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

0:00This episode is brought to you by Welch's Fruit Snacks. Back to school season can be tough on parents, but choosing a snack you and your kids can both get behind doesn't have to be. Stock up on Welch's Fruit Snacks, made with whole fruit, and now made with no artificial dyes. It's a snack kids already love, and one you can feel good about giving them. Go back to school with Welch's Fruit Snacks, now made with no artificial dyes. The diagnosis of ADHD doesn't lead to things joining together. I've seen people separating, divorcing. Now it's all in the open. Both the parties aren't able to live with that reality.

0:39Dr Khurram:If there was a child and you could only tell them one thing about ADHD, what would that be? That ADHD is not a mixture. It's a completely different neurobiology, which comes with a different presentation. It comes with a push and a pull that you do not experience in either autism or ADHD. It can be a balancing act if you get it right, but if you get it wrong, it can be devastating for you. I wasn't lonely because nobody loved me. I was lonely because so few people truly knew me. Why do you think so many people with ADHD feel lonely? It's multiple factors, I think. Can I have just a second of your time?

1:11Dr Khurram: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.

1:33Dr.

1:34Dr Khurram:Karam Sadiq, last time we did a fascinating episode on ADHD, which is the dual diagnosis of autism and ADHD. And there was one comment on the YouTube video that really stood out. I want stability, but I'm bored to death at my job. I want connection, but I'm terrified of intimacy. I want order, but I can't keep things orderly, no matter how hard I try. I want to be myself, but I'm always afraid of being too much. What are some examples of ADHD and autism pulling a person in opposite directions? The need for social interaction, but then not able to manage that interaction. I think that is the key.

2:21Because what happens is that people love to socially interact. They have the energy. ADHD provides them with the energy. They like the idea of socializing. They like the idea of being with people. And just before the interaction happens, they start to have cold feet. A lot of the times they just cancel the point. They do not go. They kind of make an excuse. But sometimes when they go, they feel kind of as if they're being judged. They're in the middle of something that they do not understand. People do not understand them. The structure is not created for them. And even if they find some like-minded people, because small talk is, for an autistic person, it's a worst case scenario.

3:12Like, they don't know how to navigate small talk. Bridging is very difficult. And I've met some people who have created scripts for themselves. And they ask everybody the same script. And when somebody was narrating it to me, and I remember my father, whenever he would meet somebody after the name, the first thing he would ask was, where are you from? He had so much knowledge around the geography of the areas and the dialects of languages and everything. He could start a conversation from there. And some people, they script it so that they come to a common ground. They can start communicating.

3:53But a lot of the times, they cannot sustain the small talk for more than a few minutes. And then the social interaction has a time limit to it. It is as much energy that you have, especially when the ADHD is generating that. Once the social battery is gone, all of a sudden you shut down. You don't want to be there. all of a sudden people see a different side to you from being very bubbly and conversational to very aloof very recluse and wanting to leave the place as soon as possible and then you take days to recover them from that social interaction i think this is one of the most debilitating

4:35Dr Khurram:things that i've seen in our dhd you mentioned that someone without dhd is concerned about being judged when they go into a social encounter? What do you think they're worried about being judged for? As I explained to the people that I see, that it feels like it is not a science, it's not an evidence base, but I'm pretty sure at some stage, five years, 10 years from now, we'll be able to see that there's a DNA connected, there's a genetic link to having a lack of social template in autistic individuals. So that lack of social template means that they don't have a map to navigate the social inputs.

5:17Somehow other people, non-autistic people, you put them in a situation, they just fly through, they breeze through it. Whereas others, they have to define the situation, then they have to define how they have to behave, how they have to converse with people. how they have to carry themselves in those conversations, what are the things that they like to wear in those situations. And if, for example, if it's a black tie event and you have not been a person who likes to wear suits because you find it very authoritarian, then again, you're uncomfortable anyways in those situations. And there's so many questions going on in your mind.

6:04what are people thinking about me am i doing it right is this the right thing to do is that the right thing to sit down or what will people think of me if i'm sitting aloof in a corner reading or going through my phone or just having a time for one to myself so those are the questions that that actually determines that and they feel that they're being judged in that particular situation.

6:31Dr Khurram:And that feeling of being judged, does that make the person feel guilty about themselves? Not guilty. I think it impacts on their self-esteem. It impacts on their self-confidence. It makes them believe that they are not wanted. They don't want to be here. The world is not made for them. No matter how hard they try, they feel that they're not going understand the codes that exist in the neurotypical world i was in a consultation yesterday and it was a three and a half three and a half hours consultation one of the most beautiful consultations that i have where you you feel that you're connected and both cried like again when the person was explaining it to me and they were tearful and i became tearful because i could understand exactly i could feel the empathy i could feel it happening to me in the past it brought back the memories and and it's so real that the feeling that you do not belong in this world the feeling that no matter how hard you try it's not going to get better because people will not understand you all the onus is on you to understand them so that's that's that actually is a killer for a lot of people killer in a way that destroys the it destroys the person the confidence the self-belief the self-esteem the strengths and all they look at is the negativity in their life what do you think are the biggest things that someone with audi hd blames themselves helpful their inability to be able to understand people it's the inability to be part of a social situation it's the inability to find the code which is actually missing in their template they don't have it and they keep on finding it but if you don't see it if it doesn't exist how can you find it and then that's why they have to create their own codes and then those codes that they create they're not kind of compliant with the society because they're seen as different like that's why they're called weird and they're called different and they're called somebody who's inept who's inept to kind of socially work towards it they haven't called so many labels like when children lazy a teenager disruptive so all of these kind of labels hide the person underneath what about being a bad friend can that be something that weighs on someone with ADHD they might not have the consistency to keep up a friendship or the way to communicate their needs and their emotions it's funny that you ask that one of the questions that ask people especially in the ADHD assessment and it's a funny one it's a controversial one so do you like people like all of a sudden they just most of them they just burst into laughter and again it's a lot to do with small talk once you find your tribe that's the important thing who are your friends what is the definition of a friend and again in our dhd that's again the differentiation between an acquaintance and a friend can be very blurring because they don't understand that and by the time they understand sometimes it's too late for them and a lot of the time when they find their tribe they don't have the pressure that they have to whatsapp every day they have to text every day they have to call every day probably they meet every in three three months time or four months time or five months time and they'll reconnect where they started from and it will be the same chemistry it will be the same dynamics and other times when they're not in their tribe somehow the activity within the group it tells them that they're lagging behind as if they do not care as if they're not a good friend, as if they should not be there.

10:29Dr Khurram:If someone never finds their tribe, if someone just goes through life and they never ever have that understanding of I am or ADHD and they're almost masking way, way too much, how can it have an impact on the trajectory of someone's life if they just go through their life and they're masking too much, they don't realize who is good for them and who isn't and they never find their tribe? I really hope not. I really hope it doesn't happen to anybody because it's a scary proposition it's a scary proposition in a way that they have to have the burden of masking and when people say masking it's not just wearing a mask it's the energy that goes into that it deflates you completely whereas people are concentrating on something else at work for example they're concentrating at their work half of the energy of neodivergent are utilized in kind of trying to fit in and fit in is a wrong word because it means that it is an implication for you to be like something else or somebody else we are all different we're born different a genetic makeup is different how do you expect everybody to behaving the same very manner and again that's that's where the neurotypical world has got it completely wrong.

11:52And to be able to think about that all their life, they have been called rude. They have been called abrupt. They have been called direct. They have been called somebody who's a disruptor, who breaks the families, who breaks the friendships, who has not achieved much. Whereas all their life, they had been working towards masking themselves. Because all their energies, all their efforts were towards that very bit. And it completely changes your trajectory. It changes your trajectory in a way that, because there is this rejection sensitivity where you are rejected by the whole society. You're the best person who would understand it.

12:40You have written a book about it. The first book ever written about it. And it is amazing to see the impact of that. You miss opportunities. You let go of opportunities because you think you're not good enough. Because everybody around you has made you feel that you're not good enough. Whereas you might be the most capable person around. Things that you did not feel that you're fit for, you won't even apply. You'd love to do that. This is your passion. but you know that everybody else has told you that you're not going to succeed. Hence, you're going to be an unsuccessful person. So the fear of failure prevents you from utilizing those opportunities.

13:26Dr Khurram:So interesting. So, so interesting, Karam. I bumped into somebody who has a diagnosis of ADHD at an event, and they were describing some of the contradictions to me. And I wrote down the quote that they said to me, and that was that I spent my whole life thinking I was lazy because I couldn't be consistent. And I thought I was broken because I couldn't be spontaneous. And that stayed with me. And I think going back to how it can affect your trajectory, on the one hand, you've got being told that you've got great potential at school, in the educational system, which was very much my story, perhaps job hopping, jumping from job to job because you lose interest or you can't stick at it.

14:06Dr Khurram:Or maybe you've got a series of failed relationships and you don't understand why they all broke down. But do you think the biggest sadness or the biggest heartbreak is really you sort of live your whole life based on a misunderstanding of who you really are? It is. It is. And again, for some people, I really hope not, but there's a possibility they might not be able to find out who they actually are. The eldest person that I've seen is somewhere in the mid 80s. And they were brought there for an ADHD assessment by the wife because she had read about something and said that, yep, here's a heart of gold, but again, completely misunderstood by everybody.

14:47And again, at times by myself as well. And again, it creates a rift in our relationship. It has created massive rift all our lives because that's where the ADHD is seen as avoidance. ADHD is seen as inconsistency avoidance rdhd is seen as as if you do not care because you're forgetful you don't do the chores hence you do not care you're hyper focusing on something you're hence you're not able to give time to your family you do not care about the family um you you're kind of losing thing that has a financial application you don't care about what happens to the family as a result of those implications so they are kind of embroiled in those firefighting all their lives not able to understand what is going on and i'm talking about globally like somewhere in the middle of pakistan and rural area there is this amazing intelligent person who has was this capable of moving mountains but he's kind of drowned under the labels of being called incompetent and lazy and inconsistent all their lives.

15:59And if they don't have access to information, if they don't have access to people who can understand themselves, if they don't have access to kind of create their own tribe, access to the professionals who can tell them that they are not what they think they are, they're more than capable, I think their life is going to be drowned in that. Gosh, yeah, no, it's heartbreaking. It is.

16:23Dr Khurram:I think it sounds like the heart of this whole conversation is a crisis of identity in the ADHD conversation, in the autism conversation, but particularly in the all-DHD conversation because of, I guess, the unique perspective of masking and the internal contradictions and all of the things that you're blaming yourself for. I spoke to someone and they said, which again, stayed with me, they said, I wasn't lonely because nobody loved me. I was lonely because so few people truly knew me. Why do you think so many people with all-DHD feel lonely? It's multiple factors. Because I think one is about misunderstanding.

16:59It's being misunderstood. For example, again, depending on what side is more prevalent, more prominent in that person. For example, if they are somebody who speaks their mind out and they're very factual about things and they're very direct about it. They're seen as rude. They're not seen as honest. Whereas it should be seen as honesty. It should not be seen as rudeness. Hence, they lose a lot of people like that. They like to be part of social gatherings. They like to be part of social interactions. But they are unable to do so because all of a sudden their social battery gets shortened and shortened and shortened.

17:37They cannot tolerate more social interactions. Hence, they prefer to be on their own. Sometimes they like their own company and they enjoy what they're doing. And hence, they do not feel the need to meet anybody else. And nobody else tries to do that because they think they're aloof. They're strange. they are self-indulgent. So there are so many labels that goes in. So these layers of misunderstanding, of not being misunderstood, the system kind of not creating systems for yourself that can't be conducive enough for you to explore your tribe or your further exploration. And as a result of you sitting in a silo wanting to do things but unable to do things because it will create more understanding.

18:23And that takes you in a state where you feel lonely. And it's happened to me. Like again, still, when the rejection sensitivity dysphoria kicks in, you feel that as if all your life you have spent, you've not made a friend or nobody cares and nobody understands you, which is not true. Like now I'm very open about my ADHD for a very long time and people understand me. People see me from that angle. Especially, I think, the most important one, the patients see me through that angle and they can connect very well with me. And I found my own tribe of few people who are those people who I can be very open about.

19:03But still, it kicks in and I feel a very lonely situation.

19:08Dr Khurram:I guess to combat the RSD and the loneliness, we learn to mask and to hide who we are in order to put on this version that gets more social communication, gets more interaction with others in a quest to cure the loneliness. But I suppose that could even lead you into a romantic relationship. The mask could be so good. But then I guess over time in a romantic relationship, you can't sustain that level of camouflage because obviously it's exhausting and over time it slips away. What do you think are some of the biggest confusions or misunderstandings that partners have towards their or DHD partner?

19:48I think this is what I was saying initially the breaking down of relationships when it happens it's like as if they do not care and as I said the mask will slip away once the honeymoon period is over the actual test is when you start living together that's where the actual test is because you start to know a side of a person that you've never seen before and if the person is comfortable with you the mask will start will keep on slipping and slipping and slipping till the real person is out and we're taking on responsibilities because it will be a shared goal to be able to sustain a household like it will be working together to be able to do things for example it's your it's it's your time to to to prepare a meal and all of a sudden when when When the partner walks in, it feels like a bombsite.

20:44Everything is all over the place. You've done a good job of doing that. But again, the mess that the person has left behind, and it is seen as very irresponsible. It's seen as not caring. It's seen as, yeah, I don't do that. How come you do not do that? Get on with your life. I think it's an excuse. You're making an excuse. again these are the things that like people have been contacting me on linkedin and and with very similar stories about relationship that they do not understand why are you hiding behind this this this mirror the hazy mirror of autism and adhd what is autism and adhd it is nothing you have to get on with your life and that help that happens a lot in ethnic communities where there's lack of psychoeducation, there is lack of sensibility, there's lack of understanding around it.

21:35And I was having a conversation earlier on, and in the past few years or so, I've noticed that sometimes a diagnosis of ADHD or neurodiversity

21:53doesn't lead to things joining together, it leads in separation. I've seen people separating, divorcing, because now it's all in the open. Both the parties aren't able to kind of live with that reality and they part ways and kind of be happy about it at the same time. So it's not all about sometimes bringing it together. It's about once they know that this is the problem, these are the issues, these are the challenges. I won't say problems. these are the challenges, people decide to just move away from each other because they know the other person won't be able to sustain it or deal with it.

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23:49Dr Khurram:Just a note though, the code only works in the web browser, not in the smartphone app. Back to the episode. I was speaking to a man who has audio HD and he was explaining to me that he often spent the day at home. His wife worked away and when he heard her pull out the door keys and unlock the door and come home from work, it would make him physically jump. And he thought that he was almost quite shocked and panicked at the point where his wife came home and he felt like he could never really be himself around her. And almost like he was in a sort of version of fight or flight, I suppose, whenever she was in the house with him.

24:27Are there any signals that somebody might be masking around their partner

24:33Dr Khurram:that they might not be aware of? They try really hard. They try to be a version that the other partner wants to see in them. But it comes with a depletion of energy. like everything, masking it takes a lot of time, the burnouts that we see it's not because they burn out because of the work that they're doing they burn out because they're using extra energy to utilize keep the mask on and that's where things start to fall apart and as the energy depletes they can go into a state of depression a state of anxiety they can develop as a comorbidity, as a co-occurrence, or as an outcome of that. They're not as capable as they were before.

25:21All of a sudden, the partner will see a change in the person. And that's where the starting, the cracks start to appear in those relationships.

25:31Dr Khurram:If someone gets an ADHD diagnosis in a relationship, that must be quite a turbulent time. Have you seen it impact a relationship in a significantly positive or negative way? I have seen both. Like in a positive way where all of a sudden the inconsistencies, the differences, the lack of focus, the kind of disruptive, the interruptions, it has a name. It has a nomenclature. And the autism ADHD or the ADHD explains their behaviors on a day-to-day basis. It's not seen as blame. it's not seen as deliberate it is seen as the neurology how the brain works and how the brain is wired together but I've seen other cases where there's a breakdown of relationship massively where the other person is not able to deal with it and where there is a divergence of the vested interest like people I always tell people that The best way around neurodiversity is to finding a tribe and then finding the right environment and the job for yourself.

26:51If they're already unhappy in a job that they like and they want to leave the job, it could be lucrative.

26:58Dr Khurram:It could be bringing a lot of money, but all of a sudden they decide to do something different, which is less paying. So the cracks start to appear because how to sustain the family, you're not thinking of family first you're thinking of yourself first and no matter how how much they like to explain that i can excel in that particular area in that particular field that does not fall well on the other person and i've seen people divorcing people separating because this partner is not able to deal with the diagnosis anymore they were happy with the way they were kind of blaming the person for their behaviors.

27:38But now since there is a rationalization, all of a sudden the whole dynamics change and the person wants to explore further, wants to make new inroads based on their strengths, based on the belief that they're no more inadequate, that they're very capable of doing things, things that they have put off for a very long time for the sake of family. But the same family, they will move away from the person.

28:04Dr Khurram:How do you think that makes the neurodivergent person feel? Because on the one hand, they've just got this diagnosis. They've finally discovered who they really are and they're making sense of themselves and their brain. But at the same time, it's also caused their relationship to break down. How does that make that person feel? There are two responses to that. This episode is brought to you by Welch's Fruit Snacks. Back to school season can be tough on parents. But choosing a snack you and your kids can both get behind doesn't have to be. Stock up on Welch's Fruit Snacks, made with whole fruit, and now made with no artificial dyes.