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ADHD Chatter PodcastADHD Chatter Podcast

3 Signs You Might Have AuDHD

Dr Mark Rackley has over 20 years experience as a psychologist, specialising in ADHD & Autism. He’s an expert in helping people understand their brains, and live a happier life.

Dr. Mark RackleyguestAlex Partridgehost
May 26, 202543mWatch on YouTube

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Transcript

  1. 0:00 – 2:44

    Trailer

    1. MR

      If you have ADHD and autism, then you're more likely to experience anxiety and depression than just having one of those. If you're going to a social event and already before you go you're nervous about small talk, you're nervous about reading the room or coming across as socially awkward, then you're already anxious before you go. And in that spiral, if the shame kicks off or the RSD kicks in, that stuff can really be upsetting and actually very dangerous as well.

    2. AP

      Dr. Mark Rackley is an ADHD specialist psychologist

    3. MR

      with two decades of experience helping people with their mental health.

    4. AP

      Due to popular demand, he's back for a third time

    5. MR

      this time to deep dive into the psychology of AuDHD. The mix between autism and ADHD for the person who has both of those going on-

    6. AP

      Mm

    7. MR

      ... they're being pulled in multiple different directions, but then trying to maintain stability. If they hear something and they want to deep dive into that, then it's like, "Well, I can't do that." So they're holding back. They're not being their authentic selves. That comes at a very high price in terms of the anxiety that that causes.

    8. AP

      How hard is it if you have that internal tug of war to find your true self?

    9. MR

      It's very tough because in order to find your true self, you have to be-

    10. AP

      Loyal listeners and viewers, I can't thank you enough for tuning in to ADHD Chatter where we ask world-leading ADHD experts the hard questions to give you access to the most cutting-edge information on the topic. If you've ever felt broken or different, I hope this helps in your search for information, answers, and community. And do you know what would really help me in return? By clicking the follow or subscribe button wherever you're listening. It might not seem like much, but at ADHD Chatter it means a huge deal, and with this I can book more incredible guests and keep the self-discovery fire alive for all of us, including myself. Just one click of a button goes a lot further than you think. We'll promise to listen to your feedback and book the guests you want on topics that matter to you. And remember, you're not broken, just different, and you have always been enough. [upbeat music] Dr. Mark, welcome back to the ADHD Chatter studio.

    11. MR

      Thank you so much for having me back. I feel like I'm part of the furniture now. [laughs]

    12. AP

      [laughs] This is-

    13. MR

      Imprinted in the chair. [laughs]

    14. AP

      This is your third solo episode, right?

    15. MR

      It is, yeah. Third solo, fourth time. Yeah.

    16. AP

      Yeah.

    17. MR

      So back.

    18. AP

      Based by popular demand. And in fact, I think-

    19. MR

      Was that my, was that my mother? [laughs]

    20. AP

      [laughs] Um, well, I re- on, on behalf of everyone who's, who's ever described themselves as an introverted extrovert-

    21. MR

      Mm

    22. AP

      ... I'm excited about this episode-

    23. MR

      Yes, yeah

    24. AP

      ... to, to dive into the complexities of, uh, of AuDHD, the, the, the dual-

    25. MR

      Yeah

    26. AP

      ... diagnosis. Um, but to start with,

  2. 2:44 – 4:30

    Mark’s mission in the ADHD, Autism and mental health space

    1. AP

      what's your mission-

    2. MR

      Mm

    3. AP

      ... in terms of ADHD-

    4. MR

      Mm

    5. AP

      ... autism?

    6. MR

      So professionally, I've been working with people with autism and ADHD for over 20 years. My voice to be part of that community is really important, um, so that I can advocate for, for that community, but also for me professionally because I hear all those stories that I, I feel a responsibility to, um, to be able to, uh, advocate.

    7. AP

      Mm.

    8. MR

      And this is a great platform to do that, obviously. And there's a great quote by, um, Kim Stagliano. I don't know if you know her. So she's a, a mother of three, uh, autistic girls, uh, in America. She's a huge spokesperson for, um, especially autism. And she said that, um, "Autism is not a tragedy. Ignorance is a tragedy."

    9. AP

      Mm.

    10. MR

      That for me, it, it kind of says it all. It's not the autism the person has that's the tragedy here. It's, it's ignorance around it-

    11. AP

      Mm

    12. MR

      ... and ignorance around kind of what's going on for this person. So in a long-rounded way, I want to remove the ignorance.

    13. AP

      Mm.

    14. MR

      'Cause if you're ignorant about something, then you, you, you don't know better.

    15. AP

      Mm.

    16. MR

      I want people to know better, 'cause when you know better you can do better.

    17. AP

      Mm. So you've very much got skin in the game.

    18. MR

      Yeah.

    19. AP

      It's, and I think ig- ignorance is, has been such a issue with the community, particularly even many people that have an, a autism diagnosis or an ADHD diagnosis-

    20. MR

      Mm

    21. AP

      ... suddenly realizing that they could potentially also have another diagnosis to get.

    22. MR

      Mm.

    23. AP

      I suppose sitting on the, on the outside and looking in, maybe to sort of c- mute some of that ignorance, a very basic

  3. 4:30 – 9:47

    What are the more common traits of ADHD and the common traits of Autism

    1. AP

      question, what would be some of the, the general common traits of ADHD-

    2. MR

      Mm-hmm

    3. AP

      ... and therefore also what would be some of the general common traits of autism?

    4. MR

      Yeah. And, and with these things, ADHD is a bit more, I suppose, um, I don't want to use the word predictable, but in terms of what you're looking for, so and, and, and how that fig- uh, figures out in the patient's life. So you'd have the, um, the, uh, I don't even like using this word, but anyway, I don't... until we change it, the, you know, the executive dysfunction.

    5. AP

      Mm.

    6. MR

      So [laughs] when it comes to-

    7. AP

      Yeah. [laughs]

    8. MR

      I mean, the, the, even it just makes no sense that word, executive dysfunction. But anyway, uh-

    9. AP

      [laughs]

    10. MR

      Anyway, the executive functioning, i.e. dysfunction. So things around like planning and, um, being able to manage, um, parts of your life to do with timekeeping and, um, just the kind of day-to-day structure can be a challenge-

    11. AP

      Mm

    12. MR

      ... because the brain gets distracted and finds it hard to stay on task. Um, for me I'd say one of the big ones is the emotional dysregulation, so the RSD, the, um, the sensitivity, the, uh, sense of being overwhelmed or, or, or finding the emotions hard to, to, to regulate. Also, the, the, the common ones of course as well are your impulsivity-

    13. AP

      Mm

    14. MR

      ... um, the, uh, chasing dopamine. The, the other big one with ADHD of course is the hyperactivity.

    15. AP

      Mm.

    16. MR

      So just finding it very difficult to kind of manage that energy that's in the body all the time. And actually, with autism, um, kind of there's two kind of main ones with autism really. It's more to do with the kind of the, the social interaction and the social challenges that person can have. And then the other big one with autism is the rigidity of thought or rigidity of behavior.

    17. AP

      Mm.

    18. MR

      So, um, they're kind of the main ones with autism actually, and then the main ones with, um, with ADHD.

    19. AP

      Mm.

    20. MR

      But of course, the thing with autism, again, it's on the spectrum. So, um, because it's on the spectrum, then it's not- ... uh, a one-size-fits-all in terms of presentation. It's very much about kind of where that person sits on the spectrum and how their autism affects their life. Yeah.

    21. AP

      Hmm. And if someone is, is listening and they might 100% relate to what you're saying, in fact, they could relate to both sides.

    22. MR

      Yeah.

    23. AP

      They could think, "I have those autistic characteristics-

    24. MR

      Yeah

    25. AP

      ... and I also have some of those ADHD characteristics."

    26. MR

      Yeah.

    27. AP

      How could that, how could those shared characteristics show up manifested in someone?

    28. MR

      Yeah. It, it's an interesting question, that, because it, it's kind of what fits where-

    29. AP

      Mm

    30. MR

      ... which can be very confusing. So, um, for somebody, say, who has, um, ADHD, then they might, um, find it very difficult to, uh, say, plan their day or keep to timekeeping. But also, if they have autism, then, um, they might be desperate to, to have structure-

  4. 9:47 – 16:41

    What are some opposing traits of ADHD and Autism

    1. AP

      if, from your point of view, like, what do you think are some opposing traits of the two conditions, and how might that create an internal battle within someone who's dealing with them?

    2. MR

      Yeah. It, it's fascinating, uh, 'cause I wanna just come back to ADHD for a sec, 'cause with ADHD, ADHD is in extremes. [laughs]

    3. AP

      Yeah. [laughs]

    4. MR

      It's like, ah, ah.

    5. AP

      Yeah.

    6. MR

      And, um, and staying in the middle ground is hard. Um, and so if you've got that in the mix anyway and then you kinda chuck, chuck in, um, some traits with autism, so, you know, what you can ha- you can see there is the impulsivity of ADHD, where the person is maybe acting impulsively, but actually the opposing side of that is, uh, predictability.

    7. AP

      Mm.

    8. MR

      So for, for, for, uh, uh, one of the symptoms of autism is struggling with change and managing change. So you can have those kind of two extremes, which is the impulsivity, but at the same time, "I don't want change," and of course-

    9. AP

      Mm

    10. MR

      ... somebody who's impulsive is changing very quickly.

    11. AP

      Yes. [laughs]

    12. MR

      [laughs] Yeah. So that can be, that can, that can be actually very stressful. And then another one that that can be massively opposing is on the social side. So somebody, uh, with, um, ADHD might be kinda craving that social stimulation and really wanting to kinda jump into that energy.

    13. AP

      Mm.

    14. MR

      But then on the, the, the, with the, uh, opposing side of autism is misreading the cues, not being able to read the room or hating small talk-

    15. AP

      Mm

    16. MR

      ... and then thinking, "Oh, God, I'm, I'm not gonna f- I'm gonna find that really, really challenging." And another thing you can see that's opposing as well is when it comes to the emotional regulation. So for, um, somebody with, again, with ADHD, they might, they might kind of be, be, uh, could get prone to outbursts or get very overwhelmed.

    17. AP

      Mm.

    18. MR

      But also for somebody, uh, again, who has autism, they might get very confused by their feelings and thinking, "What is this?" Or, or, "What's happening?" So it can be... [sighs] And this is why i- in this, this particular, um, [lips smack] the, the mix between autism and ADHD, for the person who has both of those-

    19. AP

      Mm

    20. MR

      ... going on, it can cause real stress and tension for them because they're kinda almost in a state where they're, they're being pulled in multiple different directions but then trying to maintain stability, which can be really hard, of course.

    21. AP

      Mm. Is it, can it be confusing for somebody who has both of these conditions who might experience such fluctuations in their mood, their energy-

    22. MR

      Mm

    23. AP

      ... their desire to be social? For example, you could- Get very excited about-

    24. MR

      Yeah

    25. AP

      ... an invitation to a work party because that's fun

    26. MR

      Yeah, yeah

    27. AP

      That you're gonna be social. You've, uh... In that moment, the dopamine's high and you're, you're h- really energetic to go. And then you go and you walk in, and you're, you're in a h- heightened mood. You're having a great time. But then an hour later, your social battery just, just disappears.

    28. MR

      Yeah. [laughs]

    29. AP

      And your, your, your personality completely changes-

    30. MR

      Yeah

  5. 16:41 – 19:36

    How ADHD masks Autism

    1. AP

      I- I mean, is it possible for somebody to mask so hard that they actually get missed for both diagnoses?

    2. MR

      Definitely, yeah. Definitely. I think, I was talking about ADHD. It's kind of like when you do the history and you kind of, you're, you're, you're, you're, you're... I think, I feel, I feel with ADHD you kind of, 'cause again it's a bit more, it can be very disruptive in the person's life.

    3. AP

      Mm.

    4. MR

      And if you're seeing that pattern and also, um, you are kind of listening for it, then y- I feel with ADHD you can kind of, it kind of come, almost screams at you. Uh, but with, with autism, it, it's subtle. It's, it can be very, very subtle, where if the person has been masking f- so well for so long, then, uh, it can be very hard to pick up, particularly if they've spent years, um, being able to, um, mask so well-

    5. AP

      Mm

    6. MR

      ... that it's almost become a part of their functioning. But it's just where you see with autism where it, it, it is, is, um, certainly just in the work that I, I've done, is, um, if there's a big area of kind of stress, uh, or change and then they're really struggling to navigate that change, and the change is causing a lot of, um, distress, then that might be your kind of thing, "Well, what is that?"

    7. AP

      Mm.

    8. MR

      Yeah. Because with ADHD, um, it's not the, the person with ADHD can't manage change, but they don't necessarily get so kind of stuck in being able to, to, to, to navigate that.

    9. AP

      Mm-hmm.

    10. MR

      Whereas with autism, it can be really, really hard to be able to, um, deal with those transitional changes in life, yeah.

    11. AP

      Have you seen an increase in the number of patients coming to you with AuDHD?

    12. MR

      Oh, yeah, definitely over the years, Alex. Yeah, 'cause I was just thinking about this. Back, way back when, like, I wasn't even qualified, um, back in Ireland, I worked in a... There was a specialist clinic for, at the time it was called Asperger's syndrome-

    13. AP

      Mm

    14. MR

      ... we don't call it that anymore. Um, and, uh, I remember when I was working in that clinic, all, we, we had, you know, all the young people that were, were in the clinic with us were, um, had Asperger's syndrome. But over the years, certainly in, let's say, the last 10 years, I'd say, that we're seeing that more kind of mixed presentation, which is, um, ADHD and autism. And r- and the, the research is getting there, but it's still very, like... It's still in its infancy really-

    15. AP

      Mm

    16. MR

      ... around where we're at with this. But some reche- research suggests that, um, 80% of, of patients who have autism

  6. 19:36 – 21:10

    Tiimo advert

    1. MR

      have ADHD.

    2. AP

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  7. 21:10 – 26:48

    What part of the brain is responsible for Autism and ADHD

    1. AP

      to the episode. The next question's really, really interesting, Mark.

    2. MR

      Mm-hmm.

    3. AP

      And what part of the brain is responsible for the characteristics of-

    4. MR

      Mm

    5. AP

      ... autism, and what part of the brain is responsible for the characteristics of ADHD?

    6. MR

      Believe it or not, they overlap.

    7. AP

      Yeah.

    8. MR

      So you've got two main parts, which is your prefrontal cortex, which is this bit here.

    9. AP

      Mm.

    10. MR

      So that's the bit when, way back when when they were doing crazy things. They'd lobotomize people and think, "Oh, let's take a piece of the brain away here," so they would do it-

    11. AP

      Mm

    12. MR

      ... do it here. And then the other bit is your cerebellum, which is, uh, Latin for "little brain." So this is the part of your brain back here, the back of your head. And so with the prefrontal cortex for ADHD, so we talk about this at length, where, um, in terms of understanding it from a, from research that, um, in the, the brain of a person with ADHD develops at the same rate as everybody else. However, the, um, the prefrontal cortex, the, it develops slower. So we're thinking about, like, a three-year delay-

    13. AP

      Mm

    14. MR

      ... in how, uh, in the, in terms of it, it being, um, slower in development. So what that means with a person with ADHD is that the, the, the ability to be able to, um, uh, organize and do kind of... Again, come back to executive functioning. Um, planning, all that kind of stuff is a bit more problematic.

    15. AP

      Mm.

    16. MR

      So that's in ADHD. Now in, in autism, it's slightly different. So, um, that part, uh, again, the prefrontal cortex to do with kind of social cognition, kind of s- uh, understanding, and m- and managing social, uh, situations, then that becomes a bit more problematic-

    17. AP

      Mm

    18. MR

      ... with the prefrontal cortex. Now coming back to the cerebellum, again, with ADHD, it, believe it or not [laughs] it can... That's the bit that can be to do with the, uh, the motor functioning. So, like-

    19. AP

      Right [laughs]

    20. MR

      ... with ADHD, I forget things and drop things, and it, you know-

    21. AP

      Mm

    22. MR

      ... can be someone being a bit clumsy. And timing. So does, we think that's to do with the time blindness, is that part-

    23. AP

      Mm

    24. MR

      ... of the brain kind of deals with that. So that's with ADHD. And with autism, uh, again, it's to do with more kind of executive functioning and also, um, the, the challenges with, uh, social situations. 'Cause remember, with autism, the two main, um, the two main symptoms of autism are, um, the, the s- the social difficulties and then the repetitive behaviors and, uh, the repetitive interests.

    25. AP

      Mm.

    26. MR

      So they're the two kind of main things. So we rec- from what we know, again, it's not just that. They're kind of the, the two main parts. There are other parts as well. Uh, but they're kind of the, the, the key players here when it comes to, um, the, the autism and ADHD, yeah.

    27. AP

      Mm. So good to know that there's a part of my brain that is responsible for when I think I'm gonna be somewhere in five minutes-

    28. MR

      Yes. It's your cerebellum

    29. AP

      ... I'm never there. [laughs]

    30. MR

      That's why, just blame my cerebellum. [laughs]

  8. 26:48 – 29:08

    Will AuDHD ever be a separate diagnosis

    1. MR

      Yeah.

    2. AP

      But do you think AuDHD in itself would ever be its, its own diagnosis?

    3. MR

      I hope so. I was thinking about this. Like, uh, you know the word burnout?

    4. AP

      Mm.

    5. MR

      Like, that's still not an official diagnosis. We'll often say to patients, like, "We're thinking you have burnout," but that's been around since the '70s. [laughs]

    6. AP

      Yeah. [laughs]

    7. MR

      It's been around for ages. And that's still not an official diagnosis.

    8. AP

      Mm.

    9. MR

      So I'm not being kind of negative here, but it might take a while. And the reason it takes a while is you're gonna put something into, uh, the DSM, then you have to get consensus of, um, uh, the professions agreeing with this.

    10. AP

      Mm.

    11. MR

      There has to be research. They've gotta do loads of stuff around saying that this is an official diagnosis. So I think un- until that starts to change, then you might see it, but those things can take a very long time to-

    12. AP

      Mm

    13. MR

      ... uh, reach official diagnosis, yeah.

    14. AP

      Do you think there's reluctance within the medical community in some areas of it? Do you think some doctors just don't agree that you s- can have both still, or are reluctant to diagnose it together, therefore people are still getting missed?

    15. MR

      Definitely. Yeah, definitely, definitely. The, and the funny thing, like, uh, I was talking to somebody about this the other night, um, 'cause they were asking, "Oh, what do you think about like, uh, you know, e- kind of energy therapies?" And I said, "Well, I don't know enough about those." But one of the things I think when you, when you, when you do this job is, um, you kind of tend to stay in your lane.

    16. AP

      Mm.

    17. MR

      Which isn't ideal sometimes because, you know, you, you have a job to do, and you know what you need to do. But, um, but because you stay in your lane, then like even, you know, for, certainly for some doctors, even if they think, "Oh, this could be, say, autism as well as ADHD," unless it's like glaringly obvious-

    18. AP

      Mm

    19. MR

      ... that this is a problem for this patient, or this patient ha- presents with this, then, um, you might not go into that conversation with the patient. It might... And, and that's where I suppose we come in, where, and, and certainly you can start to bring a conversation to try and uncover it, but there can be a reluctance, yeah, to-

    20. AP

      Mm

    21. MR

      ... um, to go into something if you think, "Well, um, this is not my area," or, um, "I just, I shouldn't be looking at this." Yeah.

    22. AP

      Mm.

  9. 29:08 – 35:36

    The Dr. Jekyll and Mr. Hyde internal narrative

    1. AP

      H- how common do you think it is for s- for someone who has AuDHD to have this internal self-description of, because of these contradictions, of a Dr. Jekyll and Mr. Hyde?

    2. MR

      Yeah.

    3. AP

      Like, they might, they might want to be around people. They might crave social encounters and social situations. But simultaneously, the thought of that is so exhausting.

    4. MR

      Yeah.

    5. AP

      How often do you think that is, that internal narrative, that Dr. Jekyll and Mr. Hyde self-talk? How often does that happen?

    6. MR

      It's a lot. 'Cause again, you can hear it, 'cause when I'm talking to my patients about it, like they're telling me this. Like, they're telling me that, well, I, I'm... And, and they're present, but they're not, they're not tuned in.

    7. AP

      Mm.

    8. MR

      And what I mean by that is that they're physically present, but they're like in their heads. They're, they're constantly trying to stay a step ahead. They're constantly trying to, um, not say something that is going to, um, give, bring negative attention to them, or they're desperately trying to make on- eye contact-

    9. AP

      Mm

    10. MR

      ... so they're looking interested. So, so it's all of that. And also, you know, the other, the other piece of that is that, that if they hear something and they want to deep dive into that, then it's like, "Well, I can't do that."

    11. AP

      Mm.

    12. MR

      Like, "I can't, I can't show an obsessive side to myself." So, so they're holding back. They're not being their authentic selves. Which again, is like, that's really sad because that just creates stress and anxiety in those social situations.

    13. AP

      Mm.

    14. MR

      They're, so they're constantly trying to adapt- Out of, um, trying to fit in. But actually, that comes at a very high price in terms of the anxiety that that causes.

    15. AP

      Mm.

    16. MR

      Yeah.

    17. AP

      That price, is that the inability or, or the struggle to find your true sense of self?

    18. MR

      Yeah.

    19. AP

      'Cause if, if you've got these two opposing characteristics, and sometimes they're literally pulling you in different directions-

    20. MR

      Mm

    21. AP

      ... you want different things.

    22. MR

      Yeah.

    23. AP

      How hard is it if you have that internal tug of war to find your true self?

    24. MR

      It's very tough. It's very tough. Because in order to, to, to, to find your true self, then, um, you have to be allowed to be comfortable and to, uh, allow yourself to, um, to say that, "Well, this is, this is what I like and this is, this is-

    25. AP

      Mm

    26. MR

      ... this is the stuff that, that, that," we often use the, you know, that, that, um, expression, "feeds my soul."

    27. AP

      Mm.

    28. MR

      "So this is, this is the stuff that I, that really excites me and can gets fire in my belly." Um, but if, if you're constantly, like, tuning out of that, then, like, you're, you're never really living an authentic life about, you know, life full of passion and stuff that you really care about-

    29. AP

      Mm

    30. MR

      ... and that energizes you and that makes you feel connected. It's constantly trying to please other people-

  10. 35:36 – 36:52

    The AuDHD RSD experience

    1. AP

      With RSD, do you think it's a, a different, different battleground with someone who h- has AuDHD as opposed to someone who might just have ADHD or autism?

    2. MR

      Yeah, definitely. So with the RSD, especially with ADHD, 'cause that's so, um... Obviously, the sensitivity is so present.

    3. AP

      Mm.

    4. MR

      Um, so there's, there's a, a- a sensitivity to the, the, the possibility I'm going to be rejected, but also picking up on those very small cues-

    5. AP

      Mm

    6. MR

      ... that this is what's going on. Whereas with the, uh, and interestingly, without going into too much detail with this, but I, I think it's important. Um, with the RSD, because that's such a strong feature of, of, um, of ADHD, then somebody with, with ADHD can read the room very well.

    7. AP

      Mm.

    8. MR

      Whereas, whereas with- if you've got the autistic piece, it might be very hard to read the room-

    9. AP

      Mm. That's interesting

    10. MR

      ... and actually pick up on what's going on. So the person doesn't realize, "Oh, I've crossed a line here," until they get the response, and that can be very confusing-

    11. AP

      Mm

    12. MR

      ... because they haven't anticipated that or they're not reading the room in the same way as maybe the person who just has ADHD would be reading the room.

    13. AP

      Mm.

  11. 36:52 – 39:23

    The AuDHD Addiction experience

    1. AP

      And with these additional mental health struggles, is there a higher risk that someone with AuDHD could fall into addictions?

    2. MR

      Yeah, it's-- Well, we know with ADHD that the, the rate of addiction in terms of, um... Now, when we say addiction, we're talking about the, not just the substances, but the behavior, so gambling-

    3. AP

      Mm

    4. MR

      ... and, you know, not just drugs and alcohol. They're two to three times more, two to three times more likely to have a problem with, um, with, with, with, with addiction. And definitely with ADHD. With Autism, I think, you know, probably not so much. Can-- There can be, um, there can be some kind of addictive behaviors that can take place. But again, with the, especially with ADHD, because you've got the, um, the instant gratification, the chasing dopamine, the, uh, risk-taking behavior, the excitement, then that can actually, you know, lead to the addictive behaviors-

    5. AP

      Mm

    6. MR

      ... becoming more of a problem. Whereas with, um, with Autism, yeah, possibly, but you don't have the same, um, I suppose the, the same, uh, chase-

    7. AP

      Mm

    8. MR

      ... that you'd have in the ADHD brain. Yeah.

    9. AP

      With AuDHD, I suppose we know the, the, the addiction risks with ADHD, but if someone has AuDHD-

    10. MR

      Yeah

    11. AP

      ... that, and on a day that, where the ADHD is prominent-

    12. MR

      Yeah

    13. AP

      ... and they, they, they drink or they relapse-

    14. MR

      Yeah

    15. AP

      ... or they do whatever their addiction is, the following day, could the Autism and that meticulous detail and, and focusing on it create a health anxiety, and focus on the consequences of that binge, and therefore create this, this almost hyperfocus o- towards, "What have I done to my body? I'm now really anxious about my health"?

    16. MR

      Yeah, totally. I often hear that, which is [laughs] it's funny, 'cause, uh, the, the targeted to the, the, the very kind of r- rigid thinking, it's, um, you know, that, the hangover headache is a brain tumor.

    17. AP

      Mm.

    18. MR

      Or, um, "Have I poisoned my body? Am I going to die?"

    19. AP

      [laughs]

    20. MR

      One of the very common ones I hear is, um, "Am I going to have a psychotic episode?"

    21. AP

      Mm.

    22. MR

      So yeah, absolutely. [laughs]

    23. AP

      [laughs]

    24. MR

      You can, you can spiral into that place where-

    25. AP

      Mm

    26. MR

      ... you know, the thinking becomes completely irrational. But what the person is doing there is they're, they're in that kind of very rigid thought around, um, all the consequent- consequential thinking, and they're panicking as well.

    27. AP

      Mm.

    28. MR

      So yeah, that absolutely can happen, yeah. And, and lots of reassurance-

    29. AP

      Mm

    30. MR

      ... you're

  12. 39:23 – 43:09

    The ADHD agony aunt

    1. MR

      fine, like, yeah.

    2. AP

      Just finally, Mark-

    3. MR

      Yeah

    4. AP

      ... I've decided to do the ADHD agony aunt section.

    5. MR

      Yes, yes.

    6. AP

      Um, it's called the washing machine of woes because I... You're familiar with the ADHD-

    7. MR

      I am, yeah

    8. AP

      ... very familiar with the washing machine of woes.

    9. MR

      I know, I know this washing machine well, yeah.

    10. AP

      For anyone who isn't, it's called the washing machine of woes because I always forget my washing in the machine.

    11. MR

      Yes.

    12. AP

      Uh, very classic. But I'm getting better now that I'm using the Tiimo app, which is the sponsor of the show.

    13. MR

      Thank you, Tiimo.

    14. AP

      Um, but this week- [laughs]

    15. MR

      [laughs] This- And your, I must say, your clothes look and smell very clean today.

    16. AP

      Thank you very much.

    17. MR

      So it's working. [laughs]

    18. AP

      Yeah. [laughs] This week, Mark-

    19. MR

      Yeah

    20. AP

      ... someone has written in and asked, "I've been diagnosed with ADHD, and I think I might have Autism too. But my friends think I want another label. How can I get them to understand that I'm struggling, and it's not another label I want? I just want to understand myself."

    21. MR

      Listening to that, I think, is it twice or three times the word label is in the question. And I think that's probably part of the problem here, which is, like, labels can be useful in terms of giving you s- maybe some context, but they're not hugely helpful in terms of explaining your lived experience. So listening to this, this question, I think what the person is struggling with is getting their friends to understand them.

    22. AP

      Mm.

    23. MR

      Or getting their friends to be able to, uh, realize the struggle. And I think that's the real problem here, actually, is, um, the friends might be thinking, "Well, you know, this is-- Why, why do you want that?" And for the, this particular person, well, they, they, they might need that or feel that they need that in order to be understood. So the, the, the label essentially will give them the, uh, the, the, the way to explain to their friends, "Well, look, this is, this is why I'm struggling." But I think that's the actual issue here. So what I would suggest is, you know, helping your friends understand what it is that maybe you're struggling with, and maybe also why, uh, it's important that your friends understand that struggle. Because if this particular person is feeling, "Well, they just don't understand me-

    24. AP

      Mm

    25. MR

      ... or they don't get me," or they just think, "Well, you're, you know, you're just, you're looking for attention," whatever it is, then that can feel alienating, but also can feel judg- they're, like, they're being judged.

    26. AP

      Mm.

    27. MR

      And the label's almost like, "You see? You see? This is why it's going on." So I think that's more of a, an issue with the friendship there, and also just the, uh, being able to speak to their friends-

    28. AP

      Mm

    29. MR

      ... about the experience of why you're feeling that this is so important that they understand this part of your life. And again, I think that's a very, just, just to normalize that, I think that's a very common, um, challenge that people who, who may have ADHD and Autism, which is, you know, it can be very difficult for them to understand themselves.

    30. AP

      Mm.

Episode duration: 43:09

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