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ADHD Chatter Podcast

No. 1 AuDHD Expert Reveals 5 Hidden Signs of AuDHD | Dr Khurram Sadiq

What does is feel like to live with both ADHD and autism? What are the most common signs of AuDHD? What is an AuDHD person looking for from the world?

Alex PartridgehostDr. Khurram Sadiqguest

Feb 4, 20251h 45mWatch on YouTube

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CHAPTERS

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Chapter summaries

A Father's Legacy: Why Dr Sadiq Dedicated Himself to Neurodevelopmental Psychiatry
Alex asks where Dr Sadiq's drive comes from. He describes realizing, shortly before his father's death, that his father was neurodivergent, a misunderstood genius, and how grieving him shaped his path.
- •He realized his father was neurodivergent about six months before his death
- •His father was both precise and impulsive, and others labeled him with a personality disorder
- •His father looked after his neighbors and their plants despite poor health
- •Dr Sadiq has autism and ADHD himself, in a way different from his father
- •His father's death and his grieving process led to his work
Order and Anarchy: The Conflicting Traits of AuDHD
Dr Sadiq describes AuDHD as order and anarchy in one person and explains the three presentations he sees. He argues that autism and ADHD can be told apart even though people say they overlap, and that each can act as the other's yin and yang.
- •AuDHD is order and anarchy in a single person, such as an immaculate bookshelf alongside forgotten daily tasks
- •Autism is described as a parent to ADHD and ADHD as a friend to autism
- •Three presentations: autism prominent, ADHD prominent, and variable
- •ADHD is driven by dopamine and novelty, while autistic interests give comfort, mastery and grounding
- •Autistic indifference is different from ADHD inattention
14:53 – 17:18
The Consequences of Undiagnosed AuDHD
Alex asks about the damage of going undiagnosed. Dr Sadiq says AuDHD brings more coping and defense mechanisms, and that a late diagnosis often brings relief, reflection and insight.
- •AuDHD coping mechanisms mean fewer people get into drugs or trouble with the law, as autism leans toward caution
- •Masking by each condition leaves some people with unanswered questions
- •Many people burst into tears at diagnosis
- •He assessed a 78-year-old man whose wife wanted answers and who later found peace with them
- •Answers lead to reflection, then insight, then changed behavior
The 'Naughty Child' Stereotype and Sensory Overload
After the sponsor read, Alex asks about the naughty child crying outside a classroom in Dr Sadiq's TEDx talk. He explains he chose a girl deliberately to challenge stereotypes and that her distress came from sensory overload.
- •The girl stood outside the classroom crying because she did not want to go in
- •He used a girl to challenge the stereotype of neurodivergent children
- •A man told him afterwards that the story described his six-year-old daughter
- •Noises, smells and people coming near caused her sensory overload
Does the Education System Accommodate Neurodivergence?
Asked whether schools are set up for neurodivergent children, Dr Sadiq calls the system poor because it generalizes strengths and expects the same results. He gives examples of strength-based approaches and the other speaker likens it to hammering a round peg into a square hole.
- •The spaghetti-to-biryani analogy for expecting identical results from different strengths
- •A relative's child who loved writing flourished once he pursued creative writing
- •A patient told him that normal people do not like different
- •Japanese schools teach life skills before academics
- •Apart from a few Scandinavian countries and Japan, he sees systems as not strength-based
Feeling Ostracised and Its Effect on the Developing Brain
Alex shares his own experience of feeling ostracised at school and asks about the effect. Dr Sadiq uses the Romanian orphans to show that neglect and exclusion have biological consequences for brain development, and discusses stress and adult mental health.
- •Romanian orphans had undeveloped brain regions after severe neglect and abuse
- •Exclusion and ridicule affect the brain biologically as well as emotionally
- •Raised cortisol and changes to the amygdala, hippocampus and frontal lobe
- •Adult outcomes include anxiety, depression, personality and behavioral issues
- •Stress leads to physical and mental health problems
Reading Non-Verbal Communication and the Value of Awareness
Alex asks how to spot someone who cannot communicate their needs. Dr Sadiq cites The Reason I Jump and says most communication is non-verbal, observable through body language and behavior. Alex adds that neurodivergent people may pick up this unspoken part well and stresses awareness.
- •The Reason I Jump was written by a non-verbal 11-year-old with autism
- •Dr Sadiq says voice is 7% of communication, tone about 30% and non-verbal cues around 60%
- •Psychiatric training in mental state examination is about observing
- •Autistic people may learn social cues from videos and books and read patterns by observing
- •Alex calls awareness the foundation, easing shame and anxiety
Is There Beauty in Being Different? Neurodivergent Strengths at Work
Alex asks whether there is beauty in difference. Dr Sadiq says there is, using black cutlery as an example, and describes how his team of mostly neurodivergent staff cut waiting lists. Alex ties this to problem-solving and diverse talent.
- •Difference brings different perspectives, angles and thought processes
- •Each neurodivergent group brings its own strengths
- •His team, around 80% neurodivergent and 20% neurotypical, reduced waiting lists in two years
- •Alex links ADHD problem-solving to having to devise solutions to survive criticism
What Is a Spectrum? Evolution, Survival Traits and RSD
Asked about the word spectrum, Dr Sadiq first picks up on survival and describes an evolutionary view of ADHD and autism, called gene environmental mismatch. The conversation then turns to rejection sensitive dysphoria and how it builds up from years of ridicule.
- •ADHD and autism have existed as long as humans, with an evolutionary psychiatry perspective
- •Gene environmental mismatch: environments changed faster than genes
- •Traits like distractibility and split-second decisions were once survival tools
- •ADHDers do well in stimulating jobs and badly in mundane admin roles
- •RSD builds from years of ridicule and differs between people
Obsession or Preoccupation? Shame, Passion and Mastery
Alex asks whether being obsessed should be shameful. Dr Sadiq rejects the word obsession in favor of preoccupation or passion, describes his own childhood interests, and says the shame comes from society rather than the person.
- •He prefers preoccupation or passion to the negative word obsession
- •ADHD interests last shorter, while autistic interests run deeper and lead to mastery
- •His childhood interests included counting motorcycle brands and keeping cricket stats
- •Autistic people are proud of their interests, and the shame is imposed by others
- •Alex describes being preoccupied with the stock market as a child and being called weird
Roots of Insecurity and the Changing Stigma Around Neurodivergence
Dr Sadiq explains how ridicule and unmet expectations create insecurity, low self-esteem and fear of failure. They then discuss how stigma has changed, including his first encounter with an autistic patient, the TikTok diagnosis trend, and what he would like to see happen.
- •Being picked on and compared leads to fear of failure and the thought of 'what if I fail'
- •His first autistic patient, an astrophysicist, changed his mindset
- •Awareness has grown, with the risk of normalization and 'TikTok diagnosis'
- •Alex says 'everyone has ADHD' misses the intensity of ADHD swings
- •Dr Sadiq wants embracing, mutual learning and psycho-education
Dobby, the Sock and the Washing Machine of Woes
Dr Sadiq explains why Dobby is his ADHD item, then describes diagnosis as the sock that frees someone. In the agony aunt segment he answers a teacher's question about a pupil with panic attacks in class, discussing sensory overload and attention as stimulation.
- •The Harry Potter world is seen as a neurodivergent world, with Dobby as undiagnosed ADHD with unrecognized strengths
- •Being told it might be autism or ADHD is like Dobby being given the sock
- •Panic attacks in class may be sensory overload, so ask the child what is happening and accommodate
- •Alex wonders whether attention can be a form of stimulation, and Dr Sadiq says yes
- •Dr Sadiq has put his AirPods through the washing machine
Gender Differences, Early Diagnosis and Common Misdiagnoses
Dr Sadiq describes how ADHD presents differently in males and females and the toll of masking and societal expectations on women. He then covers the earliest ages for diagnosis and common misdiagnoses of ADHD and autism.
- •Males commonly present with the combined type, and the purely hyperactive-impulsive type is rare
- •Females lean toward the inattentive type and mask and mirror to conform
- •Anxiety, depression, eating disorders and self-harm are more prevalent in females with ADHD
- •Autism can be diagnosed from around eighteen months and ADHD around four to five, with brain development in mind
- •Common misdiagnoses include emotionally unstable personality disorder, cyclothymia, bipolar, and social anxiety
What Neurodivergent People Want from the World, and Disclosing at Work
Dr Sadiq says neurodivergent people want to be listened to, understood and embraced, and criticizes firms that hire them mainly for productivity. He discusses whether to disclose to employers, saying it depends on the employer.
- •They want to be listened to rather than shut down
- •They want relationships where their behaviors are understood
- •Some bigger firms hire neurodivergent staff for effectiveness without caring about wellbeing
- •Disclosure to an employer is a personal decision, since some are supportive and others may scapegoat
- •He is open about his own diagnoses but it took him years
ADHD, Autism, Addiction and Hyper Focus Interruption
Dr Sadiq explains the link between ADHD and addiction, why autism is less tied to it, and how gaming differs between the two. They cover why interrupted hyper focus causes rage, how to approach addiction, and the role of purpose in recovery.
- •Around 30% of people with addiction have underlying ADHD, while autism tends to stay away from the unknown risks of drugs
- •Stimulants like cocaine can slow the mind, and alcohol is used for sleep
- •Gaming gives ADHD dopamine hits and gives autistic people a sense of normal socializing
- •Hyper focus in ADHD is crisis-driven and tied to norepinephrine and dopamine, so interruption brings frustration, while autistic sustained attention is enjoyed for its own sake
- •Understand the reason for addiction and replace the stimulation, since a purpose in life helped patients leave addictions
Closing Letter and Behind the Scenes Quickfire
Dr Sadiq reads the three rules left by the previous guest, then answers quickfire questions about his habits, including notebooks, impulsive decisions and fictional characters he sees as neurodivergent.
- •The previous guest's letter says to connect neurodiversity symptoms with hidden potential
- •His wife handles reusable bags and keeps the home organized
- •His most impulsive act was leaving a medical exam to meet a friend and being away for 10 hours
- •He uses a Remarkable writing pad to avoid losing notebooks
- •He names Jim Carrey's Mask as ADHD, and Snape and Luna as autistic

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