No.1 AuDHD Expert: What AuDHD Really Feels Like, This Habit Means You Have AuDHD!

1. 0:00 – 1:31

   Trailer

   1. SPSpeaker0:00

      Autism acts like a parent to ADHD, and ADHD acts like a friend to autism. One is very ordered, disconnected from the world in a nice way. On the other side is the ADHD. It is disorganized. A parent steers children in the right direction. Autism takes that responsibility. For autism, it is a friend because the friend does not let another friend be in silos. They just pull them out. They are able to connect with the world in a very nice way.

   2. APAlex Partridge0:24

      Dr Khurram is a world-renowned psychiatrist.

   3. SPSpeaker0:27

      And author of Explaining AuDHD.

   4. APAlex Partridge0:29

      He's here to explain how to spot the signs of AuDHD.

   5. SPSpeaker0:32

      And how to thrive with it. Neurodiversity does not mean a neurodevelopmental condition. You see a neurodivergent person might not be fitting in all the boxes of neurodevelopmental condition, but their brain would be different, and they will think differently because they have got overlaps of so many small bits of dyspraxia, dyslexia, autism, ADHD, not fulfilling the full diagnostic criteria. They can see things differently.

   6. APAlex Partridge0:51

      What consequences could occur-

   7. SPSpeaker0:54

      Mm

   8. APAlex Partridge0:54

      ... for someone if they are living a life with AuDHD and not knowing it?

   9. SPSpeaker0:58

      I think-

   10. APAlex Partridge0:59

       [instrumental music] It's such an honor to have such a authority on the topic of AuDHD here in the studio. And I think, without a doubt, if anyone is confused as to what AuDHD is or whether they have it themselves, I think by the end of this episode they will feel considerably understood and have answers.

   11. SPSpeaker1:22

       Yeah.

   12. APAlex Partridge1:23

       I want to start with a question that I know has got such a beautiful answer and always strikes a chord with those who hear it.

2. 1:31 – 3:14

   Is Autism a friend to ADHD?

   1. APAlex Partridge1:32

      You said to me that autism is like a friend to ADHD. What do you mean by that? Can the two conditions be friends?

   2. SPSpeaker1:40

      Yeah, these two condition can be friends. And, uh, uh, uh, autism acts like a parent to ADHD, and ADHD acts like a friend to autism. And how... what it implies, because they're on two opposite sides, opposite spectrum. One is very ordered, but that order leads them to be very secluded, sometimes very recluse, disconnected from the world in a nice way. Um, whereas on the other side is the ADHD, which is, if it is pure form, it is anarchic. It is disorganized. There's a potential to gain, in order to gain more stimulation, they get involved in things that can destroy their careers at the... And, and they can, they can, they can go a completely different direction. So what I meant was, like, a parent steers children in the right direction, at least where I come from. They do. This is their responsibility. And autims, au- autism takes that responsibility. So somehow, uh, when I've spoken to people with AuDHD and they say, "I want to do something, but something reins me in." And that reining themselves in is autism. And for autism, it is a friend because the friend does not let another friend be in silos. They just pull them out. They give them the energy. They give them the social life that they deserve. Um, and they do get exhausted after that, once the energy of ADHD runs out, but they are able to connect with the world in a very nice way.

3. 3:14 – 5:02

   The confusing nature of AuDHD

   1. APAlex Partridge3:14

      Can it be confusing to someone who is experiencing these internal push and pulls?

   2. SPSpeaker3:19

      Yeah.

   3. APAlex Partridge3:20

      What toll can that have on someone's understanding of themselves?

   4. SPSpeaker3:24

      I think the f- the first thing is that, um, people who have lack of understanding, they will definitely confuse it because people have come to me, even when I use the word they can, they exist in synergy, or they, they can, they can actually, uh, a symbiotic relationship. And they say, "Well, my AuDHD is different." And I completely agree. Everybody AuDHD is completely different. The push and pull is just one form of it. All they have to do is to understand it. And this is, again, the push and pull that I'm talking about, the autism and the ADHD. It lets them be in the center, not at the extremities. And once they start to learn it, they will understand more the analogy, because it's a very advanced level of analogy. It's not the basic level of an analogy. One, one of the other analogy that I use that, like, you're, you're flying over a pl- you, you're, you're sitting in a plane, you're at 10,000 feet. The pilot tells you that you can see the beautiful city, let's say Prague. And you look down, and there's a cloud cover. You cannot see that. In a minute, minute later, the cloud cover is blown away, and you see the city. The city, because it's constant, it's, it's autism. The cloud cover is ADHD. The blown away is management, either by strategies or by medication. So there's a const- and there's something that comes and goes depending on your neurotransmitters and, and how, how good your pathways are or how bad your pathways are connecting different parts of your brain.

   5. APAlex Partridge4:51

      So an understanding of AuDHD suddenly makes so much make sense, and everything becomes clear.

   6. SPSpeaker4:57

      Yeah.

   7. APAlex Partridge4:57

      Or a lot of stuff that perhaps was clouded in confusion suddenly becomes clear.

4. 5:02 – 7:15

   What makes sense after AuDHD diagnosis

   1. APAlex Partridge5:02

      When somebody gets a AuDHD diagnosis, what do you see becoming clear?

   2. SPSpeaker5:08

      Mm-hmm.

   3. APAlex Partridge5:08

      Do people look back, and they s- they look at behaviors, decisions and think, "Wow, that was my AuDHD at work"?

   4. SPSpeaker5:15

      Mm-hmm. Yeah. I think they reflect. When, when they come to that stage, when they come to me looking for an answer, they have gone through a lot already. They have reflected a lot on their choices. And a lot of the time, they're unable to, to kind of, to say whether they are autistic or they are ADHDers. A lot of them, they know that they are ADHDers. Some of them, they want to know whether they are ADHDers or autistic. So, but once they come to know, for example, somebody hypothetically is diagnosed with AuDHD, A, it is overwhelming to start with. B, it can bring about a lot of grief in that person. Thirdly, the missed opportunities, the trauma that they might have, uh, uh, m-Received or kind of been in the path of as a result of their AuDHD. But the best thing is once they come to know that they have an answer, I think their life changes. And I always tell them that diagnosis is not the end of the debate. It's the start of a journey. It's like starting a new book, very first chapter. You're on, you're on introduction now. So I can take you to a certain extent, but again, I can give you avenues where you can explore yourself and where your life makes-- will make more sense to me because your life is very different from another AuDHD's life, and you will have to make sense of it. I will help you make sense of it. And I have seen people where they have been going from denial to embracing it, and their lives have changed.

   5. APAlex Partridge6:55

      It's incredible, and you've dedicated so much of your career to raising awareness and understanding of AuDHD. Your book Explaining AuDHD is phenomenal. And I always wonder when I meet someone who has dedicated so much of their mind, their career to a particular topic, where that passion comes from.

5. 7:15 – 9:39

   Dr Khurram’s AuDHD mission

   1. APAlex Partridge7:15

      So what is your mission, and where does that stem from?

   2. SPSpeaker7:19

      Well, um, my-- it, it all started from the grieving process that I went through, uh, when, when, when, when my father passed away in two thousand twenty-two. Before that, I was doing combined autism ADHD assessment. I, I myself at times was not able to understand the intertwining of it, and I was in the, in the process of learning it and reflecting on it because I knew that I was AuDHD at that time. But the whole mission is to, to break down complex issues into small gullible parts, digestible kind of pouches of knowledge where people can understand where I'm coming from. It's about combination of neuroscience and the intertwining of stories with the outcomes that make sense to a lot of people. And, and this is my, this is my forte. I'm a storyteller, just like my father, just like the f-- the family of us. When I look at my uncles, my fathers, they used to be together at nighttime with my aunts and my mother, and they used to tell stories and, and, and stories with eventually a, a m- a m- a moral in it. And it, it was humorous, it was entertaining, it was captivating, and how my father broke down very complex issues into small parts and help us understand that. I understood-- He was an engineer. When he was teaching me maths, he would teach me maths in a way which I have never seen anybody do that. Like in my GCSE's paper, I was explaining the questions and the answers to the GCSE's, um, um, examiners by creating more diagrams and creating... So my, my father asked me, he said, "Because this is how you taught me, I understand it so much better now." So my mission is to kind of bring together the complexity of neuroscience, the brain, with the stories, stories of real people who have gone through it and make people understand through their experiences.

   3. APAlex Partridge9:27

      It's fascinating. I remember, Khurram, when I first heard you explain what AuDHD is and what it feels like, it, and it completely changed the way I think about it.

6. 9:39 – 15:40

   What AuDHD actually is

   1. APAlex Partridge9:39

      If you were to have a classroom of five-year-olds, for example-

   2. SPSpeaker9:44

      Yeah

   3. APAlex Partridge9:44

      ... how would you explain AuDHD to that audience?

   4. SPSpeaker9:46

      Right. Like, it, it, it will be very difficult to explain it to them. Like, I will start with the basics. I will not go into the nitty-gritties of the, the AuDHD. I will explain to them how different brain works, how brain can be so much different, how what you're doing is-- does not make you bad or lazy or make you extraordinary. It's the way you do things. This is how your brain is, is wired up. This is how, this is how the different brain structures is connect-- are, are connected with each other. And to make them understand that different is not bad, different is not fearful, different is not strange. Different is beautiful at the end of the day. I think that's the most important concept we should be teaching the five-year-old. I don't think that they will have that capacity to understand autism ADHD, but you can break it down, break it down into smaller pieces, smaller chunks. As some brains can, can, can get interested in certain subjects. They will go deeper into those subjects. They will understand those subjects much better than so many, and they can become an expert without even getting a degree on it. And they want perfection, and they want precision at the same time, like the structure. And then in that context, I'll explain them different mind without giving them any labels, so that when they grow up, they don't go for the labels. They don't see the label. They see the people, and they understand that, yes, this is, this, this makes sense. Everybody is different. Everybody thinks different. Everybody's perspective is different. And it's good to bring people with different perspective because that will help you grow, and that will help the environment grow and the communities grow.

   5. APAlex Partridge11:29

      It's so important and such a strong message. You might get a diagnosis of AuDHD or ADHD or perhaps autism, but you have to focus on the people behind them.

   6. SPSpeaker11:38

      Mm-hmm.

   7. APAlex Partridge11:39

      It's so important, I think, to start simple with the explanations to get that clarity. But-- and I very much count the ADHD Chatter listeners and viewers in this category, educated people. How would you describe AuDHD to an educated room of students?

   8. SPSpeaker11:56

      Well, again, I will, I, I will, I will go with, with, with the simple steps that I w- that I've done with the five-year-old, explaining to them what neurodiversity is because-What we sometimes lose track of is neurodiversity does not mean a neurodevelopmental condition. You see a neurodivergent person might not be fitting in all, all the boxes of neurodevelopmental condition, but their brain would be different and they will think differently because they have got overlaps of so many small bits of, let's say, dyspraxia, dyslexia or autism, ADHD, not having a full diagnostic, not in full, filling the full diagnostic criteria. But you can see that they can s- they think, they can see things differently. So even for the educated people, that's, this is where I'm gonna start from. And then talking about how the dichotomy of brain is, how you can have two operating systems in your brain. You can be operating on an iOS and, at the same time, Window. How you merge them together, how you integrate them together, how you take the best parts of each other and integrate it. For example, on Windows, like W- Word or Microsoft Office is a Windows product, but we use a lot on Mac as well. We use Excel sheets on Mac. So this is an integration, and this is how you learn about the other system. Like, there's no system which is ultimately good or ultimately bad. It's, it is, it is relative how you bring the strengths together and you, you, you, you, you create an environment where everybody thrives. So this is, this is what I'm gonna tell them, and then going to the nitty-gritties and specificities of it. I will tell them about how an AuDHD person is. Like, I see it as three different patterns. I speak about it, but I speak about it more, uh, uh, more based on the observation, the number of patients-

   9. APAlex Partridge13:44

      Mm

   10. SPSpeaker13:44

       ... that I've seen, that autism-dominant presentation, where you see the autism, you don't see the ADHD. But once you get into the nitty-gritties and exploration, you will see that the ADHD is lurking around. It's, it's like an engineer who says, um, "I love creating beautiful systems," but ADHD runs through those systems like a child scattering the papers away. Or the ADHD dominant form where, uh, uh, ADHD is more prominent, uh, they are into novelty. They are, they are into kind of bringing in more ideas, but s- somehow gravitate towards precision and perfection led by autism. And it's like a musician saying that I've got two different drummers. One is absolutely innovating on its own, and other one is following a metronome, like boom, boom, boom, not shifting from it.

   11. APAlex Partridge14:32

       Mm.

   12. SPSpeaker14:32

       And the third one, where there's a, there's a push and pull when people say variable, when ADHD can be in the steering seat and in the one moment and autism the next. And, um, I have seen a student who said, "I do coding in the mornings. It's intense. It's amazing. But by the, by the afternoon, I've lost everything, all the progress that I've made. I've started five different subjects or five different assignments, five different tasks," b- because it keeps on switching the pull and the push and the, the variable nature of autism and ADHD coming in. So this is how I'm gonna explain them, with examples, with real people who have come to me and used those analogies to help me understand, to help them manage it.

   13. APAlex Partridge15:15

       It's certainly fascinating, Khurram, and I feel like many of the people watching and listening, and they'll be thinking, "Do I have AuDHD?" And they, perhaps they've seen signs of AuDHD on TikTok or social media, and I feel like many of those signs can be slightly misrepresentations. But I remember the time I saw you on stage, and you were explaining the real signs of AuDHD, and I remember being completely shocked by them.

7. 15:40 – 20:24

   The signs of AuDHD

   1. APAlex Partridge15:40

      So what are, would you say, five signs of actual AuDHD?

   2. SPSpeaker15:44

      Well, I, I would not give a number to it, but again, I, I would say there are certainly, like there, uh, there are disparities between the two. For example, silence versus noise. You, you love your tranquility, but at the s- at the same time, you like the stimulation of certain situations as well, and you gravitate towards it as well. Um, um, organization versus disorganization, where you like your own routines and structures, you want to create it, but you're unable to sustain it. It's, it's repetition versus novelty. It's like you like to eat the same food. You want to watch the same programs over and over again, but then you're unable to follow your daily routines on, on a, on a, on a day-to-day basis. Um, it's, it's, it's about, um, people who their autism kind of grounds them to be risk-aversive, but at the same time, they like the novelty of different situation and, and they throw themselves into those situation unknowingly. So for me, those are the, the, the opposites and kind of the, the disparities of the brain and the contradictions, I would say, the contradictions of the brain that helps us to identify that this is what it is. They, they want to be focused, but at the same time, they want to be distracted at the same time by things that interest them.

   3. APAlex Partridge17:04

      So relatable, Khurram. I have my suspicions that I am AuDHD. I haven't gone for an A- autism assessment yet. Um, I crave being in a clean environment-

   4. SPSpeaker17:17

      Yeah

   5. APAlex Partridge17:17

      ... but I cannot clean. [laughs]

   6. SPSpeaker17:19

      [laughs] Yeah.

   7. APAlex Partridge17:20

      I hate loud noise, but I will listen to my favorite song-

   8. SPSpeaker17:24

      Yeah

   9. APAlex Partridge17:24

      ... in my earphones on full blast.

   10. SPSpeaker17:25

       Yeah.

   11. APAlex Partridge17:25

       And it's not the, it's not the volume of the noise that irritates me, it's the fact that I'm not in control of the volume.

   12. SPSpeaker17:32

       Yeah.

   13. APAlex Partridge17:32

       When I'm in a public place and there-

   14. SPSpeaker17:34

       Yeah

   15. APAlex Partridge17:34

       ... or a bar and there's noise playing, it's 'cause I'm not in control, and that's always fascinated me. If someone's listening and they're thinking, "That sounds like me. I could have AuDHD based on what Khurram has just said," how can they be sure?

   16. SPSpeaker17:49

       I, I think the first thing is c- curiosity is not a diagnosis. Curiosity is the first step towards it, towards knowing yourself. And, and it becomes AuDHD when it follow a certain pattern. It, it, it has its own consistency in an inconsistent way, um, where-It starts impacting your life, your, your interpersonal life, your relationships, your friends, your workplaces. You, you, you, you're trying to do something, you do it amazingly, but you have not followed the rules, and all of a sudden people see you as, as, as a maverick, not as somebody who is, who's, who's an innovator. So for me, the important thing is to kind of log why you think you have got AuDHD. What are the patterns that you've noticed? Reflect on yourself. Talk to your parents about it as to how you were. Look at your report cards. Look at the friends that you have and what they say about you. If you have an older sibling, what-- how did they see you? And if, if then you, you still believe that this is the case, then go to the credible websites. Um, I w- I would, I, I, I would refrain from going to a non-credible website because people are using their own experiences. Not that it's authentic, it's the context which is important, and you can completely take it out of context. So go to those authentic websites, speak to people who have been diagnosed, and see whether your experiences are relatable. And it's important to see that whether you want a label or whether you, you need a label for something. If it is imminent and if it is you really want it, because it will open a lot of doors, yes, go for it. But if just knowing yourself, understanding yourself, it helps, then you do not need a label. You, you're, you're enough till you need a label, until you go for a person. But again, choose the person right. Choose the person who actually has lived experience, but also able to understand the intertwining nature of autism and ADHD. Because a lot of people, they like to see autism and ADHD in the same person as two different entities, whereas the pathway is very intertwining.

   17. APAlex Partridge20:06

       What-- A bit of pushback I get towards the narrative of I don't want a label is that-

   18. SPSpeaker20:10

       Mm-hmm

   19. APAlex Partridge20:11

       ... the people I speak to who suspect they have AuDHD, they tell me that the label they get regardless of a diagnosis is that they're like Dr. Jekyll and Mr. Hyde.

   20. SPSpeaker20:19

       Yeah.

   21. APAlex Partridge20:19

       Like, these, these fluctuations in mood and the optics of what that looks like to those around

8. 20:24 – 22:49

   What AuDHD looks like from the outside

   1. APAlex Partridge20:24

      them. What labels, social labels, do you think someone with AuDHD might get other than AuDHD?

   2. SPSpeaker20:32

      I think they will see them as inconsistent, brilliant one time and, and kind of not performing, um, the other time. They will see that, see them as very passionate at one point about a certain thing, but not passionate about the, uh, the general day-to-day stuff. They, they will be seen as lazy, but then e- energetic when it comes to activities that, that kind of, um, entices them or stimulates them. So people will see them in contradictions that-- And eventually it will be you're capable, but you're not pushing yourself enough. You, you need to d- You need to do more. Sometimes they are too much, and sometimes they're not enough for people. So these are the kind of social labels that they might get. Um, I, I still remember the-- having the conversation, I don't know whether I've spoken about it or not. But, um, I remember when I was in grade eighth or ninth, and, um, my, my parents were coming from a parents-teachers meeting. And they-- Th- My father was a bit disappointed because I had come second in a class of forty. And, uh, he-- And I knew that he was not happy. Uh, he, he was a perfectionist, so he looked at me through the, through the rearview mirror and said, um, "Khurram, you are so consistently inconsistent." And I just-- Because again, I, I used to be scared of him when I was, when I was young. So I muster up all the courage, and, um, I said, "But Father Abu, isn't this consistency?" [chuckles] And he just smiled at me, and he did not say anything, but he got what I wanted to say. So this is how the picture is like. Sometimes you're performing. You-- On one grade, you'll be amazing, and the next class when you go to, it will be you are not doing a lot. And when you understand the context, it's because the teacher is not interesting or something is happen- happening around you which is not letting you achieve your standard. But if you get a good mentor, if you get a good teacher, if you get a, a person who takes you through that journey, I think your whole life changes.

   3. APAlex Partridge22:46

      Perfectionism, you mentioned your f- your father was one.

9. 22:49 – 25:11

   What AuDHD perfectionism looks like

   1. SPSpeaker22:49

      Yes.

   2. APAlex Partridge22:49

      What does perfectionism look like in AuDHD? Because it's a topic that comes up time and time again in the-

   3. SPSpeaker22:55

      Mm-hmm

   4. APAlex Partridge22:55

      ... ADHD conversation, and I feel like many people just think that it's an executive function challenge, but there's-

   5. SPSpeaker23:01

      Yeah

   6. APAlex Partridge23:01

      ... such an emotional element to it. I feel like it's the fear of letting people down. It's the not wanting to expose yourself to a criticism, so it's-

   7. SPSpeaker23:09

      Yeah

   8. APAlex Partridge23:09

      ... easier sometimes to, A, not start.

   9. SPSpeaker23:12

      Yeah.

   10. APAlex Partridge23:12

       Or B, if you do something, you have to do it to such a-

   11. SPSpeaker23:14

       Yeah

   12. APAlex Partridge23:14

       ... high standard and it, and it, and it's exhausting. But the AuDHD mind, what does perfectionism look like there?

   13. SPSpeaker23:21

       Well, w- we, we, we, we have got, kind-- have to deconstruct it from both autism and AD- ADHD perspective. As you said, the ADHD perspective is just you explain-- you, you just explained it, that it is the years of being told that you're not good enough, you have to-- you're not doing things right. So when you do it, you have to push yourself to perfect it so that nobody can critique it for you. And, and, and that is-- And if, if somebody critiques it, then all of a sudden RSD comes out massively. Whereas for autism, it's because they love the subject or they love doing it. They want to do it to perfection. And if they start something, and most of the time people come to me and say, "My child starts writing an essay, but all of a sudden on the second page, if something goes wrong, he just rips apart everything and restart again."That is autism because they want perfection as they're going along the journey, journey. So you, you mix together both autism and ADHD perspective, and you, you, you're getting a person who's afraid of critique, but at the same time he knows that he can j- achieve perfectionism, and he will try to do that as much as possible. But in most cases, no much h- how hard they try, they won't be able to because there will be an obstacle on their way to do that, and that shatters their confidence. There is impact on their confidence, their self-esteem, and there's a very good chance that they might not try that thing again, ever again because of lack of perfectionistic end to the last project that they had.

   14. APAlex Partridge25:01

       How else do you think AuDHD can show up? In other words, because I feel like it is being spoken about more now, which is obviously fantastic thanks to people like yourself.

10. 25:11 – 27:36

    The risks of undiagnosed AuDHD

    1. SPSpeaker25:11

       Mm-hmm.

    2. APAlex Partridge25:11

       But what can undiagnosed AuDHD look like? What, what consequences could occur-

    3. SPSpeaker25:16

       Mm-hmm

    4. APAlex Partridge25:16

       ... to someone if they are living a life with AuDHD and not knowing it?

    5. SPSpeaker25:21

       Okay. I think, a- as I said, the, the, the contradictions, they will live in contradictions. People have come to me that they have, they have said to me that they were not sure whether they were autistic or ADHD for a very long time. They were too organized to be, um, to be ADHDers, and they are too disorganized to be, to be autistic. But at the same time, they, things that they tried, there was a push-and-pull factor. They would not be able to achieve the full potential. Um, something stops them, and they don't understand what's stopping them. The disparity, the contradictions that we spoke about, for example, wanting something but unable to achieve it, having the attention span and the concentration but not able to sustain it for a very l- long period of time unless they go into phase of hyperfocus where there's, where there's, where there's a consequence attached to it. A lot of these people, they work in very stressful environments because the stress is leading the way, and stress is helping them achieve or finish things. You take away that stress, and if you put them in a very boring environment where there's no consequence, their work will be a very s- substandard level because there's nothing enticing them. There's nothing stimulating them towards it. And for an AuDHD, it's, it will be a story of shattered dreams, broken hearts, complicated interpersonal relationships, um, losing friend constantly without knowing it, showing, showing passion and aversiveness both at the same time towards their partners and towards friends and towards family. And people who cannot understand it and people who do not have the lens to understand these patterns will, all of a sudden they will move away from them, and they feel themself to be lonely. They, they will say, "What's wrong with me?" all the time. "Why I have not been able to achieve? Why people can think, can do things so easily whereas I'm not able to achieve it despite of having all the qualities to achieve it?" And people have told me they have all those qualities. So this is how an undiagnosed AuDHD will

11. 27:36 – 28:47

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    1. SPSpeaker27:36

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    2. APAlex Partridge27:36

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12. 28:47 – 30:28

    Is AuDHD a lonely experience

    1. APAlex Partridge28:47

       show. Do you think having AuDHD is generally a lonely experience? In other words, is it hard to maintain conne- connections, friendships, relationships when in order to do that you need to put a true version of yourself forward?

    2. SPSpeaker29:00

       Yeah.

    3. APAlex Partridge29:00

       And it sounds like many people with AuDHD don't have a good understanding of who they really are.

    4. SPSpeaker29:04

       Yeah. And, and they m- they start masking it, and masking takes a lot of energy, and masking l- let them to be what they're not. The, the burden of carrying that mask in those relationship can be intense, and they can be volcanic eruptions from time to time because they're unable to sustain it for a period. Or they could be burnouts because they're unable to have that energy to sustain that mask for a very long time. And yes, they have difficulties. Not all of them, but again, it's all, it's al- also depends on who they're with. Are they part of a neurodivergent crowd? Because if they're part of a neurodivergent crowd, if they're part of environment which helps them unmask, which acknowledges their strength, who say, "Yeah, if you have a w- weakness, so what? Everybody has a weakness. We can work on it together." If they're in that kind of environment, they will thrive. But if they're in kind of environment where they're not understood, they, people are pointing fingers at them, then they, they tend to go into silos. They burn out. They, they have their breakdowns, and, uh, they're not able to achieve what they want to achieve.

    5. APAlex Partridge30:16

       With the masking, it's fascinating. Is it possible for the AuDHD to be weighted more towards the autism or weighted more towards the ADHD?

13. 30:28 – 33:41

    How ADHD masks the autism

    1. APAlex Partridge30:28

       In other words, can someone mask one side of the diagnosis? Can they mask the autism so well that they never become aware that they are also autistic, or they mask the ADHD side so well-

    2. SPSpeaker30:40

       Mm-hmm

    3. APAlex Partridge30:40

       ... that they only think that they're autistic?

    4. SPSpeaker30:42

       The masking happens at a very, um, subconscious level or, or unconscious level. Um, a lot of the time because, uh, when you look at AuDHD, a lot of AuDHDs when they come to me, they're already ... 50% of the cases, they're either diagnosed with one condition or the other. So the other person, the other per- person, the diag- the, the assessor was not able to see the other part of it because one was masking the other part. For example, when I gave you the analogy of, of the city of Prague and, and the cloud cover in between, and that was ADHD masking the autism. But once autism comes out, it can actually mask the ADHD as well. Um, so the masking is, is different for both condition. What you have to look at is the auto- in autism, they're masking to be more disorganized, whereas in ADHD-

    5. APAlex Partridge31:41

       [laughs]

    6. SPSpeaker31:41

       ... they are masking to be more organized. Because in autism, when they look around, they are perfectionist. They do things to the T. They do want to do things in a certain order, and to them, world is not doing what they want to do, hence they see the world as more disorganized. So they have to kind of give away their autism, which can be so much difficult for them because it causes a lot of anxiety to coming out of those structures and to explore the world and to mingle with them. Whereas for ADHD, it is the other way around. It's like, "The world is so organized. Why I'm so disorganized? So I have to be organized around this world." And that takes a lot of energy. So the energy, the burnouts that a person with ADHD experiences as a result of that, putting a lot of pressure, whereas with autism, it's more social anxiety. It is, it is overwhelming situation. All of a s- all of a sudden, their soc- the, the sensory overload increases massively to the extent that they won't be able to sustain it for a very long period of time, and they go through a burnout as well. So it, it's, it's, it's how strong the au- your autism is and how strong your ADHD is, and which one is, is the most prominent part of it, and which one do you want to mask. Because sometimes, uh, I've come to a stage where I can unleash certain part of my autism and certain part of ADHD to be able to achieve something. Because if I have to think openly, then I have to unmask in a situation where I, I can be, uh, very open with my words, with my feeling, with my emotions. And when I have to concentrate and I completely shut off from the world, I like to think about things, and I know how to bring that out. So it, it takes its own time. It has ... I have my masks, but again, I use them very effectively and efficiently most of the times, not all the times.

    7. APAlex Partridge33:37

       You mentioned emotions there, Khurram.

    8. SPSpeaker33:38

       Yeah.

    9. APAlex Partridge33:38

       I want to focus on emotions.

14. 33:41 – 45:27

    Post AuDHD diagnosis emotions

    1. APAlex Partridge33:41

       What emotions crop up when someone discovers they have AuDHD?

    2. SPSpeaker33:46

       It's a spectrum of emotions, a spec- spectrum of responses that you would get from people. Um, some people who have been ... who did not come on their own volition, but again, their partners or their, their friends kind of urged them to come. They can go through a state of denial, um, and then from there, they, they would like to learn more about themselves and eventually embracing, but it takes a lot of time. Some people get very emotional. Um, they, they cry, they grieve, and they grieve because they look at the missed opportunities. They look at the parents. Why were not pa- parents able to pick those up? And I always use this analogy. I said, "Eyes can't see what the mind does not know." Like, if the professions are missing so much on, on these diagnosis or these conditions, how can you expect somebody else who is not a professional, who have not been taught, who have not been educated about it, to be able to understand that? So that helps them to, to kind of ease their pain. Some cry with joy and satisfaction and said that, "We always wanted that, but I wanted it to be rubber-stamped. I'm satisfied. I'm, I f- I feel that I'm whole now. I feel that I'm able to think from that very perspective." And, mm, like others, they, they go into a cocoon because, A, the whole experience, because when I do an AuDHD assessment, it's two and a half hours, three hours long, and it's like a chat, a chat like we're having now. It's, it's not checklist. It's not a test. And in those stories or in those conversations are, are embedded the tick, the ticks, the checklist that I have to do to kind of get the person diagnosed. So it can be very overwhelming for them. They go and rest for hours. They're exhausted after that, and they come back to me saying that, "Now I want to discuss the management," probably a week later, two weeks later. Um, and one of the most common thing is when people cry, cry with joy, because they now know that the things that they're looking for, they found it now. Because they were kind of throwing arrows in the dark, shooting arrows in the dark. They did not know what it was, and if you don't know what it was, how are you gonna manage it? But once they know what they're, what they're dealing with, they're able to deal it better. So it's a different area of responses that you get from different people, depending on the circumstances.

    3. APAlex Partridge36:23

       If somebody gets a diagnosis of AuDHD perhaps a little later-

    4. SPSpeaker36:27

       Yeah

    5. APAlex Partridge36:27

       ... in life, do you see resentment? Do you see them angry over the fact that they've perhaps lost so many years to being misunderstood?

    6. SPSpeaker36:36

       Yep. There is anger, there's frustration, and anger is towards themselves, anger is towards the parents, anger is towards professionals who have not picked that up, um, misdiagnosed with several condition. But the diagnosis or, or the kind of the surety of what they have, I think it takes over. The anger does not long for, for a very long period of time, and once they know what they're dealing with, they are happy. I think there is a lot of grief about what they could have been. They had the potential. They could have done wonders, but because of that, they're unable to do so now. Like I've... The oldest person I've seen is around late 70s, like 78, 79, and, um, it was a couple who came, um, the gentleman and his wife, and they wanted to know why. Why there has been breakdown of interpersonal relationship. Why they've, they're feeling so isolated as a family. Why people don't come to their place. Why, um, the mood s- switches or flips all of a sudden. But they wanted answers. They didn't want medication. They want some assurities. They have been misdiagnosed in the past. So it w- it is for a different reason, but again, the late diagnosis, they usually come with resentments and the missed opportunities, what they could have been if they were diagnosed earlier.

    7. APAlex Partridge38:05

       And sadly, for, for many people, I imagine you can go your whole life without ever getting answers or ever getting an understanding.

    8. SPSpeaker38:12

       Yeah.

    9. APAlex Partridge38:12

       What is the emotional toll, perhaps, of someone who has AuDHD but never figures it out?

    10. SPSpeaker38:19

        Th- this reminds me of a, um, of something that happened recently. Somebody, um, a mother, um, contacted me from, um, from Canada. She emailed me, and she said that she has read my book. She had, she had seen our, um, our, our previous podcast. She had r- uh, read the Guardian article that was written wh- where I was one of the, one of the m- main people who sp- uh, that spoke about being a professional, a- as well as a lived experience. And for a very long time she was in grief because her son died a year ago. Um, his name was Adam. Um, he was a musician. Um, he was a- at the age of 13 years, he was elected as one of the BBC Musicians of the Year. Um, gifted. He saw music on the piano. He learned, he mastered the music in two months after he learned the basics of it, to the extent that people said that he is unteachable now. People could not train him because he was at that very level. Um, and he died a year ago of overdose, fentanyl overdose, and the mother could not f- forgive him or forgive herself, had not looked at the picture for a year. And when she sent me the story and sent me the email, I cried for five minutes. Just, just l- just listening and just l- listening to the voice note and, and looking at the story that she had sent, the pictures of the person. Um, from the very onset, like again, he was, he was brilliant, but he used to forget things. He, he ended up one day with just one shoe in school. Um, he was, he was not a typical, um, AuDHD-er. And when mother raised concerns with the, with, with the school teacher, with, with, with the school nurse, and she laughingly said, "Oh, somebody who can memorize a 40-page, um, sonata cannot have any learning difficulty." So it was completely dismissed. And then there was another side to him who was very preoccupied with things, with special interests. He would not meet people. Um, he would not mingle with people. He was, uh, taught in one of the best mus- musical sc- music schools in the, in, in the world. Like he was in Manchester, uh, then he went to the Hamburg, uh, Conservatory, which is one of the leading institutes, and he played all over Europe, but again, not socializing with people. The defining factor was, in his life, was the pandemic, and that broke him. He was devastated. He was locked in the, in the dorm, not able to get out. Mother had to fly all, all the way from Canada because he had lost yet another passport, his sixth in a year, and the authorities won't issue him the passport. And mother had no alternative but to take him back because he was not able to sustain himself in Europe. Um, and with that, his dreams shattered to be a musician. Um, he was diagnosed eventually with AuDHD, but was never medicated. He could not hold a job. Um, he started self-medicating. He then it went into using hard drugs and, uh, eventually became homeless and, and, and, and the world saw him as an addict. He could not go past, beyond that addiction phase of his. Like he became invisible from a music- musical prodigy to, to being a homeless person on the streets. And according to mother, his whole life was a contradictionHe was perfectionistic, yet very chaotic. And he, he feared life more than death. When, when his mother asked him, and again, that gave me goosebumps, Sans. The mother said, "Adam, why do you take drugs?" And he says, "Mother, normal people, they fear death. People like me, they use drugs because we fear life." That's such a strong statement, and it actually shows his insight into his life and how he was misunderstood and not seen. And he eventually one day died of a fentanyl overdose. His mo- parents were in another city. And mother received a call, the doctor, that, "Your son is on ventilator. What should we do?" And that knowledge about AuDHD and his... When she started learning about it, that transformed her anger into passion, and she wanted to advocate for people, to be the voice of people. And she is still struggling, but she has come from the anger towards, for the first time, because of us, the work that we're doing in AuDHD, she was able to look at her son's picture. So this is what a missed AuDHD can look like. It, it's one of the most heartbreaking examples. But people like Adam, they just go unnoticed in this world. They became in- invisible, despite of being brilliant. And, like, the story has, has stayed with me. It doesn't go away. 'Cause every, every time I think of AuDHD, I think of Adam. Yeah. And his mother is helping for his story to be kind of revelation for others, to unravel a lot of AuDHD in other people so that they can, the parents can see them, the world can see them.

    11. APAlex Partridge44:33

        S- such a heartbreaking story, Khurram, and thank you for sharing it. I think it's a tribute to Adam, and it shines such a bright spotlight on the importance of the work that yourself and many people are doing to raise awareness. I think I, I'm certainly thinking of someone. I'm sure many of the listeners and viewers are thinking of someone that they know as well, their own version of Adam, who is deeply struggling-

    12. SPSpeaker45:03

        Mm-hmm

    13. APAlex Partridge45:03

        ... who perhaps it's themselves, who feels deeply un- misunderstood. Um, at the baseline of all of this, the, the sort of innate desire to, to, to want to be understood, n- wanting to be understood in, in order to fit in, when you don't experience that, when humans don't get that,

15. 45:27 – 47:13

    The link between AuDHD and mental health

    1. APAlex Partridge45:27

       how bad can that get? Do you see a heightened level of depression in the AuDHD community?

    2. SPSpeaker45:35

       Yeah. Depression, anxiety, um, the stress levels are increased, s- psychotic episodes because of n- not being understood, not being diagnosed, not being able to give a name to what they're experiencing. Um, a person without a nomenclature. Uh, and it is heartbreaking. And, and unfortunately, the world sees that. The world sees the depression, the world sees the anxiety, the world sees the, the psychotic episodes, which, which is happening because of undiagnosed conditions, but they don't see the context. The moment they start seeing the context, because to me, the most important thing is when, especially when somebody comes with addiction, the first thing I screen is a neurodevelopmental condition in those people. In homeless people, you would be amazed how many homeless people have got neurodevelopmental conditions because they're misunderstood. It's easy to be out and easy, easy to be invisible, because if you're capable and invisible, it's, it's more heartbreaking than being no one and invisible. And so many times when I have unraveled, it has unraveled pages which, which, which is kind of mind-boggling. And that's why a lot of misdiagnosis happen, because we see the obvious. We don't see beyond the obvious, and this is what we should be doing. We should be seeing beyond the obvious now that we have the information, now that we have the awareness. And with AuDHD, it's, it's just the start of the journey for most of us, and I'm learning so much every single day from these people.

16. 47:13 – 49:08

    When is an AuDHD person happiest

    1. APAlex Partridge47:13

       When is someone with AuDHD at their happiest?

    2. SPSpeaker47:16

       Oh, when they find their tribe, when they find the people who understand them, when they are in situations where they can unmask themselves without any consequences. So places, the safe places that are created by neurodivergent themselves, where people like autistic, ADHDers, AuDHD can, can talk openly about things, can, can use whatever language they want to, 'cause that will help them. That will help them understand. I think happiness is, is a very... It, it's a transition, transitory phase. Like, it doesn't last for long. But I would say s- s- satisfaction and peace, that's where it is, where they are heard, when people see beyond their masking, when they are recognized, unmasked, and the si- and, and the spaces which recognize them, which helps them build up. And the, the whole miss- my mission is to kind of make people aware to kind of create those spaces. Like, I-I, I naturally gravitate towards people who have got neurodevelopmental condition. A, because I know that I'm not gonna be judged by them, but secondly, it's my opportunity to help them understand their strengths. And when I talk about their strengths and they, they just, they just can't believe what I'm saying. They said, "You, you must be delusion talking. Are you talking about me?" I said, "Yeah, I'm talking about you, and this is what I've noticed about you." And, and things change. Once you give people the leverage, and once you start to help people see themselves in the mirror as to where they are and what are their strengths and what they can do, I think that's the most satisfying and peaceful experience for them.

17. 49:08 – 50:39

    The importance of early understanding in kids

    1. APAlex Partridge49:08

       How important do you think it is for a child to have the complete picture of how their brain works? Like, if, if there's a parent listening, how important is it to have a child who perhaps does have AuDHD diagnosed as early as possible?

    2. SPSpeaker49:22

       Like, it is very important for, for early intervention. It's, it is because the brain is very malleable. It is very neuroplastic. It keeps on changing from time to time. Other- the interventions that we do, for example, t-t-the social skill set, the emotional skill set, the helping them understand the context and different types of brain, and that will become part of their algorithm. Neuroplasticity happens at a later age as well. It happens throughout our life, but again, at a slow, slower process. But if you're looking at the first five years, those are, those are the most important phase. And then after 5 to 13, again, that phase is very important as well because neuroplasticity is still happening. The unbranching is happening. So those parts that are not being used, they are kind of pruned, um, slowly and gradually, where the bri- brain is forming a shape, its connectivity. And once you inculcate that information into that brain, it will become more receptive. It will mold according to that information that is provided to them.

    3. APAlex Partridge50:29

       So interesting. The next bit, very exciting. It's time for a big reveal. I'm going to reveal your item underneath that cloth.

18. 50:39 – 52:56

    Khurram’s AuDHD item

    1. APAlex Partridge50:39

       Every week, I ask the guest to bring in an item that most represents ADHD, and I've been trying to figure it out, what it is based on the shape-

    2. SPSpeaker50:46

       [laughs]

    3. APAlex Partridge50:46

       ... underneath that cloth. But I'm gonna reveal it now. Now, that is a Ted Lasso figurine.

    4. SPSpeaker50:56

       Oh, yes.

    5. APAlex Partridge50:57

       Why does Ted Lasso represent AuDHD?

    6. SPSpeaker51:00

       All right. So I think, um, when I was bringing it, I was thinking about it, why, why I'm bringing Ted Lasso. Somebody who has seen Ted Lasso, like I've-- I'm seeing it for the 50th time now, the whole three series, and I can't get bored of it. It's a depiction or kind of characterization of one of the most perfect human beings that you could see, a, a person who believes in innovation, a person who believes in managing change, a person who is, uh, very open about his thought process, very forgiving for people, um, understand people, where they come from, and let others grow around him without being insecure about them. And I think it is very important because this is the kind of people we are missing in our world. They are the bridge. They are the people who are a mirror to us, and people how a world, how beautiful world it can be once you are accepting it, once you accept the diversity of it, once you see it as a mosaic, people of different color, of different race, of different thought process, um, of different value system can come together and create something so amazing. For me, that is an ideal human being. Ted Lasso can be in bridging the gap between neurotypical and neurodivergent population.

    7. APAlex Partridge52:37

       Wow, that's incredible, Khurram. I mean, I hadn't actually seen the show, Ted Lasso, but hearing your explanation has certainly inspired me to watch it, and the figure will proudly join all of the other ADHD items on the shelves behind us. Thank you very much.

19. 52:56 – 55:53

    Audience questions

    1. SPSpeaker52:56

       Thank you very much, Alex.

    2. APAlex Partridge52:58

       I wanna move on to audience questions, which is where members of the audience every week write in with their ADHD woes, and it goes in the washing machine of woes, and it's a washing machine because that's my item, and it's my item because it represents memory loss. And the reason it represents memory loss is because every time the cycle finishes, I forget to empty it. Um, Tiimo, the app, has helped me to remember, but I do ask all my guests, do you have that same problem?

    3. SPSpeaker53:24

       Well, my wife doesn't let me do the washing because she knows that I'll forget about it. [laughs]

    4. APAlex Partridge53:28

       So that makes me feel less alone, which is brilliant. Um, this week, Khurram, somebody has written in anonymously and asked, "I've been diagnosed with AuDHD, and I think even knowing that I have this hasn't helped. Now my friends just think I'm addicted to these labels, which makes me feel really shameful. Why do people have so much trouble understanding these conditions in my friendship group?"

    5. SPSpeaker53:56

       People, um, when they look at things which are different, they're scared of it. They are not very comfortable around it, and hence where the social labels come out, where this, um, this person has been kind of labeled as somebody who is asking for more labels, whereas that's not the reality. How I have managed it and how I've helped people manage it, I, I tell them that people who are interested in you, they will gravitate towards you. People who you don't want in your life, they will automaticallyget disattracted that they'll move away from it. There will be people who will come to you to learn more about you, and those are the people who you need to be with because they are curious about you. They are interested in you. They're interested in how your brain works. So let nat- let the nature takes its course and l- and you allow it to happen. I think you will see very soon that you'll be amongst people who will understand you, and it will be a very reciprocal process. It w- and you won't, you won't feel alone. But initially, what you're feeling is very natural, and what people are doing is what they do.

    6. APAlex Partridge55:21

       Such a powerful reminder, Khurram, thank you so much, of the importance of finding your tribe, I guess, and community, people who you can have a social interaction with, and rather than walking away from it feeling drained-

    7. SPSpeaker55:35

       Yeah

    8. APAlex Partridge55:35

       ... you've walked away from it feeling energized and really paying attention to what people in your life are resulting in which outcomes. If anyone wants to submit a question for the Washing Machine of Woes, there will be an email in the description. Dr. Khurram, one final thing

20. 55:53 – 56:44

    A letter to my younger self

    1. APAlex Partridge55:53

       before we end this lovely conversation. I want to deliver to you a letter that was written by the previous guest, where they wrote a letter to their younger self. Here we go.

    2. SPSpeaker56:04

       "Dear younger me, thank you for being patient and letting me experience the world. To truly understand your goodness, sometimes we have to go through these dark times to truly understand our power and the light that we carry. I want you to keep trusting the process as everything unfolds the way it needs to. Keep shining."

    3. APAlex Partridge56:27

       Incredible, and, uh, a lovely, lovely tone to finish on. Dr. Khurram, thank you so much on behalf of everyone listening, watching, trying to grapple to understand their complex brains. Thank you so much.

    4. SPSpeaker56:40

       Thank you for inviting me again, Alex. Thank you. [outro music]

Episode duration: 56:45