, more organised and never late. Well, Timo app is here to help. Timo wasn't named app of the year in 2025 for no reason. It's the ultimate planning partner gently guiding you towards busting your day-to-day chores list. The important difference is Timo is designed by neurodivergent brains for neurodivergent brains, and you can tell it's built to adapt to your neurodivergent way of thinking and be flexible to your way of planning. And now it's even more simple with the AI planning assistant. Timo offers an incredible new voice transcribing service, making it even easier to use. It's almost so simple that it feels like a cheat code to play life on easy mode. Give it a go, and use the link in my bio for 30% off. Just a note though, this code is only applicable on the web browser, not the smartphone. Back to the episode. I speak to a number of people in this community, and one bit of feedback I get is that going for an assessment of whether it's all DHD, autism, or ADHD. There's a lot of fear that can come with the process, because there's always like this nagging feeling in the back of your mind, like, "What if I'm wrong? What if I don't have ADHD? Or what if I'm not autistic?" Like, then what's wrong with me? Yeah. I feel like that is the explanation for the struggles and the challenges that I'm experiencing and to get a diagnosis will cement that suspicion. But what if the psychologist says, "I don't?" Do you see that fear during the assessment process? Is that quite a common emotion? 100%. 100%. I went through it myself, like I was invalidated. It wasn't even a fear anymore, it was fact. And the fact that, like I say, the diagnosis, the cachira, is very confusing to most of us, because we actually do not understand it. There's a real dissonance. It feels as though you're going into a neurotypical system, even though it was meant for autistic assessment, but it feels like you're going into, you know, and being assessed in a way that actually you don't relate with. You know, so many fall below the threshold, the clinical threshold will diagnosis and then what are they? You know, and my own question to them was, if I don't get this label, then what am I? Am I just a terrible person? Because I went through loads of meltdowns during those difficult periods, you know, the two years where my therapist decided it was a good time to do a trauma therapy. And I really appreciate her, but the modality during that time was so distressing for me, because I had those memories come back in real time while I was co-parenting my children. And I remember taking myself to the bathroom just to be a safe person for them so that I don't disregulate and shout because some things that they were doing were triggering me. And yeah, I was having those meltdowns and it was awful. And I know now that we really need to think about timing when we do this deep work, you know, because no one's, not everyone's ready for that deep excavation. Some of us really, you know, really need that protective layer, because if we're not ready for that work, it can unveil a whole lot of different things. difficulties that you have very neatly concealed for decades. So if the medical community is woefully behind in recognising and understanding what ADHD actually feels like and looks like in women, with your experience, how would you describe it? What would you look for? So I was recently at the Royal College of Psychiatry's Conference and I find that awareness is divided. So I want to be fair to those who are advocating for better diagnosis and care because those are led by really passionate neurodivergent individuals who are also psychiatrists. And so we understand that there is a huge monocoreal occurring conditions inside the autistic ADHD community and more so in women, you know, in nearly all the major organ systems. That is a big one, physical health, co-occurring conditions, especially later in life. I dug into the science, which I talked about, I think, to you in that the autistic ADHD, the ADHD neurotype is different to pure ADHD and pure autism. But it all war laps with autistic social communication patterns. And I actually do not think that it's any autistic social communication patterns. It's autistic girls and women's social communication patterns, which is that we are driven to connect. We want to be around people. We talk. We also mass so much. We have difficulty really trying to understand what people want from us, you know, and it can come across us looking quite innocent and having dissonance about how people feel and what they tell you and what they really want because the thing is it's not that we do not sense it. It's that we sense so much and we're trying to make sense of what is it, you know, which is the truth here. And it's sometimes really hard to figure it out when the person you're trying to figure out is even clear about what they want. And so you're picking up all these cues and you do not know what to do with it. Just analysis, paralysis and somehow you feel it in your body and, you know, people get an anxious or, you know, avoid it in different situations. That's one part of it. The ADHD site, if I were to say ADHD site, even though it looks different to pure ADHD, it's more destabilizing. And that, I think the brain dynamic paper actually did a really good job at looking at how people usually follow a thought pattern, you know, how the brain dynamics tend to work. And so when you're in that stable, autistic site, you know, when the brain networks are lit up in that way, then you have that want for sameness, you know, you want control, you could be quite rigid. But then when it then, you know, moves over to the instability, that can be even more unstable than in a pure ADHD individual. But it tends to follow the same pattern and they do, and to emphasize the remination that can happen inside an ADHD individual. And it makes sense to me because I've been, you know, called intense in various situations. And so I do worry about things. I worry about things. And the way I deal with my worry is I'm always looking ahead, maybe a year or two years or ten years, and figure out what I need. I have an anticipatory unslighty, you know, for everything in life, you know, and it goes back to the conversation we were having about how, why do I come across anxious? Have you ever had a social interaction with someone who's communicated in such a way with you that, with your experience and intuition on being able to perhaps recognize ADHD and other people? Is that somebody that you've met who you've thought, right, that is super clear, like that person has ADHD, they just don't know it? Yeah, a lot of women tend to come to us and ask, you know, if they have ADHD because they resonate with what I say about being, you know, your pure like a swan on a surface, but underneath your paddling like rigorously, you know, and then you dysregulate at home. That's the part people really relate to because it's like you can function all day, you know, appearing almost neurotypical. Then when you get home, you have to go into a dark room, no one talked to me. I've got like, you know, my salt lamp and I've got my teddy dressing gown and all this fluffy things that I like to cuddle. So there is that keeping up with the sad, I think that's probably the most telling thing about an autistic ADHD woman, but for a man. In my experience, I've seen many ADHD men aren't very resilient to stress and I don't expect them to be, but they can be quite easily dysregulated when, yeah, in sensitivity comes into the picture. What happens if you are somebody like you said, you get home, you get very dysregulated, you want to decompress, you have your weighted blanket, you turn the lights down, whatever your routine looks like for you, but you live with someone who doesn't get it, you live with someone who doesn't understand that you need to go through that process. That'd be quite turbulent. Yeah, because then you are masking, you're walking on eggshells if you don't have that, because if you need recovery, and if that person doesn't allow that recovery, you can't live with that person. You know, like the number of partners that I've come across who look good on paper, but actually I just can't live with, then it's a no. Your nervous system needs recovery from the sensitivity to the world. You take on so much, you know, your sensitive, your brain's fast moving and it's changing. And so when you get home, you need an anchor and for me it's lying horizontally. Maybe. Could somebody reach for unhealthy ways to dysregulate if they're not supported and they're not able to do it a healthy way? Could that lead to drinking or explosive arguments? What could that look like? So, we don't reach out for those coping strategies to have fun or, you know, because good for us, we reach for that to calm ourselves down, right? For me, definitely when I go into a social situation, I use to need to drink, you know, to kind of be sociable. Otherwise, I'll be quite awkward or, you know, it's just hard. But I think what you do on a daily basis to cope very much depends on what you, people around you and the culture really thinks that's normal. You know, and I talked about this, like in this culture, it's very much drinking or, you know, various recreational drugs or working is a really big one shopping for many women. But in my, the culture I grew up in, it's very much eating, you know, getting together with people, families, drinking to a lesser extent. How do you advocate for yourself now? Because I imagine you are very busy. You go to events, you talk on stage, you go to social gatherings. How do you cope with those now that you have a better understanding of how your brain works? It's tough. I'm not going to say that it's easy for me because I'm not a Gen Z. I didn't grow up talking about mental health or, you know, telling people my mates and creating boundaries. I grew up with no boundaries, you know, just people walking all over me and, you know, me doing things for people. So when I go to events, now I have minimum requirements to actually just get a picture of the room that I was speaking at. They, they send it to me and I tell them that's the things that I absolutely cannot live with, which is hot, you know, heating when it's too much. I literally cannot function. It's counterproductive to actually me being there. I'll just be talking gibberish. And microphones, that's been a real problem because every time I turn up, you know, I never know the quality of the microphones. Sometimes the echoes, that's it, you know, there that goes the rest of presentation. But I tend to avoid really big conferences. If I do have to go them, I'll just go for that slot and then come back. I really cannot deal with large volume of people. Are there some events that you go to where it does feel safer to retreat back to the safety of masking? I think because I, you know, often feel like I don't want to mask a lot. I tend to be more of a lone wolf now and I do go to events. I tend to, you know, try and stay by myself. Sometimes I run away from people. They were the exits all the time. It's not the people so much. It was the whole vibe. You know, it's like you're going there and you're absorbing everything and it's so hard for someone who doesn't have a filter. And for me, what's safe me is my nice cancellation headphones, you know, like you have music in your ears. And sometimes I'm singing out loud. But no one can tell. But yeah, it's having my own quiet space and sometimes it's carrying that with me, having my name. headphones and creating that micro environment. Do you think it's possible for autism to mask ADHD to such an extent that perhaps somebody might never have that realization that they're all DHD? Yeah, that's probably what you'll get from just looking at me. My clinical psychologist who assessed me for autism didn't see anything. You know, they were like, you were fine. You know, a lot of the traits could be ADHD. And they overlap, you know, executive function, sensory challenges, emotional dysregulation or ADHD. You know, but the stuff that are autistic, you know, it's the, I do think the remination, the worry and the intensity is not ADHD so much as it is. And the definitely the RSD, you know, it's definitely more painful. What is RSD to you? I know it's three letters that we speak about a lot on the podcast and everyone seems to have their own individual journey with it. You know, we know that it's a horrendous emotional pain in response to perceived criticism. But how does it show up in your life? So it's interesting, Alex, like I think every time I come and talk to you, I have a different version of it. Because my very first interview with you was RSD, you know, and at the time I talk about the trauma that we experience, the difficulty that shape, you know, our lives that make it difficult when we encounter triggers where, you know, we feel completely paralyzed by this emotion, this self-justicing that happens. And then over time, we know that there is neuroscience involved as well, you know, with ADHD, there is that heightened cue detection. I'm talking about, like, the saline's network, you know, trying to pick up stimuli from your environment, but an ADHDer who had been through trauma in their lives, that saline's network then becomes threat detection, more than cue detection, then everything feels more sensitive and you're looking and scanning for triggers, you know, it then becomes this thing like, am I safe to be in this relationship, this work, you know, what is that person saying? Like something that maybe the other person doesn't, you know, mean for it to be a trigger, it becomes triggering to you, but that's the thing about being an empath, an empath who has been through trauma is that you pick up the things that they don't say more than, you know, what they are telling you, and we know people, we know people in our bones, you know, but why won't they just say what they want? You know, that's what our RSE can make us more hyper vigilant. If the autistic traits, perhaps are causing challenges on one day, I guess you could put extra effort into masking them and hiding them or vice versa, if the ADHD traits are causing challenges on a particular day, then you might lean more into the autistic side, but I suppose each one of those options comes with a sense of abandoning who you really are, because who you really are, is a blend of the two. So is there a degree of perhaps triggering yourself through not accepting the challenges that either one of them present is part of you and you need to embrace them rather than mask them? Yeah, that's such a valid question. It's like, yeah, that is a reality for most of us, it's that contradicting parts are constantly trying to both be expressed. And you feel like if you're trying to suppress one side, it's like you're not really being true to yourself too. So you're constantly trying to navigate, how do I satisfy this two crazy sides? And I really think that where we are at in our lives, really determined how well we can integrate this, it's really hard. How do you acknowledge what is right for you? So I guess maybe that's when you rise above these two contradicting sides and actually should start making decisions for you, what makes you feel at peace? That's how I guide my decision making process. Now, how do I feel after saying yes to this? Really turbulent, it's like, no, that's a bad idea. And that's usually how I guide myself. Yeah, it's a difficult, because I also know that just based on having looked at my own biology and genes and biochemistry from my own health crash, that if I'm not authentic to myself, my body suffers. I've been in periods where when I was going through the wars, when the relationship breakdown, my serotonin levels were on the floor. That what was happening in my real life, it was showing on my body, my biochemistry, my hormones were really dysregulated, stress was through the roof, and that didn't do me any favors. RSD is clearly incredibly crippling and we know that well on this podcast. What would you describe as the most crippling anecdote of RSD that you've heard from somebody? So I'll go back to when I first learned about RSD, which is if you internalize it, it can feel like major depressive disorder. When you're so depressed and you feel alone and you cut off, that's a sense of disconnection from the world. That's this huge, like, inner critic that grows in a loop and you just dies yourself. All this is really bad for your health. And then if you externalize it, it can look like anger. You know, people can have dysphoria. I made my joke, actually, it's dysphoria. And that, yeah, I know so it can cause suicidal ideation where people may think like it's dyspatterant to not be here, you know, but that anger can be destructive. You know, if it's coming in a burst from the RSD and, yeah, personally, I know or have, you know, encounter people who went in the heat of RSD. They also shift the blame to the other person, but actually it was that own internal self-justising they're dealing with. I recently interviewed Dr. Will William Dodson and one of the top comments was we were talking about RSD for an hour and a half and one of the top comments was, well, how can you tell the difference between an RSD episode and narcissistic rage? Because apparently they look quite similar, but the rage. Can they look quite similar? They can be because people who have narcissistic rage may have, you know, very intense RSD. And as I said, I said to you back to the point of listening to that interview with Dr. Annelem Ki, where she mentioned that those who are deep in addiction or have been perhaps, you know, have had a history of trauma in their early life, whether it's abuse or, you know, things that happen to them, maybe it's neglect or they also have a history of substance use and also a different addiction. There's more of a tendency for that person to deval up narcissism, you know, or narcissistic personality disorder, but I guess there's a difference between narcissism and narcissistic personality disorder. Just focusing back on ADHD, Sam. It's such an interesting co-existing diagnosis. Is it possible for the two to almost form like a parent and child relationship within the person's brain? Yes, yeah. It's like, yeah, I definitely experienced that. So like when my life is too stable for too long, I'm like, kind of want something to make me feel a bit alive or, you know, and I do think that there is that trauma layer in there as well in that if you've experienced, you know, difficulties and challenges in your life, then you're more likely to need more senses to feed that need to feel alive, you know, and I've been introduced to this term called emotional junkie. I wish you first. Express to me by my coach, I have a spiritual coach and he said, you're not that bad, but you know, some people are like quite bad in actually being an emotional junkie in that even though they know what is good for them and they know what to do, but because they want that intense drama and chaos to an extent, because that is what they're used to. And that is what they look for. And I was just like, oh no, that kind of does explain me a little bit, but you know, he said I'm not too bad, too far down the line so I can, I still have hope to come back. This has been absolutely fascinating. So I think we always try and get some hacks in these episodes. Do you have any? life hacks, any emotional or practical tips somebody could implement if they are ADHD that might help them with some of the perhaps the challenges they come with with the contradicting brain. So right because the ADHD brain can shift you know depending on what context and situation that you live in the most important thing is to understand what is your environment light what is the quality of your significant relationships. Are you good at keeping you know creating boundaries to protect your needs so much rest on those basic needs sleeping well and eating well and having energy you know leading a relatively low stress life and having period for recovery that is the most important one you know because maybe we won't always be able to choose what environments we go into unless we want to live in a cave. But yeah how can you create that recovery plan for yourself you know a space for you to come back to every time. But we were speaking off camera before we started chatting today and I think you echoed what was the first hack in a recent ADHD hack except said I did which was start with no if someone's asking something of your time in your case a conference or a speaking gig or a new cohort or whatever it might be a podcast appearance. It's so easy to say yes instantly as a knee jerk reaction and just rejigging that as a no and protect that time because I think it's so much easier to turn a no into a yes if you change your mind rather than all of the panic of trying to change a yes into a no once you realize you've perhaps double but yourself or you just don't have the capacity to do it. I want to move on to the washing machine of was which is questions from the audience these were the most requested questions to ask you today Sam yeah and it's a washing machine because the regular watches and listeners will know that it represents memory loss for me so I forget my clothes the machine and so it's a little reminder to everyone to empty the machine and I do use the team out now which is the sponsor and does help me to remember to empty the machine. Gosh there's three questions so these are the most requested questions from the audience on the topic of ADHD and in third place somebody's asked I honestly think I'm ADHD and it's causing me huge anxiety as I don't know if I'm coming or going does all DHD cause depression. Yeah I mean it sounds like that person is an anxious and depressed you know you kind of like yeah that makes up the entire population we were misdiagnosed as being anxious or depressed before we come to ADHD yeah you and definitely if you're like that like I think because you're toggling between two different nervous system states so that the this way of being is all about regulating you know your nervous system on the go obviously you can't regulate yourself out of a biochemistry trap so look after your basics as well as I say. Sure and is it I mean I hear a lot that people have been misdiagnosed with anxiety in the past is that quite common? Oh yeah so common like it there's so many reasons that can make that worse you know hormonal changes it's one of them. I think that actually leads into the next question which is the perfect segue so thanks for accidentally doing that. Okay how can ADHD crop up during menopause and is it going to be hell for me? Not necessarily we have a mixture of anecdotes but generally during menopause when progesterone drops and estrogen is much lower you will start to feel like the anxiety you know crop up first and then the sleep goes and then you know brain fog starts and your whole body starts to wonder what is going on and then you get to feel you know 10 to 15 years before menopause actually happens is that period of a roller coaster that a lot of people talk about but it really depends on each individual experience not everyone's going to have it bad but yeah it's definitely looking to your hormones first before you know taking any medications. Is it possible to almost mask say well and have all of your ducks in a row and to go through life having not thought that you are or DHD but then something happens like menopause and there's such a big hormonal shift that that's actually what tips you over into the assessment process. Yeah absolutely I mean most people have what I would call ideal conditions where they have supportive relationships you know things are working out they have great jobs and then the hormonal changes start to happen the esophageants starts to you know oscillate and then the progesterone starts to you know drop that's when they lose the ability to filter their thoughts and the ability to mask also diminishes and I know of a certain you are worried about going out because you don't know if you're gonna say something that offense somebody so yeah we do see this period of time even though it comes with instability as a gift because it is a gift for you to be authentic and really start to advocate for your authentic needs and become who you really are. And finally Sam someone's asked some days my ADHD is no problem at all and I think I'm or DHD too to be honest should I seek a diagnosis even if it's not really causing issues in my life. It depends because the thing is is that is that person a man or a woman because then if she is a woman and she's wondering if ADHD is gonna cause any problems if it's not causing any problems now then I would say that when hormonal changes start then it may have a higher tendency to cause problems so if you are trying to understand a way of being so that you can support yourself down the road then yes you know for me it's always better to know than not to know and yeah not everyone really wants to. Sure this has been truly insightful Sam thank you so much it feels like it's been almost been like a master class on ADHD and thank you again for being so brave and open and vulnerable to share your personal story it was very powerful and I think on behalf of everyone listening grappling to understand their brain I think they would have recognized a lot of what you said in themselves so thank you once again thank you so much. Thank you so much for having me Alex you're so easy to talk to I don't think I would have been able to say the same thing to another person so thank you.