ADHD + Autism Expert: How To Stop RSD Instantly! Is Your ADHD Actually AuDHD? | Dr Alex George

0:00Propel Fitness Water with Gatorade electrolytes, zero sugar and vitamins. Propel hydrates better than water to help you get the most out of your workout and get back to your best self. What propels you? Propel with Gatorade electrolytes. If you combine ADHD and OCD, that's an even bigger recipe for disaster because you've got a brain that is impulsive, that is emotional, that can kind of jump to the worst case scenario with an obsessive compulsive brain. That's why I think OCD and ADHD is so commonly coexisting because you have a sensitive brain that has this impulsivity, that has this higher emotional state of ability with this part of the brain that will latch on and think and think and think and think and think.

0:38Dr. Alex George is an ADHD specialized doctor. And one of the most renowned voices in the ADHD space. With personal experience involving ADHD and mental well-being. This is a conversation you can't miss. If you want to understand your ADHD on a deeper level. Rejection sensitivity is for it. It isn't just about being a bit sensitive. I think it is a risk to life and certainly a risk to health. Turning to alcohol, a very common coping mechanism for many ADHD traits, but certainly for rejection sensitivity, because actually it hurts less when you drink. It creates a delay between experience and the pain.

1:08Do you think generally, overwhelm, burnout, what can that look like in someone with ADHD? To reality, most of the overstimulation I experience is actually... Dr. Alex, welcome back. Thank you for having me. It's nice to be back, back on the comfortable chair, the ADHD chair. pleasure to have you back i have interviewed 200 people on this podcast and i think only you can answer this question goodness me that is quite bad i don't know very much depends on the question let's go let's try it you are in the public eye you've got millions of followers on social media and you have adhd do you find that combination overstimulating

1:47that's tough um potentially i mean depends in what sense i think it's kind of a blessing and a curse with adhd i think in some sense because you have an opportunity to use your creativity to make content it can become very much a dopamine driver in itself but equally there can be a lot of noise and messages and stuff that you're just kind of exposed to and see that can definitely be overstimulating. But I don't know that in of itself, being in this space and having this public platform is negative with ADHD. I just think that the change for me, it was the change of going from someone who was just like a regular person, the regular following to someone who's still regular, but suddenly has a really big following.

2:35That kind of shift was quite big for me um but no i enjoy the creativity i love that side of it um i think i just have to learn and i have been learning to manage the risk of becoming too drawn into it to allowing it to become too much of my identity i guess like there's alex and then there's dr alex i think that's quite important distinction i think the conversation of overstimulation is will be very relatable to the watchers and the listeners of this podcast but if we were to zoom out a little bit what do you think generally overwhelm burnout what can that look like in someone with adhd listen to most of the overstimulation i experience is actually around people in certain circumstances so rather than being so much overstimulated by noise online which actually i can create a gap from i can just put the phone down and easily go i'm feeling but chuck it aside what gets me usually is i end up in a place where there's lots of noise there's loads of people a lot of people talking to me, I'm having to present myself to different people, all of a sudden I can feel very overwhelmed and the overstimulation can feel like being on edge.

3:39Not necessarily an overt anxiety, but just feeling like, oh, too much. And agitation actually is a good way I describe. I feel a bit agitated. I suddenly feel frustrated. I'm like, oh, I just need space. You have this desire to remove yourself. You feel this sense of like, I need to get out. And yeah, often the only way to resolve that is to go to a quiet room put my hair dryer on which of course was my item last time is the highlight right there um put the hair dryer on and calm down and that's the only way i'm able to kind of do it and i i don't know how much of that is adhd um um i mean a large part of it but i'm obviously or at the moment going through assessment for asd as well so what flavor of what I don't know, is causing it.

4:26But it's quite a unique experience for those who are neurodivergent. I think a lot of people can be overstimulated. I think if you're neurotypical, you can say, oh gosh, I've had a bit too much of people. But I think it is a form of shutdown. I think when you're really overstimulated and you're neurodivergent, it actually means you kind of shut down. You can't do it anymore. You have to stop. You have to remove yourself then. Do you think that can come out as rage sometimes? If suddenly there's like a change in state, someone does something someone turns on the big light without warning or there's a loud cheer on the train for example there's humor in these examples but if that tips someone over the edge could that come out as anger do you think definitely i mean i actually and it can be odd the over simulation can be from odd things um like i was driving home yesterday from wales and there's just a squeaking noise in my back of my car and i kept pulling over three times i pulled up to work out what it was and i couldn't eventually i was like what is this sound and i think what happens it's like it's like ah um i think what happens is that you know you are in a state where this your your stimulation levels your your kind of ability to cope has been put to the limit um it might be a sudden change or might be a lot of people around you and then something happens so the straw that breaks the camel's back and then like that frustration can really come out what i've kind of learned to try and do over the last few years is to recognize not just when it's happening but the circumstances it's likely to happen so if i go into a room and there's lots of people, there's lots of sounds, there's noise in the background, there's some sort of like drilling going on in the background as well as this busy room.

5:56I'm like, ah, this might be a situation and I end up being overstimulated. And often I'll think, how long am I going to be here? How long do I need to be here? And I'll often plan my exit in that sense. And then if I recognize, okay, I'm suddenly getting like agitated, I'll just tell people around me now. I think the biggest thing is just saying to people, say to your friend your partner whatever like i'm feeling overstimulated because the worst thing that happens is that you become overstimulated someone says something small to you and you snap at them or you're like oh and they're like they're offended because you've just been snappy or frustrated and they don't understand they feel upset because it's like what have i done but it's not them so often i if i feel overstimulated just by saying everyone just so you know i'm feeling a bit overstimulated i'm gonna go head out and have a breather for 10 minutes it means everyone else is like, ah, okay, I know what's going on.

6:43Like vocalizing that you feel that way is the best remedy for me. Absolutely. I think there's that joke where you say you can't be held responsible for your actions when there's too many noise going on at the same time. But I feel like there's a lot of shame associated sometimes. If you do act out in a certain way at a party or you snap at your partner or your boss, then you can be ruminating in bed all night thinking, oh my gosh, they definitely hate me. Why did I say that? I'm an awful person. And you've been on a fascinating journey yourself with ADHD. You mentioned ASD earlier, autism, and I'm keen to get in that a little bit later on.

7:18But how does this all tie into your mission within ADHD? What would you say that is? I think my mission personally is to understand and accept myself and be able to live with as little friction as possible. I think my mission in terms of helping other people is to help them do exactly that on scale, to be able to be accepting and understanding of who they are. I think what's important to me is that people are recognised, if they are neurodivergent, if they have ASD, ADHD, dyslexia, whatever it might be, that is recognised for a young age. I think we shouldn't underestimate the damage that's done from late diagnosis.

7:57I'm pretty sure that most people you've had on this podcast who sat down with you, including yourself, has talked about the kind of trauma, the challenges, the bad things that have happened in their lives because of a late diagnosis or not being diagnosed. And I think that is really important. And, you know, I quote this quite a lot, and it's not because I want to be really morbid, but, you know, a person who is undiagnosed with ADHD lives on average eight years short of life if they're a woman and six years if they're a man. and that is a stark reality and that is an absolute fact and so what i want is to be in a situation where people can understand themselves accept themselves get the help they need and live prosperous lives good lives um you know there's so much pain that's happened in my life that could have been avoided the alcohol definitely hugely could be avoided some of the arguments i've had some of the mistakes i've made the impulsive decisions that i've made in my life that have caused a lot of pain, all avoidable.

8:54All of those things didn't have to happen. Yes, you learn from your experiences. Yes, I've grown from them. But that doesn't mean we just want people to put a hand in the fire for the sake of learning that it's hot. I'd just kind of like to have had some of these tools when I was younger. And in many ways, I do believe I was failed. I do think that I was failed by the system. I think the education system failed me. I was labeled as a naughty kid up until the age of six or seven. I was told at kind of eight or nine that we need to lower expectations of you in front of my parents. And I think I battle the system all the way through.

9:26I was very fortunate to come out and do what I've done, but I am not the norm in that sense. I read a study literally on the way to recording this podcast with you from Cambridge University saying that they basically had six centres in London in police stations where they were assessing and screening people who are arrested for ADHD. And on half of the people arrested had significant indicators that they have ADHD. Obviously, that's not a full assessment, but as a screening. And I think if you look at the female prison services, female population in prison, around 30 to 40 % have ADHD. I think that there's a lot of problems that we see that actually could be prevented if you were at the root cause, help people understand who they are and help them, you know, through life early.

10:18You know, that's really important, I think, in my mission. I share so much of that mission with you, Alex. I probably, like yourself, I believe school is a trauma factory for many neurodivergent kids. When I was seven, someone said to me on the playground, you could be one of the cool kids if you weren't so weird. I think there comes a point in every ADHD child's life, neurodivergent kid's life, when they realize they're different. And from that point on, they abandoned who they are in order to fit in and mask and change and become the ultimate actor playing this character called normal what do you think the consequences are of somebody masking from a young age self-harm i think masking from a young age is a form of self-harm i truly believe that you cannot pretend to be someone else or force yourself to be someone else without serious personal consequences.

11:09I think when I had a moment of realization, I've always felt different, but when I, and I remember this teacher saying, we need to lower expectations for Alex in life, and the context was I've been pulled out of class and put in a separate room, not to have support, just to kind of be sat there out of mainstream classes. And, you know, I was an intelligent child. My parents were like, he's pretty bright. He's our firstborn child, but he seems quite intelligent. Like, why are we pulling this kid out of class all the time? Not to support him, just to remove him. And for context as well, I wasn't a naughty kid as rude or anything like that.

11:40I just couldn't concentrate. And respectfully, I was very smart. So I learned things very quickly. And once I knew it, I wasn't interested in the rest of the activity, which I understand can be problematic. But I was literally like a seven or eight-year-old child. I need to help and guidance not to be kind of like, right, because you're not interested in this thing, we're going to drag you out. So, you know, I feel at that time I had to make a decision. Do I continue as I am and end up being removed from the system or do I force myself to be normal and push through it and the results of that were utter exhaustion after school every day frequently feeling incredibly anxious feeling often physically almost ill kind of forcing myself in class to focus and sit still and I just became a different person I learned all these ways to kind of fit in and appear normal that would please my teachers.

12:30And if I pleased my teachers and they were happy, it meant that I could stay in class and continue and be treated like a normal kid. And I think the consequences of that were huge. And as an adult, I didn't really know who I was. I felt even more so like I was a weirdo that was in disguise. And I think when I became an adult, the remedy to that was alcohol. It's like, well, in the social situation, which becomes a new school, which is kind of going out and things, how do I be normal? I'll drink. And drinking will make me normal. So I think the onward cost of that was huge. I think it contributed to my experience of OCD, my experience of anxiety as I grew up.

13:11Would I have experienced those things at anywhere near the level of severity? Probably not, if I knew, if I knew when I was young. it sounds like a really exhausting and probably lonely experience if the version you're putting out into the world is so disconnected from like who you really are underneath that you could be in a busy party and you're getting attention you're speaking to people but if it's the masked version of alex that's having the communication and connecting with people the the real you inside isn't connecting with anyone is it a lonely experience if you're an expert masker i think it is i mean i don't know what you think but i think when you're kind of presenting a version that's not you.

13:46You're aware that it's not you. You don't feel that any response or any sense of connection that person has with this version you're presenting is truly you. Therefore, you don't absorb that. So all the nice things you have about compliments or people being kind or people showing interest in you just doesn't seep through to the deep sense of self because you know, ultimately, it's a front. But when it goes on long enough, you don't even realize you're masking. And that's the crazy thing is that for a long time, I eventually almost believed my own mask. I was like, this is who I am, until eventually that mask was pulled off.

14:18And I was like, who actually am I behind all of this? And it's not like an attempt to trick or deceive anyone. It's an attempt to be accepted, to be allowed in, I guess. But I think that's a great cost. It's much better to be accepted for who you are than who you pretend to be. And as I got older, I realized that some of the things that used to hide a lot, my sensitivity, rejection sensitivity, which we spoke about last time being by far, I think, the worst part of ADHD for me personally. My sensitivity has become a great strength. It does cause me still pain, but I also appreciate that I don't think I could do what I do and have the empathy that I have in this space if it wasn't for my sensitivity.

14:59Like, how could I have been the doctor that I was? How could I care about what I care about now if you remove that? So, the odd thing is the thing I saw as my greatest weakness growing up has now become my greatest strength. And I genuinely believe that. So when I was younger, if you said that, what's the worst thing that you hate about yourself? I'd have said how sensitive I am. Absolutely, I would have said that all throughout my childhood. And then being tall, actually, my second hated thing was being tall. Both of those things I kind of like now. I like being tall. You said rejection sensitivity, dysphoria is the most challenging aspect of ADHD.

15:30And I totally agree. I think it is the epicenter of the whole conversation. It turns you into a people pleaser, a perfectionist. So often you just don't even bother because it feels safer to not open that door and put your foot forward no one can criticize me if i don't do anything that exposes me to negative feedback it's an extreme emotional pain when you perceive a criticism or a rejection it's fascinating why do you think for you it's the it's the most challenging aspect of aghd how does it show up with you it causes so much um so much um turbulence and arguments even like with people around you because often um when you feel criticized criticized you can feel very defensive and like oh well hang on why am i getting attacked and that often can you know something that's said very innocuously might turn into something big i think in relationships that's always been challenging um you know romantic as well as friendships as well as professional relationships um you know it's almost like a perceived like threat is coming like this is a threat um and often someone's making a very they might not even actually be criticizing you um or they're making a very low level comment but you're taking that hugely personally and then you know if you have been at all defensive you go home and then ruminate about it for like three years whatever it might be i mean i remember a situation where um until this day i think about it um i i remember actually a few years ago that someone came up to me in a bar and at the time this is actually many years ago now and i've been drinking and um this is just actually after i became like known and this person came up and said oh i want to ask you a medical question they asked me this really a complex question and i was like why are they asked they're trying to and they're like do you know the answer and i was like hey like why you know you're just i think you're just trying to like show me up or whatever like why are you asking that i was being friendly but then they were kind of asked in that way and anyway um uh it turns out that the person that asked the person asked me the question was a doctor and i was like you know why why you know why would you ask that you're trying to like make what are you trying to do and i think they were just trying to make a joke um and i think they were offended that i was then defensive and then i was then absolutely mortified for months later that i'd come across quite defensive and maybe even rude and i didn't mean to be mean to be but you know i felt like someone was attacking me and and maybe they were actually just trying to take the mick out of me i don't know but i perceived i should have just brushed it off and thought ah well whatever you know if they are being mean then whatever um or maybe they're joking but instead i took it very very deeply and you know i think sometimes that creates conflict or upset that could otherwise be avoided like i'd love to be someone that could brush things off i really do i really would love that quite a lot easier like i mean have you found i mean of all the kind of conversations about here obviously you came on my podcast the stomcast we've talked about rejection sensitivity do you think you've got any better at dealing with it after all the conversations you've had or learning you've done are you any better at dealing with rejection in the moment no when i am triggered the intense feelings are still very real very strong and there's no way to bypass that i feel like i think having an awareness of it is huge because then you can acknowledge it you can almost hold it out in front of you and say, this isn't me.

18:47This is rejection sensitivity dysphoria. I know why this is happening. William Dodson, the great psychiatrist, theorized that we were exposed to 20 ,000 extra negative comments. That comment I said earlier, Alex, you could be one of the cool kids if you weren't so weird. Stop fidgeting. Why are you so lazy? Why can't you just start the task? What's wrong with you? Stop it. And I totally relate to that. And I remind myself of that at the moment. and I try my best to remove myself from the situation with that awareness. This is RSD, don't say anything in the moment because you're probably not responding to the comment your boss or your friend has said in the moment.

19:28You know, if there's a social event and you find out about it and you say, oh, can I come? And they say, oh, yes, you can come if you like or if you want. And your nervous system gets snapped back to all of those feelings of rejection and having approval taken away. And because of that, you're responding to the compounding effect of all of those horrible 20 ,000 comments. If you respond in that state, you're probably going to say something that is disproportionate. It causes you huge amounts of shame and anxiety. So it's not always possible, but I try and remove myself. And often, you come down from it incredibly fast.

20:01And you avoid so much of that shame and anxiety of perhaps responding in the moment. People have said, I want a divorce. They've raged quit. the job when they're triggered uh and then they come back with their tail between their legs like i'm so sorry i didn't know i am i honestly like i'm not sure that i've heard of a technique that is truly curative of this i'm not sure if you've someone's come and given a piece of advice that i think fully cures it the only thing i think that works to an extent and i agree it doesn't stop happening it's just creating space between your um awareness and reaction so like you're aware that, oh my gosh, I'm triggered.

20:37I'm feeling rejected here. Right. Shut up. Basically don't say anything then allow this to pass. You know, the thing that I've found, I think helpful is trying, I'm not sure I'm always good at this, but try and use like a 24 hour rule. So think, right. If I still feel strongly about this in 24 hours, then I'm going to discuss it with this person. But until then I'm going to try and park it and sit with the feeling. But it's very difficult to do. The sense of rejection you feel, I think is incredibly crippling. I mean, as I said to you before um you know my psychiatrist um who's been working in the space for 20 plus years within the adhd space you know she feels strongly that it is the most painful for almost every adhd you know experienced the rsd side of things because it just it's not just the experience of the direction it's what happens afterwards it's the kind of as you said the knee jerk reaction the removing yourself from a situation that could have been great the ruining of an otherwise good day, you know, because of an already unpleasant experience, it's like a double pain, isn't it?

21:36If the rejection is painful, then the consequence of that rejection or perceived rejection is often even worse than the initial feeling. It's very, very cruel. And I don't know that there's an easy way to have like, to fix that for people. I think the only way I think is to just be really quick at recognizing it, naming it, saying this is rejection. I'm going to give it three hours, see how I feel in four hours, just to practice with four hours, and then work it up to say 24 for hours where you're able to sit with it, remove yourself, whatever you need to do, and then come back to it if necessary in a measured state.

22:07I think it could be so derailing. I was in an Alcoholics Anonymous meeting recently, and I share this story with absolute permission, and I've changed her name. Bethany said that she had been sober for seven years, and she was sat in the office on a Friday night just about to clock off for the weekend, and her boss sent her an email saying, can we have a chat Monday morning, have a lovely weekend? And that's all it said. and she instantly snapped. Well, now my weekend is not going to be lovely. Well, yeah. Everything but. What have I done wrong? They found out I'm useless. I'm going to get fired.

22:39And on the way home, she went to get a bottle of wine and she got absolutely drunk that night. And after seven years of sobriety, she relapsed. And she had the meeting on Monday morning. She went in shaking and he said, I've got some good news. You've got a promotion. And I posted that story on social media and she and i got a comment saying well she's obviously not working the program properly she should have just called a friend pick up the phone before you pick up a drink but i think with rsd rejection sensitive sensitivity dysphoria it's so visceral it's so unbelievable instant that often all logic and what you know to be true and all the good advice you've had in that moment we know that the problem is with the emotional part of the brain is hugely spiked the logical part of the brain is decreased they can't really exist together a highly emotional state doesn't really interact well or doesn't mean or correspond a logical state of brain it's very hard to have the both really it's like this once emotional part of you is really high in spikes all the kind of logical processing the executive functioning part decreases and we know that obviously with adhd you know it's a challenge of executive functioning it's the ability to that part of the brain's already not the best at dealing with executive functioning like okay pause um so you're lacking that side of things but you've also had a massive emotional trigger so it's like it's like a it's a it's like a it's like a perfect storm in a sense you've got a massive emotional trigger that is already switching off that part of the brain that's already under performing or not the most kind of controlled part of the brain and therefore it's a perfect situation for you know a horrible experience and i genuinely think if you can if you can find techniques to not control and prevent i don't think it's actually possible to prevent but you can manage it and you can create space then then i think that can really help but i think some of it is to that example of that situation i think sometimes you have to say to someone hey just you know like i've got adhd or rejection sensitivity is a big thing for me do you mind if we jump on a quick phone call can you just give me any details of the conversation so i have it with my team like for example abby if she says oh can we chat about something later i'll say to her what's the details in fact abby will just tell me what the details are of the conversation so i know what it is i guarantee whatever you tell me my vision of what it actually is is 50 times worse if you combine adhd and ocd which is what i have then it's that's an even bigger recipe for a disaster because you've got a brain that is impulsive that is emotional that can kind of jump to the worst case scenario with an obsessive compulsive brain and that is a perfect storm it's why i think ocd and adhd is so commonly coexisting because you have a sensitive brain that has this impulsivity, that has this higher emotional state of ability with this part of the brain that will latch on and think and think and think and think and think.

25:28It's a painful combination at times. So I'm really careful with people. If I think that I'm going to overthink this, I'll say, can you just give me clarity? Even if we don't talk about it now, I just need to know what the conversation is because I can deal with that. And exactly that scenario, it ended up being something positive. You know, the thing you thought it was wasn't even not as bad. It was a bloody good thing. And you've, like, it's not her fault, but you've, in a sense, self-sabotaged the situation out of nothing. Absolutely. In the absence of positivity, the RSD brain jumps to extreme negativity.

25:59We catastrophize, we assume, the worst-case scenario. How bad do you think it can get for someone? I've had a couple of doctors on the show who have said that if someone is triggered with an RSD episode, sometimes they can be at risk of thinking terrible thoughts, really intrusive thoughts. and I had Dr. Mark Rackley say on that actually it's quite high risk if someone is depressed for them to take their own life in that moment. Do you think it can get that bad? Definitely. I mean, I think I've definitely had moments where I've had very dark thoughts off the back of it. You know, an offensive fear is often a situation where you're getting rejected about a sensitivity of a possible event that might happen, usually more so than something's actually happened, you know, which is the things you can feel rejected about something that hasn't actually happened.

26:46You've just imagined it. And so, yeah, that can send you into a state of panic and desperation. Because, of course, again, to go to that point, when you have high emotional state, your logical brain is becoming depowered. So, when you're highly emotional, the ability to rational and think actually taking my own life in this situation isn't proportional to what this is, becomes weaker and weaker. And the voice becomes louder and louder. This is terrible. You're terrible. It's awful. Your life's ruined. Everything's terrible. What's the point anymore? And it's a frightening state of being, especially if you have a situation where someone's already depressed or in a vulnerable state or has coexisting OCD, for example.

27:23You know, there's compounding risk factors for those situations. So, you know, rejection sensitivity is for it isn't just about being a bit sensitive. I think it is a risk to life and certainly a risk to health. I mean, to that example, turning to alcohol, you know, very, very common coping mechanism for many ADHD traits, but certainly for rejection sensitivity, because actually it hurts less when you drink. And that's the reality. In the long run, it doesn't hurt a hell of a lot more. But in the moment, it hurts less. It creates a delay between experience and the situation that's happened, the experience of pain.

27:55Earlier, you mentioned you were considering getting an assessment for ASD. What makes you suspicious that you might have autism? I've always felt very different. And there's some things that I think can be explained by ADHD. And there are other things that I think aren't necessarily so. For example, on the sensory side of things. so since the age of probably six or seven I've used a hairdryer sound to soothe so my mum said as a baby I was very restless and when I used to dry her hair I'd kind of really calm and go to sleep and I think for a very young age I realized that I felt most calm when the hairdryer was on so from literally like seven or eight I'd go downstairs in the morning before school put the hairdryer for half an hour sit with it on the sofa just for the hairdryer held like this and I do that before school and after school and eventually whenever I'm in my room I just put the hairdryer on and I do that now I have a hairdryer in the lounge I have a hairdryer in the bedrooms it's a specific hairdryer that I like that I take everywhere and you know that people often use white noise for concentration and ADHD is what often described as using it to help focus but for me it's not focus it's soothing which tends to be more of an autistic spectrum trait I've also felt that the masking has been to a level of often trying to deal with like social situations and really present like a version of myself not just in terms of like i need to like manage the adhd symptoms but i need to like be a certain role be a certain person and i've often wondered like is there more going on here than uh adhd and specifically also the kind of social i have challenges sometimes reading what people want um i find it hard to trust people and sometimes i trust people when i shouldn't and other times i don't trust people and i'm very untrusting people when i should trust them more and so i just really wanted to understand you know like is there more going on here than meets the eye we know that asd and adhd co-exist quite commonly i suspect as research becomes further understanding the brain becomes further perhaps there are many people that have a neurodivergent that has some sort of structural physiological difference in the brain that presents with varying amounts of traits of OCD and ADHD and autism.

30:10Like I often wonder, I mean, because they affect similar parts of the brain with some of these conditions, is this that there is a more common theme going on here that envelops all of these things. And actually, each person presents slightly differently with it. Because, of course, adhd was described as a collection of symptoms right the attention deficit and the hyperactive kid bouncing around the room that like there seemed to be a feature but actually we've already described the rejection sensitivity is probably the worst thing many of the common features people talk about in adhd aren't recognized in those early diagnostic processes and aren't recognized in the naming so perhaps is it possible this uh you know this kind of idea of autism and adhd being a combination experience or many people actually having both that don't realize i kind of wonder that and in myself i wanted to understand and so i look at my dad and i believe firmly that he is likely to have autism and adhd he's not been assessed but i believe that and i wanted to understand and so after a long time of thinking about it i i've gone for the assessment um my psychiatrist said look i think you probably are on the spectrum on the autistic spectrum i think it's worth you doing the assessment for understanding and i was kind of like oh am i going to do this though because the adhd i kind of understood why a bit more and she said listen did you reject regret doing the adhd assessment said no what has been the greatest thing that's come from the adhd diagnosis i said understanding she said why will this be any different so i've started it it's a big process you've got the questionnaires endless questionnaires you fill in um that take a long time and then you do your interview processes so um developmental interview which is two hours with one clinician and a different clinician does your like assessment where they test you doing all these different things um which is crazy i didn't look into a talk so i wanted to go in blind um and not understand what was going to happen but you're constantly thinking like is this a double bluff what's going on a fascinating process and it's been really unmasking i'm now just at the stage as we speak where my family are going to be doing the assessments they talk to them to look at what you're like throughout your life.

32:10And so I don't actually know the answer. If you were to ask me right now, do I think that I'm likely to be told I'm autistic? I'd say probably yes. The more that I've done the assessment, the more that I've myself been unmasked. I walked out of a developmental conversation and I said to my mum, I don't think I've ever felt so unmasked in my life, but not necessarily a positive or negative way, but almost a sense of things that I thought were my personality might actually be autism. Things that I thought were my own quirks might actually be autism and i don't know how i feel about that really like who is me then who am i one of the comments that i get quite often in the comment section when discussing masking is masking is an autistic trait alex and some of the guests that i've had on here have said similar do you think that masking perhaps is more of an autistic trait than an ADHD trait?

33:03No, I don't think so. And I think you do it for different reasons. I think masking ADHD is trying to bend and flex into this shape that's required for the situation to round yourself, to be acceptable for this scenario. I think from an autistic perspective, if this is what I have as well, it is trying to be something. You're trying to become something. You're trying to bend yourself. You're trying to be something. You're trying to, what is it that I need to be? Who is it that I should be? It's a subtle but important difference. I think it's bending into shape versus going, what is it that someone needs a doctor to be?

33:43How should I be as a brother? What should a good partner look like? I need to be like that person. And it's like stepping forward into that. I think that's a common reason why you find a lot of autistic people as doctors, as actors. People often assume that people autistic can't be expressionate that's not true uh some many actors are coming out and saying they're autistic they're definitely i've worked with many doctors who are autistic and are fantastic communicators with patients um and one of the questions i was asked actually and i want to be careful not to kind of share too many questions from the assessments it's important that people might be going through it and might influence things but a common question i think is talked about is like do you enjoy kind of social situations are you good at social situations and it's interesting because i think i'm good with people um but i'm good at people often as a superficial way i find it hard to take social interaction to depth not depth of conversation but to the next level where i feel like a deeper bond with someone that i'm going to hang out with them they're going to become my friend virtually all my friends virtually everyone that's a close friend to me i've known all of my life i'm not very good at making deep friends and you know there are important differences, I think, there that become highlighted.

34:53It's like, yeah, I'm good with people. I've learned how to be. My mom is fantastic with people. With respect, my dad, who's a wonderful man, isn't naturally a person that is good at chatting, but he doesn't form deep bonds with that many people. And I grew up looking at my mom going, she's really good at talking to people. I need to be like her. So I copied her. And I learned my skills of communication from my mum. But that doesn't mean as a person that I'm able to feel a depth of feeling or able to take something from us chatting here today to me and you hanging out all the time. We could be good friends, but I wouldn't necessarily naturally know how to take it to that level.

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