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ADHD Chatter PodcastEllie Middleton details impact of late AuDHD diagnosis
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Catching Up and Late Diagnosis Story
Ellie Middleton reflects on a busy year and on feeling more like a human being than before. She explains being diagnosed with ADHD and autism at 24 after years of anxiety and depression diagnoses, and how a counselor's question about taking things literally started her search.
- •Over the past six months she has worked on being a human being rather than staying in ADHD mode
- •Teenage diagnoses were generalized anxiety, panic disorder and anxiety-related depression
- •Cycles of ADHD-driven activity followed by crash and burnout
- •A counselor's question about taking things literally led her to research autism and then ADHD
- •ADHD diagnosis in October 2021, autism in April 2022
Why Neurodivergence Gets Misdiagnosed as Anxiety
Alex shares that he was also misdiagnosed with generalized anxiety disorder at 15, and asks why this is so common. Ellie describes her time with CAMHS and explains how masking hides everything but the visible explosions.
- •Ellie was with CAMHS from 15 to 19 and was put on antidepressants
- •Her mum suggests clinicians only saw the panic attacks and low mood she presented
- •Masked traits build up like a volcano, with panic attacks as the eruptions
- •Bipolar, BPD and eating disorders are other common misdiagnoses she mentions
Childhood Masking and the Cost to Identity
Ellie describes morphing into whoever her friends were, from haircuts to interests, and how she later realized she had been masking as a different character after diagnosis. She explains how this leaves little sense of who she really is and that she feels closest to herself with her brother and family.
- •She changed appearance and interests year to year to fit each friend group
- •After diagnosis she realized she was masking as the person she thought the neurodivergent community wanted
- •She struggles in therapy to have a sense of self
- •Showing her real self feels risky because rejection would be personal
- •Unmasking will take more undoing than she expected
When Masking Is Necessary
Alex raises the tension between unmasking and RSD and asks if masking can be a useful protective tool. Ellie says it can be, noting that marginalized people may not be able to unmask safely, and describes masking on screen as a content creator.
- •Unmasking is not safe for everyone, with her example of a Black man stimming versus a small white woman
- •She is always masking to a level on camera, and a friend sees the mask going on and off while editing
- •The aim is to choose when masking benefits her and when it will drain her and cause burnout
Unmasked and Uncomfortable: Shutdowns, Parties and Texts
Ellie recalls an airport shutdown abroad and an empty-battery moment meeting a partner's friends. She shares the code-signal tip from her book, the cycle of never letting people see you in that state, and her advice to just send the text after leaving early.
- •She had a shutdown in an Egyptian airport with no energy left to mask
- •A code signal such as tapping a partner's arm lets them do the explaining
- •Never showing that side of yourself means you never get proof people will respond kindly
- •Her tip is to send a brief text such as sorry I had to go, though she admits she often fails to do it herself
- •Delayed replies have led to friendships fizzling out with no argument
Feeling Unmasked and Accepted at Gigs and Football
Ellie says she is most herself with her brother. She describes how football matches and gigs were safe places to mask and are now easy places to unmask, including a recent gig where they left early.
- •She and her brother are on a similar unmasking journey
- •Crowds mean no eyes on you and you can follow what everyone else does
- •They left a gig after seeing their favorite band and neither drank
- •Leaving early without embarrassment suits her energy
- •Alex says it is good to normalize leaving events early
The Toll of Being Misunderstood
Alex asks what toll being misunderstood takes and how it grows into adulthood. Ellie says it made her a skilled explainer who uses analogies, but that any misunderstanding now triggers all earlier ones, though it hurts less than when she was younger.
- •Late-diagnosed friends often become natural explainers
- •She uses analogies such as executive function being air traffic control for the brain
- •A new misunderstanding feels like number 800,000 and triggers past ones
- •Teenage misunderstandings felt like the end of the world
- •Her career has pushed her toward more self-acceptance, though it still hurts
Autism and ADHD Pulling in Opposite Directions
Asked about the sibling-dragging analogy, Ellie says one condition tends to lead at a time in seasons. She gives examples of ADHD leaving things late and autism stressing about missing information, and describes her fixes such as management reminders and an access rider.
- •She agrees the sibling analogy is good and describes seasons where one is more prominent
- •ADHD means she forgets to ask for event details until the morning, while autism makes her very stressed about not having them
- •Her management automated reminders to request information on her behalf
- •An access rider tells collaborators what she needs, such as an agenda and direct communication
- •ADHD usually causes trouble for autism, like the chaotic sibling versus the sensible one
Pendulum Swings, Burnout and Doing Less
Ellie says burnout after her first book launch looked like severe depression. This year she has deliberately done less and looked after herself, which has reduced the intensity of the lows, though recording the audiobook still drained her.
- •Around the book launch she was sobbing and exhausted at what was meant to be the happiest time
- •Burnout presents as depression for her: losing interest, struggling to shower or eat
- •She has consciously done less this year and avoided a big depression phase
- •Recording the audiobook was one of the hardest things she has done
- •Exercise, walks and better eating have lessened the lows
ADHD Item: Fizzy Bubblegum Bottles
Ellie reveals her ADHD item, fizzy bubblegum bottles, tied to her mum putting sweets in her blazer pocket to get her through school days in sixth form. She links it to her view of her ADHD as a toddler that needs a treat.
- •During sixth form she went in for one lesson or the morning, with a sweet every five to ten minutes as motivation
- •Her mum put fizzy blues in her blazer pocket until the packet ran out and it was time to go home
- •She says her ADHD is like a toddler that you give a little of what it wants
- •She mentions sensory seeking as possibly part of the appeal
Washing Machine of Woes: Advice for a 16-Year-Old Without Friends
In the agony aunt segment, a listener asks how to help a 16-year-old daughter who struggles to make friends. Ellie relates it to her own school years, recommending finding one like-minded friend and empathy about how hard those years are.
- •She kept befriending popular girls as a masking survival mechanism, and it didn't end well
- •She suggests quality over quantity and finding a friend who is more like you
- •Telling a struggling teenager school is the best time of life makes things worse
- •The pressure at 16 to 18 around exams, university and identity is huge
- •Alex adds that the effects of masking compound each year
Tolerance Between Neurodivergent People and Community Themes
Ellie says tolerance is yes and no, as traits can click or clash, such as her disliking last-minute changes while sometimes canceling herself. She also describes common themes among people who contact her: diagnosis, support and finding community.
- •Neurodivergent people may have more compassion but can still be triggered in the moment
- •Alex says understanding and willingness to learn help neurotypical-neurodivergent relationships thrive
- •Many people she hears from want to know how to get a diagnosis and where to find support
- •Running a community as a business is hard for her, partly because of demand avoidance
Managing RSD and Reframing Rejection
Ellie says RSD is always there and she realizes she avoids rejection by keeping people at arm's length. She describes a reframing rejection framework from Leanne's coaching training and says feeling the gut reaction but not letting it ruin the day counts as a win.
- •A video skit made her realize how many ways she isolates herself to avoid rejection
- •She has more friends than before diagnosis but they are more controlled friendships
- •The framework asks what thought you are choosing to believe, the consequences, and the opposite thought
- •Looking for evidence for each thought shows there is little for everyone hating you
- •The gut feeling will always show up, but what matters is how she brings herself out of it
Literal Communication, Snapping and Asking for Reassurance
Ellie explains how being misread by people who know her upsets her and how she can snap when overstimulated. She describes asking loved ones to remind her they care, while Alex highlights the self-awareness in naming overstimulation.
- •Being misread by a stranger is fine but being misread by someone who knows her really bothers her
- •Her mum, as her support worker, receives most of her overstimulation snaps
- •Communication after the fact, such as apologizing, helps
- •She asks people to remind her frequently that they love her, in the same way she needs an agenda before a meeting
- •Alex says relationships may have ended because overstimulation was not understood
Setting Boundaries as a People Pleaser
Ellie says boundaries protect energy and sense of self, but are hard for a masker because of fear of rejection. She suggests writing boundaries down, making them specific, outsourcing them to management and treating them as guides, while admitting there are tricky trade-offs.
- •Boundaries help define who you are rather than who others want you to be
- •Setting a boundary and having it accepted feels empowering
- •She learned from Leanne to write boundaries down in a visible place and make them specific, like SMART goals
- •Outsourcing boundaries to her management helps when her excitable brain wants to say yes
- •Boundaries can be trial and error and cost her opportunities, and she has no answer to that flexibility problem
Too Much but Not Enough, the Unwritten Rulebook and Forward Grief
Ellie describes the contradiction of feeling too much but not enough, and the endless but not too of social expectations. She explains the double-sided coin of diagnosis and introduces the idea of forward grief as well as backward grief.
- •She feels too much in enthusiasm but not enough in finishing tasks or replying
- •Social dynamics have unwritten rules and she can never find the sweet spot
- •Before diagnosis she wondered whether everyone found life this hard
- •Diagnosis brings validation but also the realization that it will always be this way
- •Forward grief comes from knowing there is no fix, unlike hopes with anxiety treatments
Letter from the Team and Rapid-Fire Impulsivity Questions
Alex introduces a new letter segment and Ellie reads three rules to live by, agreeing with them. The episode then closes with rapid-fire questions about impulsiveness, unread emails, screenshots and her stinginess about finishing purchases.
- •The letter's rules are no regrets, that a weakness may become a strength, and that two good mates beat twenty poor ones
- •Ellie says she would have been happier had she read it as a teenager
- •Her most impulsive act was quitting a bank job on a month's notice to travel for two years
- •She has 96 unread WhatsApps and 3,074 screenshots
- •She is a self-described stingy Yorkshire girl who finishes what she buys
Publisher timestamps
- 0:00Trailer
- 3:04Shall we start by explaining in brief your diagnoses and where they came throughout your life?
- 7:52What were the various iterations of masking throughout your childhood?Read this chapter
- 10:51What are the hidden costs of masking
- 16:06When was the last time you felt truly 100% unmasked and this made you feel uncomfortable to feel like you're being yourself?Read this chapter
- 23:59When was the last time you felt truly 100% unmasked and this made you feel incredibly liberated and accepted?
- 27:12From your experience, what toll does the feeling of being misunderstood take on a person at the time it's happening, and in hindsight what toll do you think it can play on a person when they reach adulthood?Read this chapter
- 31:14We’ve had a few guests on with AuDHD and one of the most illustrative of analogies is "it's like 2 siblings dragging each other across the room by their hair". How would you describe these two sectors of the brain colliding on a day-to-day basis?
- 35:46Last time you were on you described a sort of 6 month pendulum swing of depression that would then swing to optimism and ambition. You haven't been on here for around a year, so I was just wondering if this has cropped up again in your life and how?Read this chapter
- 39:48ADHD itemRead this chapter
- 42:24The washing machine of woesRead this chapter
- 48:19Does having ADHD and Autism make you more tolerant of other people who exhibit what might be frustrating symptoms of ADHD and Autism in your personal or professional life?Read this chapter from 48:20
- 51:04You’ve built a fantastic community online lending support to neurodivergents, from those who have reached out, do you see any common themes in the turmoils of those who are feeling lost?
- 53:23Have you made any steps over the last year to manage your R.S.D and has it cropped up in your life since you were last on?
- 58:23For someone who has said they take things literally and can maybe be more blunt than people are used to, this must cause confusions in conversations and friendships, how does your RSD deal with these confusions?
- 1:04:07Why are boundaries important to a person?
- 1:11:16At the beginning of your Ted Talk, you listed contradictions of social dynamics that you had trouble balancing. Could you mention a couple of them now?
- 1:13:18You then go on to say other neurotypical people just seemed to have a metaphorical rulebook which helped them understand these things that you couldn't get to grips with, did this lead to resentment of being different? Having to work so hard to understand something others know intrinsically?
- 1:17:01A letter from the previous guest
