ADHD Chatter PodcastADHD + Autism Expert: How To Stop RSD Instantly! Is Your ADHD Actually AuDHD? | Dr Alex George
EVERY SPOKEN WORD
70 min read · 13,979 words- 0:00 – 2:47
Trailer
- AGDr. Alex George
If you combine ADHD and OCD, 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'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
- APAlex Partridge
Dr 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 wellbeing this is a conversation you can't miss if you want to understand your ADHD on a deeper level.
- AGDr. Alex George
Rejection sensitivity dysphoria 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, very common coping mechanism for many ADHD traits, but certainly for rejection sensitivity, 'cause actually it hurts less when you drink. It creates a delay between experience and sense of pain.
- APAlex Partridge
Do you think generally overwhelm, burnout, what can that look like in someone with ADHD?
- AGDr. Alex George
To be honest with you, most of the overstimulation I experience is actually-
- APAlex Partridge
Dr Alex, welcome back.
- AGDr. Alex George
Thank you for having me. It's nice to be back, back on the, uh, comfortable chair, the ADHD chair.
- APAlex Partridge
Pleasure to have you back. I have interviewed 200 people on this podcast, and I think only you can answer this question.
- AGDr. Alex George
Goodness me. [laughs] That is quite a... I don't know. Very much depends on the question. [laughs]
- APAlex Partridge
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?
- AGDr. Alex George
That's tough. Um, potentially. I mean, depends in what sense. I think it's, it's kind of a, 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, uh, 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. Um, but I, I don't know that, I don't know that in of itself being in this space and having this public, public platform is negative with ADHD. I just think that the change for me, the d- it was the change of going from someone who was just like a regular person with a regular following to someone who's still regular, but suddenly has a really big following. That kind of shift was, was quite big for me. Um, but no, I, 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, and I think that's quite an important distinction.
- APAlex Partridge
I think the, the conversation of overstimulation is, will be very relatable to the watchers-
- AGDr. Alex George
Mm. Mm
- APAlex Partridge
... and the listeners of this podcast. But if we were to zoom out
- 2:47 – 7:03
How to manage ADHD overstimulation
- APAlex Partridge
a little bit, what do you think generally overwhelm, burnout, what can that look like in someone with ADHD?
- AGDr. Alex George
Listen, to be honest with you, most of the overstimulation I experience is actually around people in certain s- 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 a bit..." Chuck it aside. What gets me usually is if 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 like present myself to different people, all of a sudden I can feel very overwhelmed, and the overstimulation can feel like being on edge. Not, and I can ac- not necessarily an, an overt anxiety, but just feeling like, oh, too much. An agitation actually is a good way I, I describe it. I feel a bit agitated. I suddenly feel frustrated. I'm like, "Oh, I can't... I, you know, I just need space." You have this desire to remove yourself. You, you, you feel this sense of like, "I need to get out." And yeah, often I, the only way to resolve that is to go to a quiet room, put my hairdryer on, which of course was my [laughs] item last time.
- APAlex Partridge
Here it is, yeah. It's over here.
- AGDr. Alex George
There's the hairdryer there.
- APAlex Partridge
[laughs]
- AGDr. Alex George
Um, put the hairdryer 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, [laughs] is causing it. But it's quite a, it's quite a, a unique experience for those who are neurodivergent. I think a lot of people can be overstimulated. I think, you know, a lot of, you know, 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.
- APAlex Partridge
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 churr 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?
- AGDr. Alex George
Definitely. I mean, I actually... And it can be odd. The overstimulation 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 over to work out what it was, and I couldn't. Eventually I was like, "Ah, what is this sound?" And, and I think what happens is 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 it might be a lot of people around you, and then something happens. So the straw that breaks the camel's back, and then you're like, that frustration can really come out. And 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, um, there's noise in the background, there's some sort of like, uh, drilling going on in the background as well as this busy room, I'm like, "Ah, this might be a situation, gonna end up being overstimulated." And often I'll think, "How long am I, am I gonna be here? How long do I need to be here?" Um, and I'll often plan my exit [laughs] in that sense. Uh, 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 'cause 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." Like, vocalizing that you feel that way is the best, best remedy for me.
- APAlex Partridge
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.
- AGDr. Alex George
Mm-hmm.
- APAlex Partridge
But I feel like there's a lot of shame associated sometimes.
- AGDr. Alex George
Mm.
- APAlex Partridge
If you do act out in a certain way at a, at a party, or you snap at your partner or your boss, then you can be ruminating in bed all night-
- AGDr. Alex George
Mm-hmm
- APAlex Partridge
... thinking, "Oh my gosh, they definitely hate me. Why did I say that?"
- AGDr. Alex George
Mm.
- APAlex Partridge
"I'm an awful person." You've been on a fascinating journey yourself-
- AGDr. Alex George
Mm
- APAlex Partridge
... with ADHD. You mentioned ASD earlier, autism, and I w- keen to get in that a little bit later on.
- 7:03 – 10:34
Dr Alex’s ADHD mission
- APAlex Partridge
But how does this all tie into your mission with AD- within ADHD? What would you say that is?
- AGDr. Alex George
I think my, 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, on scale, to be able to, um, be accepting and understanding of who they are. I think what is important to me is that people are recognized, um, if they have neu- if they are neurodivergent, if they have ASD, ADHD, dyslexia, whatever it might be, that that is recognized from a young age. I think we shouldn't underestimate the damage that's done from late diagnosis. I'm pretty sure that most people you've had on this podcast who've 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 n- or not being diagnosed, and I think that is really important. And, you know, I quote this quite a lot, and it's, it's not because I want to be really, uh, morbid, but, you know, a, a, a person who's undiagnosed with ADHD lives on average eight years shorter life if they're a woman, and six years if a, 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've been avoided.
- APAlex Partridge
Mm-hmm.
- AGDr. Alex George
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. All 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. [laughs] 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. Um, 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," w- in front of my parents. Um, and I think I battled the system all the way through. I was very fortunate to come out and do what I've done, but I am not the norm in that sense. Look at... I read a, a study literally on the way t- to recording this podcast with you, um, from Cambridge University saying that, um, they basically had six centers in London, um, uh, in police, uh, stations where they were assessing and screening people who were arrested for ADHD, and on half of the people arrested, um, had significant, um, 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 service's f- female population in prison, around 30 to 40% have, uh, ADHD. Um, I think that there's a lot of problems that we see that actually could be prevented if you, at the root cause, uh, help people understand who they are and help them, you know, uh, through life early. You know, that's really important I think in my mission.
- APAlex Partridge
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 abandon who they are-
- AGDr. Alex George
Mm
- APAlex Partridge
... in order to fit in, and, and mask, and change, and, and become the, the ultimate actor, uh, playing this character called
- 10:34 – 13:24
The emotional consequence of masking
- APAlex Partridge
normal. What do you think the consequences are of somebody masking from a young age?
- AGDr. Alex George
Self-harm. I think masking from a young age is a form of self-harm. I truly believe that you cannot, um, pretend to be someone else or force yourself to be someone else without serious personal consequences. Um, I think when I, I had a moment of realization. I th- always felt different, but when I re- and I remember this teacher saying, "We need to lower expectations for Alex in life," and the context was I'd been pulled out of class and put in a separate room, not to have support, just to kind of be sat there, uh, out of mainstream classes. And, you know, I was an intelligent child. Um, my parents were like, "He's pretty bright. He's seem... Like, 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. Uh, and for context as well, I wasn't a naughty kid, isn't rude or anything like that. I just couldn't concentrate. And respectfully, I was very smart, so I learnt things very quickly. And once I knew, 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 needed help and guidance, not to be kind of like, "Right, because you're not interested in this thing, we're gonna 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 ex- utter exhaustion after school every day, um, frequently feeling incredibly anxious, um, feeling oppsi- 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. And if I pleased my teachers and they were happy, it meant that I could stay and be in class and continue, a- a- and, and be treated like a normal kid. And I think the consequences of thatWere huge, and as, as an adult, I mean, I didn't really know who I was. I, um, felt, um, even more so like I was a weirdo that was in disguise. And I think, I think when I became an adult, the remedy to that was alcohol. It's like, well, in the social situation, which becomes the new school, uh, which is, like, 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 to that was huge. I think it contributed to my experience of OCD, um, uh, my experience of anxiety as I grew up. Would I have experienced those things at anywhere near the level of severity? Probably not, if I knew, if I knew when I was young.
- APAlex Partridge
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, a busy party, and you're getting attention, you're speaking to people. But if it's the masked version of Alex-
- AGDr. Alex George
Mm
- APAlex Partridge
... that's having the communication and, and-
- AGDr. Alex George
Mm-hmm
- APAlex Partridge
... connecting with people, the, the real you inside isn't connecting with anyone.
- 13:24 – 15:11
The connection between masking and loneliness
- AGDr. Alex George
No.
- APAlex Partridge
Is it a lonely experience if you're an expert masker?
- AGDr. Alex George
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, it's... You're, you'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, 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 kind of that mask was pulled off, and 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, um, to be allowed in, I guess. Um, but I think that's a great cost. You know, it's much better to be accepted for who you are than who you pretend to be. And, uh, you know, as I got older, I realized that some of the things I used to hide a lot, my sensitivity, so rejection sensitivity, which we spoke about last time, being by far I think the worst part of ADHD for me personally, um, 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. Like, 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, like, "What's the worst thing that you hate about yourself?" I'd have said how sensitive I am. Absolutely, I would've 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.
- APAlex Partridge
[laughs]
- AGDr. Alex George
I like being tall.
- 15:11 – 27:39
Rejection Sensitivity Dysphoria
- APAlex Partridge
You said rejection sensitivity dysphoria is the most challenging aspect of ADHD, and I totally agree.
- AGDr. Alex George
Mm.
- APAlex Partridge
I think it is the, the epicenter of the whole conversation. It turns you into a people pleaser, a perfectionist. So often you just don't even bother 'cause 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, um, 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 ADHD? How does it show up with you?
- AGDr. Alex George
It causes so much, um, so much, um, turbulence and arguments even, like with people around you, because often, um, when you feel criticiz- criticized, you can feel very defensive and like go, "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, uh, friendships as well as professional relationships. Um, you know, it's almost like a p- p- 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 [laughs] 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, um, and I'd 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, like, complex question, and I was like, "Why are they asking? 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?" I was being friendly, but then they were kind of asking that way. And anyway, um, uh, it turns out that the person that asked, the person that 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, 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 then maybe they were actually just trying to take the mick out of me. I don't know. But I perceived it. 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. [laughs]
- APAlex Partridge
[laughs]
- AGDr. Alex George
It'd be quite a lot easier life. I mean, have you found... I mean, of all the kind of conversations you've had here, obviously you came on my podcast, The Stomp Podcast. 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, all the learning you've done, are you any better at dealing with rejection?
- APAlex Partridge
In the moment, no. When I am triggered, the intense feelings are still very real-
- AGDr. Alex George
Mm
- APAlex Partridge
... very strong, and there's no way to bypass that, I feel like.I agree ... um, I think having an awareness of it is huge 'cause then you can acknowledge it, you can almost hold it out in front of you and say, "This isn't me. This isn't, this is rejection sensitivity dysphoria." Mm-hmm. "I know why this is happening." William Dodson, the great psychiatrist, theorized that we were exposed to 20,000- Yeah ... 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." [laughs] Mm-hmm. 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- Mm ... with that awareness. This is RSD, don't say anything in the moment because you're probably not responding to the comment your boss- Sure ... or your friend has said in the moment. You know, if, if there's a social event and you find out about it, and you say, "Oh, can I come?" And th- 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- Mm ... of rejection and, and having approval taken away. And because of that, you're li- almost like you're responding to the- Yeah ... compounding effect of all of those horrible 20,000 comments. But if you respond in that state, you're probably gonna say something- You'll regret ... that is disproportionate. Yeah. 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, and you avoid so much of that shame and anxiety of- Mm ... perhaps responding in the moment. People have said, "I want a divorce." They've rage quit the job- Mm ... when they're triggered, uh, and then they come back with their tail between their legs like, "I'm, I'm so sorry. I didn't mean that." Yeah. I, um, I honestly, like I- I'm not sure that I've heard of a technique that is truly curative of it. 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 it happening, is just creating space between your, um, awareness and reaction. So like you're aware that, "Oh, my gosh, I'm triggered. I'm feeling rejected here." Right. Shut up, basically. Don't say [laughs] anything then. Allow this to pass. You know, the, the thing that I've found I think helpful is trying, I'm not sure if I'm always good at this, but trying to use like a 24-hour rule. So think, "Right, if I still feel strongly about this in 24 hours, then I'm gonna discuss it with this person, but until then, I'm gonna try and park it and sit with the feeling." Uh, 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 this space for 20-plus years, uh, within the ADHD space, you know, she feels strongly that it is the most painful for almost every ADHDer. You know, experience the RSD side of things 'cause it just... It's not just the experience of the rejection, 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've 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? It's the rejection's painful, then the consequence- Mm ... of that rejection or perceived rejection is often even worse than the initial feeling. It's very, very cruel, and I, and I, I don't, 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 gonna give it three hours, see how I feel in four hours." So practice with four hours and then work it up to, say, 24 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. I think it can be so derailing. I was in a Alcoholics Anonymous meeting recently, and I share this story with absolute permission- Mm ... and I've changed her name. Um, 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, um, "Can we have a chat Monday morning? Have a lovely weekend." And that's all it said. Oh, okay. And she instantly snapped to- Well, now my Mon- morning, my weekend is not going to be lovely. [laughs] Well, yeah, she's- [laughs] It, it- Everything but ... "What have I done wrong? They found out I'm useless. I'm gonna get fired." And 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- Unbelievable ... story on social media, and she... And I got a comment saying, "Well, she's obviously not working the program properly. She should've 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- Oh, unbelievable ... instant that often all logic and what you know to be true and all the good advice you've had in that moment goes out the window. Well, we know that the, 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 mea- mean or correspond a logical state of brain. It's very hard to have the both really. It's like this, once the emotional part of you is really high and spiked, all the kind of logical processing, the executive functioning part decreases. And we know that obviously with ADHD, you know, the, the, it's, it's, it's a challenge of executive functioning. It's the ability to... That part of the brain's already not the best [laughs] 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 un- underperforming or not the most kind of controlled part of, [laughs] of the brain. And therefore, it's a perfect situation for, you know, a horrible experience. And I ju- 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 so 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 that I know what it is. 'Cause I guarantee whatever you tell me, my vi- visi- vision of what- Mm ... it actually is is 50 times worse. If you combine ADHD and OCD, which is, uh, what I have, then it's, that's an even bigger recipe for disaster because you've got a brain that is impulsive
- AGDr. Alex George
That is emotional, that can kind of jump to the worst case scenario with an obsessive compulsive brain. Uh, and that is a perfect storm. It's why I think OCD and ADHD is, is so commonly coexisting because you have a sensitive brain that is, has this impulsivity, that has this higher emotional state of lability with this part of the brain that will latch on and think and think and think and think and think. It's, uh, it's a painful combination at times.
- APAlex Partridge
Mm.
- AGDr. Alex George
So I'm really careful with people. If I think that I'm gonna 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 'cause 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 re- like, it's not her fault, but you've in sen- in a sense, self-sabotaged the situation out of nothing.
- APAlex Partridge
Absolutely. In the absence of positivity, the RSD brain jumps to extreme negativity.
- AGDr. Alex George
Yeah.
- APAlex Partridge
We catastrophize. We assume the worst case scenario. How bad do you think it can get for someone? Um, 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 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?
- AGDr. Alex George
Definitely. I mean, I think I've definitely had moments where I've had very dark thoughts off the back of it. Um, you know, and often s- a feared... It's often a situation where you're getting rejected about a sensitivity about possible event that might happen, usually more so than something that's actually happened, um, you know, which is the things you can feel rejected [laughs] about something that hasn't actually happened. You've just imagined it. Um, 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 rationalize, 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 of, "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, and especially if you have a situation where someone's already depressed or in a vulnerable state or has coexisting OCD, for example, you know, there's compounding risk factors for those situations. So, you know, rejection sensitivity dysphoria 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, a very, very common coping mech- mechanism for many ADHD traits, but certainly for rejection sensitivity, because actually it hurts less when you drink, and that's a reality. In the long run, it doesn't.
- APAlex Partridge
Mm.
- AGDr. Alex George
It hurts a hell of a lot more, but in the moment it hurts less. It's, it creates a delay between experience and, yeah, the, the situation that's happened,
- 27:39 – 32:43
Signs of AuDHD
- AGDr. Alex George
the experience of pain.
- APAlex Partridge
Earlier you mentioned you were considering getting an assessment for ASD. What makes you suspicious that you might have autism?
- AGDr. Alex George
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, um, so since the age of probably six or seven, I've used a hairdryer sound to soothe. So my mom said as a baby, I was very restless, and when she used to dry her hair, I'd kind of really calm and I'd go to sleep. And I think from a very young age, I realized that I felt most calm when the hairdryer was on. So from, from literally like seven or eight, I'd go downstairs in the morning before school and put the hairdryer on for half an hour and sit with it on the sofa, just with the hairdryer held like this, and I'd 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. Um, there's a specific hairdryer that I like, that I take, um, everywhere. And, you know, that's... People often use white nose-- noise for concentration, and ADHDers will often describe as using it to help focus. But for me, it's not focus, it's soothing, which tends to be more of an, uh, 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 and be a certain person. And I've often wondered, like, h- 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, um, very untrusting of 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 and understanding the b- brain becomes further, perhaps there are many people that have a... They're neurodivergent, that have some sort of structural physiological difference in the brain that presents with varying amounts of traits of OCD and ADHD and autism. Like, I often wonder, I mean, 'cause 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, this seemed to be a feature. But actually, we've already described rejection sensitivity as 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 there's, 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, "Ah, am I gonna do this though?" 'Cause ADHD I kind of understood why a bit more. And she said, "Listen, did you reject- regret doing the ADHD assessment?" I 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 that you fill in, um, that take a long time. [laughs] And then you do your, uh, 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 it at all 'cause I wanted to go in blind, um, and not understand what was gonna 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, and I'm now just at the stage as we speak where my family are going to be doing the assessment, so they talk to them to look at what you're like throughout your life. And 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, um, conversation, and I said to my mum, "I don't think I've ever felt so unmasked in my life," but not in a necessarily positive or negative way, but almost a sense of, like, things that I thought were my personality might actually be autism. [laughs]
- APAlex Partridge
[laughs]
- AGDr. Alex George
Things I thought were my own quirks might actually be-
- APAlex Partridge
Mm
- AGDr. Alex George
... autism, and I don't know how I feel about that really. Like, who is me then? Who am I?
- APAlex Partridge
One of the comments that I get quite often in the, in the comments section when discussing masking is, "Masking is an autistic trait," Alex. And some of the guests that I've had on
- 32:43 – 35:14
Masking
- APAlex Partridge
here have said similar. Do you think, though, masking perhaps is more of an autistic trait than an ADHD trait?
- AGDr. Alex George
No, I don't think so. Um, and I think you do it for different reasons. I think masking in ADHD is trying to bend and flex into this shape that's required for the situation, to round yourself to be acceptable for the scenario. I think from an autistic perspective, if this is what I have as well, um, it is trying to be something. You're trying to, like, 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 very... 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? How 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. You know, people often assume that people who are autistic can't be expressionate. That's not true. Uh, some, many actors are, 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 wanna be careful not to kind of share too many questions from the assessment 'cause it's important that people might be going through it. It might influence things. But a common question I think that's talked about is, like, do you enjoy kind of social situations? Are you good at social situations? And it's interesting 'cause I think I'm good with people, um, but I'm good at people often in 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 gonna hang out with them, they're gonna become my friend. Virtually all my friends, w- 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, there are important differences I think there that, that, that become highlighted. It's like, yeah, I'm good with people. I've learnt how to be. My mum is fantastic with people. With respect, my dad is a, was a wonderful man, um, isn't naturally a person that is, like, gr- he's good at, like, chatting, but he doesn't form deep bonds with that many people. Uh, and I grew up looking at my mum going, "She's really good at talking to people. I need to be like her." So I copied her, and I learnt 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
- 35:14 – 53:09
Tiimo advert
- AGDr. Alex George
take it to that level.
- APAlex Partridge
My sincerest apologies for interrupting your hyperfocus, but a quick word from our sponsor. Like many in the new year, we want to turn over a new leaf, looking to be more productive, more organized, and never late. Well, Tiimo app is here to help. Tiimo wasn't named App of the Year in 2025 for no reason. It's the ultimate planning partner, gently guiding you towards busting your day-to-day chores list. The important difference is Tiimo is designed by neurodivergent brains for neurodivergent brains, and you can tell. It's built to adapt to your neurodivergent way of thinking and be flexible to your way of planning, and now it's even more simple with the AI planning assistant. Tiimo offers an incredible new voice transcribing service, making it even easier to use. It's almost so simple that it feels like a cheat code to play life on easy mode. Give it a go, and use the link in my bio for 30% off. Just a note, though, this code is only applicable on the web browser, not the smartphone. Back to the episode. Socially, what are you like with small talk? Because I've spoken to many people who have got an autistic diagnosis, and they find small talk truly exhausting. They're just not interested in it.
- AGDr. Alex George
Mm.
- APAlex Partridge
They find it more challenging, more draining to talk about the weather. But if you move on to something that they're truly interested in, a topic perhaps that many people would find exhausting to talk about-
- AGDr. Alex George
Mm
- APAlex Partridge
... they're in their element, and they can, they can chew your ear off for hours. Like, we met off camera today, and as far as I know, we didn't really do much small talk. We went straight into podcast strategy. [laughs] Uh, and I thought that-
- AGDr. Alex George
Straight into full cu- full-blown podcast discussion. [laughs]
- APAlex Partridge
'Cause that's what... We're both passionate about that.
- AGDr. Alex George
Yeah.
- APAlex Partridge
And we went straight into it, and I, and I, I suspect I, uh, would get an ASD diagnosis if I went for an assessment. Um, but how are you with small-
- AGDr. Alex George
Why don't you? Why don't you get assessed, then? If you think that, why don't you?Just if I did a terribly SD thing and interrupted you, but-
- APAlex Partridge
Yeah. [laughs]
- AGDr. Alex George
... what, why, why, why would you, why would you not do it?
- APAlex Partridge
For me, it's not something that I am interested in. I mean, I, I, I kind of have self-diagnosed myself with autism, and I give myself a lot of s- slack in some social situations.
- AGDr. Alex George
Mm.
- APAlex Partridge
Um, for me, it's my ab- I think... Fascinated to talk to you about OCD more 'cause I think I fall there as well. It, it's just such a, my obsession is this podcast and the work that I'm doing, and to go to a clinic and get assessed and to spend hours with a psychiatrist or a psychologist, even though it's clearly very related, it's just not within that lane of that obsession and I just can't bring myself to do it.
- AGDr. Alex George
It's really interesting 'cause I think what, I get it, and I completely understood that, and I kind of, that's how I felt. And a- again, I'm saying this now, I might be told that I don't have autism. I'd still say it's an invaluable experience because regardless of what I, what just happens at the end of this, I have learnt so much of things that I am actually masking, that I actually am doing to please other people or to bend and be. So actually I'm, even the assessment is actually giving me a huge spotlight of stuff and making me question stuff and look at things that I know is gonna benefit me in the long ti- long term. And I think this is something we talk about in the medical space and often working in A&E, it's not the known unknown that's the issue, it's the unknown unknown. So it's the stuff that you don't know about right now that might change your life, but you don't know that you don't know about it.
- APAlex Partridge
Mm-hmm.
- AGDr. Alex George
You know, it's often when you go into business, it's not the problems that you're thinking about. "Oh, I've gotta think 'cause I know in two years I've gotta pay, you know, I gotta think about a year and a half, I've gotta pay tax," or whatever it is. It's the stuff, the letter you get through the post, the thing that you should have known at the start that you don't know about. It's bitten you in the backside, that's the problem. But you didn't know to not to know about it. And so I think that's the beauty is like going through a process, um, like learning about tics, for example, like ticcing all my life, but finding out that I've got vocal tics. Um, I think like actually, for example, the social stuff, I would've said three months ago, "No, no, no, I'm really good in social situations. I'm always good with people." But through this assessment process, I've actually realized that actually I've been tricked many times by people. I've been in situations where I shouldn't have trusted people and did, and vice versa. I've actually had friction with people throughout my life. I've often tried to present a version of myself. I've often struggled to create deeper friendships, and this is something I had no realization about. What can I do with that? I can start questioning, what kind of friendships do I want? What do I value? You know, what if I rather than present what people want and I present who I am, maybe I'll create deeper connections with people who love me or like me for who I am. Because it's impossible to become deep with someone if you're presenting something else. And again, it's different, I think, to a pure ADHD presentation where you're bending to conform. This is about who are you? Who are you really? Who's behind there truly? You know, there's a lot of overlap, and actually the truth is there'll be a lot of overlap because I suspect many people watching this who have ADHD probably would have ASD as well. I would... You wouldn't be surprised. Look at the co-occurrence rates, very, very high, and then OCD as well, of course.
- APAlex Partridge
I spoke to Dr. Khurram Siddique, one of the leading psychiatrists who specializes in the dual diagnosis of autism and ADHD, and he described it as a very, well, confusing condition to have both. Very one of many contradictions.
- AGDr. Alex George
[laughs]
- APAlex Partridge
One that craves stimulation, but often makes you overstimulated. You know, you can be very impulsive and you want to do something, but then you can get very overwhelmed at all the necessary moving parts in order to get there, so you-
- AGDr. Alex George
That happens to me a lot. I experience that one specifically a lot.
- APAlex Partridge
Do you find that your life is one of contradictions?
- AGDr. Alex George
Yeah. I mean, my life is entirely confusing from the out- from the outside. You've got this young, sensitive, quiet boy from West Wales who, um, would be terrified to go to a new sports club or to join in on a team sport, um, who was very nervous about having friends over, didn't wanna go and stay at other people's houses, who ended up, you know, being on a massive television show, being very well known. You know, putting myself in situations of doing talks in front of hundreds of people and writing books and podcasting, and all these different things that I've done. It just like, it's all a massive, like, confusing mess in, [laughs] in a way.
- APAlex Partridge
Yeah. [laughs]
- AGDr. Alex George
And I think that probably it's a mixture of things, but there, there at the core of it, I am someone who wants to, I want to live a life that is, um, that is, that is meaningful. And I think that sounds very, like, that can sound a bit like, I don't know what the word is, but I, I really feel it's important to me to like, do something with the time that I have. I think one of the things actually, so I was asked the question, uh, in the, in the assessment, "What are you most afraid of?" And I said, "Time." It's my immediate reaction. I'm afraid of time, and specifically losing it. And, um, that has actually been a crippling experience because sometimes it's very hard to motivate and do something for the ADHD, but also I'm very obsessed about not wasting time. It's why I can't lie in in the morning. I get up at 7:00 or 6:37 every single morning. I can't have a lie in 'cause I have a terrible fear of time. If I... Oh, my worst nightmare is oversleeping an alarm and waking up at 11:00. And that'll be on a Saturday, let alone a working day. Um, and so I think my whole life when I look at all these different things, it's this combination of wanting to do something, but often being paralyzed, having a great visionary idea for something, but unable to follow it through. You know, I think I've had, you know, some terrible ideas, but I've also had some brilliant ideas that I didn't actually realize because I had the idea and vision, but I couldn't complete it and do it. And with the impulsive stuff or the desire to do something spontaneous, I wanna do something spontaneous, but I also live by rigid routine. Uh, and I think that is a, a really difficult combination. I love all food and wanna try everything, and yet I eat the same meal every night. I discovered, um, the salad project around the corner, uh, three weeks ago, and I've had more salad projects than it has been days since my discovery.
- APAlex Partridge
[laughs]
- AGDr. Alex George
And every single salad project meal has been identically the same. Um, and that's not because I don't have a broad flavor and not 'cause I wanna try different things, it's like this, the routine sometimes becomes this like strangulation-
- APAlex Partridge
And if something knocks you off your routine, how does that make you react if something unexpected happens?
- 53:09 – 58:09
Dr Alex’s ADHD item
- APAlex Partridge
is the ADHD item section. Now, every week-
- AGDr. Alex George
Not chucking me in the tumble dryer, are you, a washing machine?
- APAlex Partridge
[laughs]
- AGDr. Alex George
Chuck, chucking me in the washing machine.
- APAlex Partridge
That comes afterwards. [laughs]
- AGDr. Alex George
[laughs] Okay, fine.
- APAlex Partridge
Every week I ask my guest to bring in an item that most represents ADHD. They all end up on the shelves behind us-
- AGDr. Alex George
Mm
- APAlex Partridge
... and become part of the set. And for now, yours is patiently waiting underneath this cloth, and I'm going to reveal it now.
- AGDr. Alex George
Drum roll. Some trainers.
- APAlex Partridge
Right. Pair of trainers. Now, why does a pair of trainers represent ADHD?
- AGDr. Alex George
I think that, um, if you were to capture what exercise does for ADHD in a pill and sell it, you would be a trillionaire overnight. You'd beat Elon Musk to his trillion, uh, pound, billion dollar, trillion dollar fortune, because I think what exercise does for the brain and body is just incredible. And specifically, there is something about running, running that has changed my life, and I know that people use that a lot and it's cliched, but you know, I remember three years ago when I stopped drinking and I started walking outside every morning, as that was the first thing I started doing to try and, like, ground myself and think, "I need to heal myself. I'm gonna walk for an hour every day. I'm gonna work out what the hell to do with my life." I saw people running past, and I was like, "These people run. It just looks such hard work. Why do they do this thing? It's miserable." And people, people go say how amazing it is, how fantastic. I'm like, "God, I don't know if I like that." And I started losing weight, and I started lifting weights in the gym and, you know, feeling better, losing some weight, and I thought, "Do you know what? I might give this running thing a go." And so I went for my first run, and I hardly ran a kilometer in the first go, but even at the end of that, I was like, "God, that was really hard work, but I feel something." And that was the start of a journey to eventually running the London Marathon, which I achieved this year, and genuinely, the difference it's made to my brain, to my mental health, is even greater than my physical health. I'm no longer 20 stone. I'm kind of 14 stone, fit and strong, and the running has definitely been a big pa- big part of that. But when it comes to ADHD, it quietens the mind, it lifts my mood, it makes me feel alive, it brings me into the present moment, it reminds me of my strengths. Um-It's just incredible. And I know that you're an avid runner yourself, so I know that I'm talking [laughs] about something you very well understand. Rather than turning to a bottle of beer, rather than turning to something else, like food to numb, this thing gives you dopamine in a way that is incredible, that helps you, that builds you, that makes you feel strong and purposeful. So I am actually incredibly grateful to running. I genuinely believe... Actually, to be honest, to tell a, kind of a dark story, I actually felt very, very low not that long ago, in the last kind of 18 months, and I felt I was having very dark thoughts. And I thought, "I don't really know what to do. I feel that bad." And I thought, "Well, I'm here to stay and I need to stay, so perhaps I'll go for a run." And I went for that run, and when I came back, I came back from the edge, if you like, and I found, again, a reminder myself that it's worthwhile staying. And I often wonder if I didn't go for a run, you know, what would've happened? So I think it is a, a lifesaver for me personally. It's, it certainly saved my life on that occasion. Not specifically these trainers, by the way.
- APAlex Partridge
[laughs]
- AGDr. Alex George
Not sponsored by Brooks.
- APAlex Partridge
Yeah. [laughs]
- AGDr. Alex George
Specifically these trainers.
- APAlex Partridge
Yeah.
- AGDr. Alex George
But what that represents saved me, I think.
- APAlex Partridge
Yeah. I mean, it's incredibly powerful, Alex, and thank you for sharing that. And I completely agree. As you said, I, I try and run as often as I can, and it just gives me the mental clarity that you, you mentioned.
- AGDr. Alex George
You're a 5K man, aren't you? You like to go for short runs, right? So you go for short-
- APAlex Partridge
5K, yeah
- AGDr. Alex George
Yeah, you like the 5Ks
- APAlex Partridge
I like to run London a couple of-
- AGDr. Alex George
You don't, I know you don't run, but you like going out for...
- APAlex Partridge
Yeah, yeah. That's, that's the... Anything more, I get [laughs] probably the ADHD, I get a bit bored.
- AGDr. Alex George
[laughs] The irony of the whole thing is that you go for-
- APAlex Partridge
Yeah, anything less, it doesn't give me that sort of like mental clarity for the rest of the day. Anything more and I feel like I'm just spending too much time doing it and I'm missing out on, on, on other things. But yeah, 5K for me seems to be the sweet spot. But the t- the trajectory of my day in terms of productivity, focus, general wellbeing, happiness is mind-blowingly altered to the positive if I do my run.
- AGDr. Alex George
I think the thing is that was interesting with the 5K is that you need to run long enough to have the kind of endorphin, big dopamine release, and they say that's like 20 minutes plus is where the key beauty spot is, right? So I'd say to anyone, if you're starting out running and you're like me and you went for your first run and you could only do like a K, even though I felt like kind of good afterwards, oh my God, that was 10% of what I felt versus when I could do kind of 4 or 5K. Once you're able to run for 20 minutes, doesn't need to be fast, it can be super slow, whatever you wanna call that, like once you get over that 20-minute mark, then you're entering the magic. And I think I agree with you. I think that 20 to 30-minute window of running is where it's at. You know, some people love s- super long distance. You've run, you know, super long distances. That's great. You don't need to be able to do that. If you can go for a run for 20 minutes, 25 minutes, you'll gain 80% of the benefit, I think, mentally.
- APAlex Partridge
Couldn't agree more. Movement for ADHD,
- 58:09 – 1:02:31
Washing machine of woes
- APAlex Partridge
absolutely fantastic. Now I am gonna throw you into the washing machine.
- AGDr. Alex George
Come on then, chuck me into it. Is it the tumble dryer or washing machine? The washing machine.
- APAlex Partridge
Uh, washing machine of woes-
- AGDr. Alex George
[laughs]
- APAlex Partridge
... because my item is a washing machine, 'cause for me, I think I explained last time, it-
- AGDr. Alex George
Yeah
- APAlex Partridge
... it represents memory loss, because I often forget to empty the machine after the cycle's finished.
- AGDr. Alex George
Mm-hmm.
- APAlex Partridge
And I do ask everyone, 'cause it makes me feel less alone. Do you relate to that?
- AGDr. Alex George
I do. Yeah.
- APAlex Partridge
That's-
- AGDr. Alex George
I do. I absolutely do. God, the memory side of this.
- APAlex Partridge
[laughs] I have been using the Tiimo app, which is helping me to remember, but not perfect yet, but we're getting there.
- AGDr. Alex George
Getting there.
- APAlex Partridge
This week, Alex, someone has written into the washing machine of woes and asked, "I'm a 55-year-old woman and my ADHD is unbearable at times, but a lot of people in my life think I'm acting up or exaggerating. Is this common for ADHD women to come across like they're over the top?"
- AGDr. Alex George
I think it's, you know, [sighs] I think we let down a lot of people in the neurodivergent space, and I think we have to be honest. I think we probably let down women the most of all, whether that's ADHD or actually ASD, because we've had a selection bias or diagnostic bias towards men. We have built the idea of what ADHD looks like as a, through a male lens. Indeed, a lot of the researchers have been men, typically, in this space. But also the kind of specimens, if you like, or examples of what it looks like have been men. It's why the hyperactivity is such a central idea of what people think it looks like. It's like the boy bouncing around the room, right? So what that means is we're missing a shed load of women, um, to, in, in diagnostic e- element. A- and also because it's not what we see as ADHD, in some kind of subconscious level I think people kind of reject it. It's almost like, "Oh, you have ADHD, but you're a woman." Like, can you have ADHD if you're a woman? You know, and I think that that kind of, not necessarily overt sometimes, al- although it can be, that subconscious kind of, "Hmm, is it really ADHD?" means that people get rejected and they don't, you know, they think it's just like made up or jumping on the trend. I mean, this whole thing recently I think is utterly outrageous, this whole idea that we have an over-diagnosis of ADHD. It's, it's, it's factually incorrect. I mean, a, a Lancet study published, uh, only a f- few months ago, um, looking at 9 million GP records found a diagnostic rate of 0.32% on the GP records of a very broad spectrum of people. We know that the true prevalence of ADHD is about 4%, thus 10 times less people diagnosed than have it. Um, and so, you know, it's really frustrating, this over-diagnostic thing, this idea that, you know, just men have it, it's usually damaging for women. So I really sympathize with this person, this, this lady that sent this question in, and I would just really encourage people to try and, first of all, be kind. Try and understand. When you, there's something that you don't understand about, uh, uh, understand, rather than rejecting it, try and learn about it. A human flaw that I think I witness a lot is that when we don't understand something, we don't trust it. So this is where ignorance often comes from. Because we don't know about something, we kind of push it away, reject it, or think like, "This can't be real 'cause I don't understand it." If we approached it and said, "Well, actually, what is ADHD? How does it present in women? What challenges might they experience?" that could change everything. And do you know what? Why does it matter? Because this woman might be someone that you're married to, it might be your daughter, it might be someone you work with. You know, I, I recently did a... And I do a lot of talks-In corporate settings, you know, you know, 4 or 5% of people might have ADHD, but everyone interacts with someone with ADHD. You know, you might be someone's line manager. You might be married to this person. One gentleman, one gentleman put their hand up in a, in a talk I was doing the other day and said, "My wife and three daughters all have ADHD, so I'm rather invested now."
- APAlex Partridge
[laughs]
- AGDr. Alex George
You know, and I thought it was... And then actually he spoke really well about it, and I think it was very important. The point he was making is that this knowledge isn't just for people with ADHD, it's for everyone. You know, empower yourself with knowledge 'cause that knowledge will combat ignorance.
- APAlex Partridge
Mm. So true, and I, I, I've really nothing to add. I mean, you said that perfectly, and on behalf of the 85% of people that listen to this podcast who are women, I think they come to this podcast and others because they have been, like you said, let down horrendously for so long, been misdiagnosed with anxiety perhaps, told that they're crazy often even by their doctors, been made to feel like they're-
- AGDr. Alex George
Told they're hormonal.
- APAlex Partridge
Exactly. It's, it's, it's, it's podcasts like this, things you just said, that add so much validation and really counters that horrendous narrative that, that the UK government came out with recently.
- 1:02:31 – 1:03:49
A letter to my younger self
- APAlex Partridge
So thank you so much, Dr. Alex.
- AGDr. Alex George
Thank you.
- APAlex Partridge
Just finally, I want to deliver you a letter that was written by the previous guest-
- AGDr. Alex George
Mm
- APAlex Partridge
... in which they wrote a letter to their younger self.
- AGDr. Alex George
Mm. Okay, brilliant.
- APAlex Partridge
If I could pass that to you-
- AGDr. Alex George
Yeah
- APAlex Partridge
... and if you'd kindly read it.
- AGDr. Alex George
Absolutely. The handwriting to the next guest is probably gonna be a lot better than my-
- APAlex Partridge
Yeah, good-
- AGDr. Alex George
... good handwriting. God help the next guest after me.
- APAlex Partridge
[laughs]
- AGDr. Alex George
Um, to your younger self. "So one day in the future, it will all become clearer, and you will understand yourself better. The world owes you nothing. Seek knowledge, understanding, and share that to help others less fortunate. Be kind to yourself and enjoy moments with those that matter the most, as they won't be around forever. Experiences matter more than material things." Very wise words, I'd say.
- APAlex Partridge
Mm.
- AGDr. Alex George
Nothing much to [laughs] to add to that really.
- APAlex Partridge
Yeah.
- AGDr. Alex George
Very important. But what I said here is knowledge and understanding is exactly what I think is so powerful about this. Number one thing that I've ever gained through ADHD diagnosis or listening to this podcast or any d- discovery I've done is purely understanding. Understanding and knowledge helps you live a better life, uh, full of acceptance.
- APAlex Partridge
A lovely tone and a ro- a reminder to finish on. Dr. Alex, congratulations on the book.
- AGDr. Alex George
Thank you. I appreciate that.
- APAlex Partridge
Thank you so much. [upbeat music]
Episode duration: 1:03:50
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Transcript of episode EH5D1UeRSFo
