ADHD Chatter PodcastDo you have AuDHD (Autism & ADHD)? 10 Signs | Dr. Samantha Hiew
At a glance
WHAT IT’S REALLY ABOUT
Understanding AuDHD: masking, meltdowns, misdiagnosis, and relationship support strategies
- AuDHD often involves difficulty “shifting gears,” where a person simultaneously craves freedom and needs routine, making last-minute changes uniquely destabilizing.
- Shutdowns and meltdowns are differentiated as internalized vs externalized responses, with meltdowns often appearing sudden because triggers accumulate long before the visible breaking point.
- Masking is framed as a survival adaptation driven by nervous-system stress, social reward-seeking, and threat detection, but it can erode identity and increase burnout, shame, and depression risk.
- Women are frequently missed due to historically gender-biased, child-focused criteria and the late recognition of autism–ADHD co-occurrence, alongside newer research suggesting multiple autism subtypes.
- Support and recovery center on trauma-informed, intersectional assessment, nervous-system regulation, values-aligned (selective) masking, and relationship fairness around emotional labor and energy limits.
IDEAS WORTH REMEMBERING
5 ideasAuDHD distress often comes from a collision between “control” and “chaos.”
Hiew describes AuDHD as swinging between autistic needs for predictability and ADHD-driven variability, making sudden changes (cancellations, interruptions) especially overwhelming and disorienting.
Shutdowns and meltdowns are different coping outputs, not “bad behavior.”
Shutdowns tend to be internal (mutism, withdrawing to process), while meltdowns are external (rage/outbursts); both can follow prolonged unaddressed overwhelm rather than a single event.
Meltdowns can look ‘out of nowhere’ because the stress load is cumulative.
Small triggers, emotional absorption, sensory overload, and ongoing adaptation build over time; the visible eruption surprises others because the internal strain was hidden via masking.
Masking may be more common in AuDHD—and it can create an identity crisis.
Rapid adaptation to survive (e.g., pretending to understand instructions despite processing differences) can become so habitual that people later ask, “Who am I under the mask?”
Misdiagnosis and missed diagnosis in women are partly structural, not personal failure.
Dual diagnosis wasn’t widely accepted until 2013, criteria skew toward childhood/“white boy” presentations, and many clinics still assess ADHD or autism separately, missing the combined profile.
WORDS WORTH SAVING
5 quotesIt's, it's, um, a lot of the time, it comes like a tsunami-
— Dr. Samantha Hiew
... 'cause there is a collision between, like, just control and chaos. And in that collision, we sometimes just don't know who we are, you know, and why we can't just switch, you know, as easily as, as other people.
— Dr. Samantha Hiew
... the very being, you know, of being the AuDHD neurotype and the way of being will predispose us to trauma on our nervous system, and that trauma causes us to mask, camouflage, adapt, become what is needed in order to survive.
— Dr. Samantha Hiew
So many people have struggled needlessly because we were just waiting for the science to catch up, and not only that, we were waiting for the clinics to catch up with what it means to live, you know, as a human who perhaps have not only autism, not only ADHD, but AuDHD and mental health, uh, differences.
— Dr. Samantha Hiew
And, you know, so many people I speak to in an AuDHD community are talking about authenticity, you know, to be able to be ourselves on purpose, and actually being loved for us- it's, it's invaluable.
— Dr. Samantha Hiew
High quality AI-generated summary created from speaker-labeled transcript.
