5 Signs You're A High-Masking Autistic With ADHD (AuDHD Expert Explains)

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0:30I've always described ADHD as like a social butterfly. So you get super interested in somebody new, it's novel, it's interesting, so you're all in. And then somebody else new comes along. So you float from the original person to this new person. With autism, you have a few friends, but it's incredibly close and you might have had them for a very long time and you feel very comfortable with them. Then something happens. It's a bit of a disagreement, a misperception of things, and that's really confusing. Can it be possible for someone to be in a crowded room and still feel exceptionally lonely?

0:58Absolutely. Self-modulating, reining in your usual behaviours in order to fit in. Although you're around people you like, perhaps even people that love you, you don't feel like you can be your true self. What do you think people are scared of being judged for? It's a mixture of things. So it is. Can I have just a second of your time? If this podcast has helped you understand your brain or made you feel less alone, can you do me one favour? Can you hit the follow button? And I'll repay the favour by continuing to book the best and most exclusive conversations on this topic. Please enjoy the episode and always remember, you're not broken, just different, and you have always been enough.

1:41Dr. Asif, welcome to the ADHD Chatter Studio. Thank you very much. It's a real honour to be here. I'm so excited about this episode. How to spot masking in autistic ADHD and all-DHD individuals. There's four boxes in front of us. Each one has within it a sign that someone is masking. And there's also a fifth sign. And a visual representation of that fifth sign is hidden somewhere in the studio around us. And we're going to come back to that at the end. But before we dive in, Dr. Asif, you're a consultant psychiatrist. You've spent years assessing and supporting individuals with ADHD and autism but what made you dedicate your career to people whose struggles are so often misunderstood it's a really good question and I think for me getting involved as being a psychiatrist was having a genuine interest in people I like their stories I like to understand where they come from and I remember when I was a medical student a particular patient I was fortunate enough to sit in with um didn't have adhd or autism but it really struck me her experience and i thought actually if i'd gone through that experience i would have had the same thing so the scenario was was she worked in a betting shop um in east london um and in essence somebody came in to rob her um or rob the shop and obviously had a weapon and she was speaking to a psychiatrist and describing what I later learned was PTSD symptoms.

3:18And I think there's always that perception, isn't there, that people with mental health problems can be weak or there's a flaw. And that's obviously very old-fashioned and not the kind of prevailing understanding of it. But I thought, actually, if that was me and I was working behind that counter, that could happen to me and I could have PTSD. And that really normalized the whole experience around mental health for me. And I thought, actually, anyone can have this with the kind of different circumstances. And so that got me really interested in psychiatry. With ADHD and autism, it was something I kind of fell into.

3:55And obviously, I've subsequently been diagnosed with ADHD myself. And so perhaps I always liked ADHD and autism, but I just didn't know it at the time. And I was just fortunate enough to be trained by my organization in ADHD and autism. and again that it was almost like a light bulb moment that patients that I was seeing on a regular basis people that didn't quite fit what we were taught or what was in the textbook suddenly there was a revelation that they could have ADHD or autism at that point in time there wasn't really an understanding that ADHD and autism could be together so it's either you had ADHD or autism and again of course we've evolved but even that understanding was a real revelation for me and And it became so interesting to learn about their experiences, what they've struggled with, what they can do really well.

4:47And I really wanted to help them on that journey. Incredible story. Was there a particular moment that stands out, one that perhaps changed how you think or understand ADHD and autism? Yeah, absolutely. I mean, there's a couple of people I think about. one is a teacher that I was treating who had a diagnosis of schizophrenia and what I struggled with was he seemed to get really well very quickly on low doses of medication and what we've subsequently learned or he subsequently got diagnosed with autism was that we know that actually those kind of serious mental illnesses don't always present in the classical way and And actually what we're taught is people with kind of severe mental illnesses, be it bipolar or schizophrenia, often they can't function in a day-to-day life.

5:41Yes, not always, but sometimes. Whereas this chap was really high functioning, was a teacher. And again, you might not think, how does teacher and autism fit? Because you want that predictability and routine. But he actually, he was a, he was an, what I would call a locum teacher. So it's a supply teacher. And it was like, I don't know how that fits, but it just really worked for his internal rules. But obviously when he became unwell, he became unwell, but he recovered really quickly. And that made me think, well, actually, these kind of neurodevelopmental conditions can really just change people's outlooks, presentations, recovery journeys.

6:14So that's really stuck in my head because it made me think that actually there's probably a lot more people with ADHD or autism within services. I mean, more recently, there was a study from Sweden where they looked at their kind of general adult population within the clinic. And they used a screening tool for autism and found 20 % of their population that they were looking after or serving, whatever the right word is, actually had autism. But they didn't know about it. Wow. So I think on one level, that's really helpful because you want to make sure you're treating the whole person and not just the condition or particular disease.

6:53but on another hand, I think it was probably a bit of a revelation to them because they just didn't know that. It can also mean for some people with ADHD and autism, they're much more likely to have a secondary condition. So it's very much comorbidity. Having a second condition is very much the norm. That's huge. That's unbelievable. It's so interesting, sat opposite a psychiatrist and so many people, the ADHD Chatter listeners, are looking for answers to their own identity questions. And so many people come to psychiatrists to figure themselves out. But if I flipped that question around, after all of these years, what have neurodivergent people taught you about being human?

7:38I mean, it's so invaluable. It makes me think about that Forrest scum saying about yes there's something like there's different chocolates or you know varieties of spice that's it yeah um so for me it's taught me that you know people are different um i i think different makes it interesting um and you know again and perhaps in the past we would have said different means bad but i don't think it's as simplistic as i i think actually variety is a spice of life and people can be incredibly creative incredibly organized incredibly detail focus and for me it's taught me that there's a place for everyone um and and i know people don't often like the fact of talking about neurodiversity or being neurodivergent is as a superpower but i think it teaches me that there's a place for everyone you've just got to find your right place and sometimes that's easy and that takes weeks months but other people it can take a really long time but once you find your right place you can certainly thrive yes absolutely gosh there's a lot to unpack.

8:42It's so fascinating. I'm always interested when someone perhaps goes through many, many years, decades sometimes without answers, and they are living with thoughts inside their own heads. They tell themselves horrible things. Why can't I just keep that relationship going? Why can't I just stick at that job? Why can't I not buy a domain and not get bored of that hobby after two weeks when someone finally gets a diagnosis whether it be autism adhd or both is there a common sentence that you hear people say for sure um and that makes so much sense or the other one that people often talk about is i've always felt different i've never really felt like i fit in um i've always felt like slightly on the outskirts of people and it gives people a framework or an understanding about who they are and why they are who they are um and you can because of the way that society is so society is built around neurotypical people yes so so again what we're starting to learn is that perhaps a neurodiverse neurodivergent population is about 20 but the world's built for the 80 yes so you can feel like a square peg in a round hole but i always think to myself well why is it a round hole why can't we have different sized holes that fits everyone so i think it gives people an opportunity to say look you can accept who you are as with anything in life there will be things that you're good at things that you're less good at and actually we want to kind of focus on what you're good at on and what you enjoy and again if we can find something for you with that then again you can thrives.

10:23Absolutely. And all of the items on the shelves behind yourself and I represent a part of the neurodivergent experience. And what you were just explaining, it perfectly encapsulates the toy behind you to your right, which is the many holes in it and lots of different sized objects trying to perhaps squeeze through a hole that was designed for them. Does that explain why so many neurodivergent people grow up truly believing that how they are and how they present is part of the human experience for sure um and again we get these messages all the way through our lives um from early childhood for our schooling in our adulthood maybe even relationships in the workplace so we're constantly getting the message that maybe we're not doing something right or this why is this so hard for you or why have you reacted in this way and actually you're making a mountain out of a mohill and so the constant messaging that's coming back to you is you're not fitting the mold but who defines that mold yes society defines that mold and i think we're in a really progressive space where we're starting to accept and recognize differences um but they're getting those messages from a from a young age hopefully that's changing and and and for this new generation that's growing up that will be less problematic but they're getting those messages all the way through their life so you then modulate their behavior which ends up being called masking doesn't it that you're modulating your behavior in order to fit the mold that society puts tries to put us in so again square peg round yes wow it's like living a life with an instruction manual but one that wasn't written for you perhaps yeah i sometimes i mean maybe it's not the best analogy in the world and i love analogies so i'm going to bore you with analogies but i sometimes say to people it's a bit like everyone's playing football but you're playing rugby wow yes yes So for me, I quite like those visual analogies because it makes sense for me.

12:20And I wouldn't say I'm necessarily the most cleverest person in the world. So I want to keep it as simple as I can. So again, if we take that analogy and pick it apart, it is a game with a ball. You play in a team. There are rules, but the rules are different. Yes. And so if you're playing rugby and everyone else is playing football, sometimes that can go hand in hand because, you know, there's goals and tries or whatever. But on other hands, you're not supposed to pick up the ball or you're supposed to use your foot. So that's where those differences can misalign. And so that's the difficulty.

12:50And the other thing that sometimes happens is it feels like everyone else has been given this rule book, but somehow you're never given it. So you're trying to kind of figure out what you're doing, bumbling along, learning from the external world, whereas everyone else feels like or seems to know what they're doing. Yes, and I suppose if you're playing rugby when everyone else is playing football, you're probably going to get quite a lot of bruises and get told off quite a lot when you try and kick the football over a metaphorical rugby post. You're going to get the whistle blown, you're going to get told off, you're going to be told that you're doing it wrong.

13:22And the compounding effects of many, many comments are going to really damage your self-esteem. Do you think that's why a late diagnosis can be so emotional for many? Absolutely, absolutely. because you in essence you felt like the square peg in a round hole all your life and again metaphorically and probably taking the analogy a bit too far but you tried to bang your your screw into that hole and it doesn't fit and it's tough and so you're constantly getting messages that you know what you're doing isn't right you're too emotional why you know why can you not manage a busy pub and you want to go to a quiet place because of the sensory overload so that can be incredibly damaging and so you get a mixed range of emotions yes you get anything from relief and validation to even grief because you're thinking well i've lived all of these years decades of my life thinking there's something wrong with me why can't i do this um there must be something wrong with me versus actually you just have a different different operating model yeah everyone else and again does that mean your operating model is wrong and there's one is right no it's just different Yes, gosh.

14:30And the compounding effects, the consequence of that bombardment of extra criticisms can make you feel very vulnerable to criticism when you're older. Absolutely. And so it can be very damaging to self-esteem. It's not uncommon for people then to present with anxiety or depression and PTSD. And again, what do we know? We know that it's much more common in the neurodivergent population to have anxiety and depression. So actually, some of my patients, they've come and said to me, you know, I've got anxiety or I've got depression. I've been on antidepressants. In fact, I've been on loads of antidepressants.

15:03None of them have worked. I know something's not right. And I'm being told by my GP or by another psychiatrist I've got anxiety, depression, but I just don't feel that it fits. And when you start doing those kind of screenings and assessments, you then realize, actually, they've just seen the tip of the iceberg, which is the anxiety and depression. But what's driving everything else is the neurodiversity underneath. And actually, sometimes when you treat the neurodiversity or support the individual with neurodiversity, the anxiety and depression goes away. Yes. I've spoken to so many people, particularly women, it seems that the anxiety is often like one of the primary manifestations.

15:38And they go to care, explaining that they are crippled with anxiety. And then they're perhaps diagnosed with an anxiety disorder. And this completely perhaps delays an ADHD or an autism diagnosis? absolutely because again you're treating what you see in front and we've all done it i've done it yes though i'm not saying that i'm anything special or different to anyone else we often treat what's in front of us yes until we get that knowledge so again if i think back to when i was training before i'd been trained in adhd and autism i'd absolutely missed it yes and so the solution is which again is easy to say is that we have to increase the general medical or clinical workforce understanding of anxiety and depression i think podcasts like yourselves um kind of perhaps is where social media is quite helpful is people's understanding of autism and adhd are is better so they can go to professionals and say well actually i know that i come across as anxious or depressed but actually that doesn't quite fit who i am and i'm i'm not anxious and depressed all of the time it's i'm only anxious and depressed in certain situations or certain points of points of time and again that may not fit classical anxiety and depression and it may be an underlying underlying adhd and autism and again we know these things are becoming increasingly common yes so up to 20 of people have some sort of neurodiversity so that basically means if you know more than five people one of those people is neurodiverse yes yeah that's so interesting i really want to unpack this even further i want to get a little bit geeky for a second we're getting closer to unboxing the five signs that someone is masking without even knowing it.

17:14But before we get there, I want to just talk about all ADHD for a moment. And that's the dual diagnosis of ADHD and autism, and perhaps the contradiction of all ADHD that nobody talks about. On the one hand, I suppose your ADHD side of your brain can crave novelty, but the autism side of your brain perhaps craves predictability. How is it possible for one brain to experience both of these happening simultaneously? Yeah, and it doesn't seem to make sense, doesn't it? How can that happen? So in essence, it's the kind of neurological, the pathways within your brain that are somewhat similar, but also different.

17:52So again, in my mind, I think about it in two different ways. It's having two operating systems. So again, if we talk about that in the modern world, one part of your brain, Apple, another part of your brain, Android. Yes. And in essence, they're doing the same thing, but it don't work exactly the same. So I have an Apple phone, for example, but I really struggle if I have to go on an Android because it doesn't work the same way. And so that can be a way that you can see ADHD and autism. They are trying to almost do similar things, but not obviously exactly the same thing. And it feels like this push-pull factor.

18:24another way of looking at it is uh and as i said i love love analogies is the car analogy so you could look at it as saying adhd is like putting your foot on the accelerator you want to look at that exciting new stuff do something new this novelty new situation whereas the autism side of you says hold on hold on i don't like new things i like predictability and routines i'm going to break so different parts of your life or different situations you can have more foot on the gas and more foot on the brake but if you're doing both at the same time then you kind of feel like you're a bit stuck yes you're not going anywhere and that's where it ends up being it can be tricky and confusing and difficult for you as the individual and people around you as well just expanding on the the windows or the android versus mac analogy if we move the cursor over a folder called audio hd contradictions and we double clicked on it and we went into that what does it actually feel like to live with those contradictions again it can feel so confusing difficult to you as the individual and again people around you and you can have different situations so you can have a situation where your adhd side of you really likes new things um likes uh things that are stimulating things that are exciting uh you know really focuses us down on things that interest you so you might say something like coming on a podcast that's really exciting and it will kind of give you an adrenaline buzz or dopamine buzz but then your autism side or if you had autistic traits like me then says hold on hold on but I like predictability it's not safe being at home is more comfortable do I really want to go out and do those sort of things so again you have those kind of push pull factors so that's the break accelerator situation Dr.

20:16Kuran Sadiq who you've had on before we'd talk about it in a different language he'd use order versus anarchy and it's about what you want so a different example might be a holiday so at home you've fully organised your holiday you know exactly what you're doing minute by minute, hour by hour on the holiday and you get there and your ADHD says oh that's a bit boring, I don't want to do that so you throw out the whole script and go and do something different and that's where the two sides of your brain so it depends on where you're at how anxious you feel what's going on is a comfortable environment is it not comfortable environment is the lights too strong is the noise too much so it can flick in between and we have different presentations so we have people who are a udhd and maybe adhd dominant we have people who have a udhd and might be autism dominant and we have people who are variable who flick between the two yes i laughed in the middle of that because i'm going on holiday tomorrow to france that I have meticulously planned day by day this particular itinerary.

21:14But last night I saw an advert for this show in Paris and I was like, oh, I want to go see that. But I've already planned it. So I don't, I'm sure my impulsivity will squeeze it in. So interesting. So I've spoken to many people with ADHD, autism or ADHD. And one thing they tell me is that they're terrified of being judged. What do you think people are scared of being judged for?

21:40Dr Asif Bachlani:push your limits train with precision see the results at equinox that's high performance loving everything you need to lock in and unlock your potential at equinox start today at equinox.com

21:57it's difficult because you have been given multiple messages through your life about what you're doing or what you're saying or how you're behaving may not be right or it doesn't fit into the social norm so then what you then do as a kind of protective adaptive mechanism is mask yes um and so what you're really worried about is does the person like me for who i am or does people like me for the mask that i'm wearing um and so what they're worried about is if they reveal their true self or even parts of themselves are they really going to be liked and actually the person liking them is it because of their masked self and is that why i've got friends or why i'm popular or i get along with my family versus actually um they don't really like the real me or if i start talking about um i can't go to this pub or restaurant because i find it too noisy or the lights are too bright and actually am i being difficult or awkward or do i overreact am i having to modulate or hone in my behaviours.

23:03So really what we're worried about is being judged and perceived for who perhaps we really are. What do you think they're scared people will see? I know you said who they really are, but can we zoom in on that a little bit? Inside the person's head, what do you think they're scared someone will actually see if the mask slips? so i think it's a mixture of things so it is perhaps they don't come across as competent or capable as they as they kind of come across so a classic example is um people with adhd struggle with organization losing things and forgetting things now you might put mechanisms into place that in say in a work setting you are really good at what you do yes but there's a lot of work that's done underneath the surface so that's kind of that iceberg metaphor that what you see at the front is somebody who is doing really well very organized you know doesn't is not late for meetings it doesn't miss things but what you might not see is that they don't go to the toilet they don't drink enough uh they're they're putting in so much compensatory behavior to manage that that by the end of the day they're burnt out or tired um i think the other thing is is that maybe you know they're worried that they can come across as too much or too difficult yes so meaning am I talking too much am I talking not enough am I giving enough eye contact am I staring at people oh my god was that joke appropriate or is that inappropriate they didn't laugh or was my joke not funny are they going to think you know all sorts of things so I think we're constantly second guessing trying to interpret modulate modify our behaviors because ultimately we want to feel that we're a good human being and that we have a place in society but we're often getting messages that actually we don't quite fit or we don't have a place in society but i think that's obviously changing but that's what we often as you see if you were my my age in my late 40s that you've got those messages throughout your life yes it's so fascinating i feel like a simple conversation in the workplace maybe or the playground or even with your partner for some that can be a fleeting moment.

25:12But for someone with ADHD or autism, perhaps it can linger for many hours, days, longer, you're ruminating. They stopped asking follow-up questions. They thought I was too much. They didn't laugh at that joke I made, or there was an awkward shuffle with their feet. And you sort of focus in on everything and you internalize it to think that that person didn't like you. And then that ruminates and it can be exhausting. Do you think masking is a conscious decision is it something you physically or mentally know that you're doing in the moment i think it's a mixture of both i think it can be over the years that you've learned that behavior so it's like learning a new skill yes that initially it feels artificial or it feels like it's a very active process and that can especially be sort of in childhood but as it becomes part of your day-to-day life as you grow up as you become into an adult then it becomes routine so it can almost be subconscious so again another analogy for you is a bit like when you first learn how to drive so when you're a kid and you're getting that kind of feedback that may be you know what you're doing or what you're saying or or you know for example your stimming behavior isn't socially acceptable you then actively try to change that behavior so it's it's you're having to learn it on the job as it were.

26:34But as you become an adult, you become more experienced, more comfortable with it. It's maybe not what you want to do, but it's certainly getting more comfortable and it becomes automatic. So it's almost, it's not even in your kind of conscious brain, it's just done subconsciously. Yes, eye contact, I think for me, was a big realisation of a sort of subconscious mask that I had adopted. I guess as a child, you observe human behaviour, you see that what's accepted by the world, what's criticized, if you don't make good eye contact as a child, or with me certainly, you get told off. You get called rude.

27:09Whereas you can either have my perfect eye contact or my undivided attention, but you can very rarely have both. And I think that was a huge realization of how much I was forcing myself to make eye contact with someone. And actually, as a consequence, I had no capacity to actually take in what they were saying. And often didn't know what to say and then I thought I came across as as as weird as a consequence how many people do you think you've assessed for autism and ADHD it's really good question so I've been doing this for coming up to about 14 or 15 years so kind of rough ballpark figure I would say somewhere between three to five thousand wow okay so a lot and obviously without identifying anyone is there a particular assessment that stayed with you forever there's actually two that i wanted to mention um and actually it was linked to a recent article that came out in the press uh last week which i at least saw um in the news which was around asians so obviously my community being sort of three to four times less being diagnosed with adhd and autism so there's a chap who is almost the same age as me, Asian, who came with depression and anxiety.

28:28And similarly to somebody else I've described, said that that doesn't quite fit me. And there's something else going on. And we eventually diagnosed him with ADHD and autism. And the reason that it kind of stuck out in my mind is, as I said, roughly the same age me um lives in a place i used to work um and really enjoys his work but finds it incredibly difficult um being around different people and one of the things that he has is this incredibly strong sense of right and wrong that kind of moral justice and so when he sees something that doesn't quite work or it doesn't quite fit the usual processes or processes that are supposed to be followed he will rightly point that out unfortunately it hasn't been received very well and actually one of the things that was driving his depression and anxiety was that actually there was a grievance against him and I guess it really resonated with me because he's doing something he loves uh he's good at his job but he also then points out things that are not following the systems that that that perhaps they're supposed to and it's about those unwritten rules whatever i say those written rules and then there was a uh a young lady who's at uni um and again that we diagnose with ADHD and autism again from the South Asian community and again very bright going to be a scientist going to be really successful at what she does but it's the lack of understanding from the people around her about what's going on for her so there's often a mismatch between what you do outwardly and what's going on internally.

30:25And they're both, in my way anyway, in my opinion, good at what they do or outwardly successful at what they do. But the internal mechanism, what's going on inside them is very different than what's presented externally. And that mismatch, that perhaps lack of understanding from the people around them has caused the problems for them. Sure. Wow. Yeah, that's fascinating. The justice sensitivity piece is so relatable. I was in a coffee shop recently and someone just walked in. I was queuing up to get a coffee. And that person walked in and they just went straight to the front of the queue and ordered their coffee and got served.

31:03And with complete disregard to the queue and they picked up the coffee and walked out. And no one said anything, but it really stayed with me for hours. I was like, how dare they just violate this social rule that everyone else is following? Do you think a particular sensitivity to justice, is that an innate part of being ADHD autistic? Or is it a consequence of living your life and feeling like you have to stick to the rules because you've been made to feel different? I think it's a bit of both. I think we have been, as I mentioned before, squashed into this hole that we don't quite fit into.

31:42so then we are kind of repeatedly from different um people family friends colleagues told that we need to follow the rules these unwritten rules that somehow everyone else knows about what we don't know about and then when other people don't feel that follow those rules there can be a really strong sense of well that's not really fair why am i expected to follow the rules but they're not um and no one says anything to them as as your example in the coffee shop but i think we feel it very intently um and i've often described it as a kind of burning feeling i sometimes have got that you know when uh you're sitting in a kind of a conversation or a classroom or something and you you feel like you know the answer to it but maybe your autistic side is making you feel anxious so you don't say anything but you knew the answer so you've got this strange feeling that you've got this burning sensation that you know the answer and you want to say it but you haven't got the confidence to say it so you keep it quiet and that and that's really difficult uncomfortable discomfort feeling can last for many hours and for everyone else it's not a big deal yes or if you're in a meeting and the boss or they're putting a problem to the group and you've got this really really good idea but you're too anxious in that environment to say it and then someone else shouts out an answer that you deep down know isn't quite as good as yours and the boss says that's brilliant and they run with that and you're thinking why didn't i just say it yeah a big piece of feedback i've heard from the community is that they at least they feel like they're a bad friend to people that are around them and as a consequence of that sometimes they can leave friendships that are actually quite dear to them and that they truly value but for many reasons that i think we should go into they don't feel safe in that friendship why might someone abandon a friendship that they deep down do truly care about and again that feels that that kind of push-pull factor that doesn't really make sense so i think it can be a lots of different reasons um one is obviously they've been masking um and so they're not presenting their true self and then they worry that if they don't mask or take the mask off completely maybe the other person won't like them as much or they'll reject them you can feel I guess even with people that you get along with or people that you like you can still feel like a stranger because the way that you think the way that you process is not a neurotypical way of doing that and again even though you like your friends and you might have some shared interests you still feel otherly or different and then there's the classical one that I often do which is somebody texts you and you look at it and you think okay that's interesting but actually it's not urgent and i don't need to deal with it now and if i deal with that now i'm not going to finish the piece of work i'm doing over here so then you don't respond and then days become weeks weeks become months and you suddenly think oh my god this is going to be so awkward that i have to text this person back but i haven't texted them for months will they think i'm just ghosting them or why am i so then that becomes really awkward so then you're starting to think about well what's more awkward texting a friend that you like after months or not texting them at all and then i think sometimes you do the lesser of two evils which is not text them at all yes and then you can kind of lose that relationship um and again the autism side can be different that you can have very intense friendships and but not very many and i think that's one of the differences between adhd and autism so i've always described adhd is a bit like a social butterfly so you get super interested in somebody new exciting somebody that shares your interest um it's novel it's it's interesting so you're all in meeting up all of the time texting all of the time and then somebody else new comes along and they're also interesting so you float from the original person to this new person and it's not that you don't want to be friends with that person the first person it's just this new person is way more interesting at this moment in time so that's the kind of social butterfly thing with autism it's not that you have loads of friends but you have a few friends but it's incredibly close and you might have had them for a very long time and you feel very comfortable with them then something happens so something ambiguous happens there is a bit of a disagreement or a misperception of things and that's really confusing because what what people want with autism is is as much as possible predictability and reliability so then you're faced with a situation where i really like this person i've known for 10-15 years but we've had a bit of an argument so again what's easier to deal with easier to deal with the argument and the kind of anxiety or complexity or is it just easier to step back and again people end up stepping back and then you might lose that friendship because it feels like what was certain is no longer certain yes so much time can go past because you're avoiding the text message it's too late now You have to probably say, I'm so sorry for the late reply or something that's in your mind, at least very combative and scary.

36:57So that just creates more pressure to avoid it. Therefore, more time goes past. And maybe in your mind, it's just, well, the path of least resistance at this juncture is to just not speak to this person again, which I think is actually heartbreaking because that is or could have been a friendship that A, was already something great or B, would have turned into something great. Do you think this cycle of perhaps becoming super intensely interested in people and then maybe for whatever reason that friendship gets abandoned, can that over time within the autistic person's brain or ADHD person's brain, can that create a unique experience of loneliness?

37:36for sure because you end up having a pattern don't you of you make you could make friends easily so people with ADHD tend to make friends easily yes you make friends easily but one of the things that is so effort requires a lot of effort and seems so difficult is sustaining and maintaining those relationships because it's that novelty interest uh newness um that it's exciting but it's hard to maintain it over time and then you have the kind of what you might call that executive dysfunction which is it's hard to respond to messages responding to messages feels like a mountain you're trying to to um climb up that you're forgetful um you you know may not remember to respond to this message in a good amount of time um so for sure it can be incredibly difficult and sometimes that means that actually you find your own tribe um and you're naturally drawn to people who are neurodiverse because some of these unwritten rules you don't need to explain because they're often having the same sort of experiences so you can be awkward or geeky together and that's okay you can talk a lot about a particular interest and get really into it and then not say anything at all for a couple of minutes and that's also okay but perhaps when you're around neurotypicals you feel like you have to explain or even apologize why you're doing one thing or another thing.

39:03Just zooming in on the topic of loneliness for a moment, because I feel like that's such a point of struggle for many of the listeners. If someone doesn't unmask and they feel like to be around people, they have to put on this character that they believe is called normal. Can it be possible for someone to be in a crowded room and still feel exceptionally lonely absolutely um for sure i mean again you might be surrounded by people that you get along with that you like that you share some interests but what you're feeling is you're hiding your authentic true self and that you can't really fully be you and you're kind of self-modulating reining in your usual behaviors or your kind of your what you would see as part of your personality in order to fit in so again although you're around people that you like and perhaps even people that love you you don't feel like you can be your true self and you're kind of worried about talking too much not talking enough maintaining eye contact not having enough eye contact overreacting interrupting people for ADHD people it can be just getting up and walking around during the conversation uh for autistic people or people with autistic traits it may be that you need a certain degree of predictability so you need to have learned scripts or you've learned small talk in order to manage these situations so it feels like you're having to again adapt in order to fit in with this within this broader crowd so is loneliness really about being alone or is it about never feeling understood yeah so i think that's very true actually and it's it's a it's a good nuanced point which is it's not really around how many people you've got around you it is more about do people really understand you that they maybe not share the way that you think but understand where you're coming from and that you can be your true authentic self and that you can share that interest in Harry Potter or comic books or trains or particular TV programs and not feel like you're weird or you're that weird kid or that weird adult.

41:27So really what you're looking for is connection and understanding. Not necessarily that you want people to think like you, but you just want to understand that we think differently or are wired differently and we might come to different conclusions and that's okay. But I think that's the variety in life. I've grown up in a household where one of our popular sayings in our household is, not all five fingers are the same. Because if they were the same, you couldn't make a fist. And so for me, that is a variety is a spice of life situation. Actually, it is really helpful that we're different sizes or different lengths or opposable or non-opposable, because actually we all have a role to play.

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