Psychiatrist Who's Diagnosed 10,000 Women With ADHD & Autism: "THIS Still Shocks Me!"
Dr Shyamal Mashru is an award-winning psychiatrist and ADHD expert who has treated thousands of people with ADHD.
Drawing on years of clinical experience, he shares one of the most honest and comprehensive conversations we've had about the realities of living with ADHD. We explore the emotional impact of diagnosis, why so many people with ADHD grow up believing they're broken, the loneliness and rejection sensitivity that often go unnoticed, and the identity crisis that can follow unmasking.
We also discuss shame, addiction, burnout, AuDHD, ADHD medication, depression, and the life-changing power of finally understanding yourself.
Chapters:
00:00 Trailer
01:27 The Most Life-Changing ADHD Diagnosis Story
03:52 The Emotions Nobody Warns You About After an ADHD Diagnosis
05:18 Why People With ADHD Believe They're Broken
06:48 The Damage of Spending Decades Thinking You're the Problem
08:24 The ADHD Assessment That Saved a Life
12:23 Why Self-Understanding Changes Everything
14:12 The Pain of Rejection Sensitivity Dysphoria (RSD)
18:34 The Loneliness of ADHD Nobody Talks About
20:45 The ADHD Identity Crisis After Unmasking
22:22 Tiimo Advert
23:42 A Quick Test to See How Much You're Masking
27:27 When Shame Leads to Addiction
31:37 How Common Is AuDHD?
36:48 Why ADHD Burnout Can Appear Out of Nowhere
38:38 What Happens When You Stop Masking?
40:16 Does ADHD Medication Change Your Personality?
41:41 Can Untreated ADHD Cause Depression?
42:50 A Letter to My Younger Self
Dr Mashru runs the ADHD Health Clinic where you can be seen by him 👉 www.adhdhealthclinic.co.uk
He is also a Consultant Psychiatrist that works in the NHS as the Medical Lead of Harrow Health ADHD service.
Book for an online adult adhd assessment 👉 https://adhdhealthclinic.co.uk/adhd-treatment-options/book-an-adhd-assessment/
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Book for in person adult autism assessment 👉
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Book for online combined adult adhd and autism assessments 👉
https://adhdhealthclinic.co.uk/autism/book-a-combined-autism-adhd-assessment/
Book for in person combined adult adhd and autism assessment 👉
https://adhdhealthclinic.co.uk/autism/in-person-combined-autism-adhd-assessment/
Book for child online adhd assessment 👉
https://adhdhealthclinic.co.uk/adhd-treatment-options/book-an-online-child-adhd-assessment/
Book for child in person adhd assessment 👉
https://adhdhealthclinic.co.uk/adhd-treatment-options/in-person-child-adhd-assessments/
Book for child online autism assessments 👉
https://adhdhealthclinic.co.uk/autism/book-an-online-child-autism-assessment/
Book for child in person autism assessment 👉
https://adhdhealthclinic.co.uk/adhd-treatment-options/in-person-child-adhd-assessments/
Book for child online combined adhd and autism assessments 👉
https://adhdhealthclinic.co.uk/adhd-treatment-options/book-an-online-combined-child-autism-adhd-assessment/
Book for child in person combined adhd and autism assessments 👉
https://adhdhealthclinic.co.uk/adhd-treatment-options/in-person-combined-child-autism-adhd-assessment/
Book for talking therapy and coaching 👉
https://adhdhealthclinic.co.uk/adhd-treatment-options/adhd-coaching-and-counselling/
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Complete the Focused survey 👉 https://uk.focused.clinic/adhd-health-survey/quiz
Previous Focused survey results 👉 https://uk.focused.clinic/myhub/adhd-workplace-survey-results
Buy Alex's book entitled 'Now It All Makes Sense' 👉 https://www.amazon.co.uk/Now-All-Makes-Sense-Diagnosis/dp/1399817817
Order Alex’s latest book about Rejection Sensitive Dysphoria 👉 https://linktr.ee/adhdchatter?utm_source=linktree_profile_share<sid=9ffd8709-06df-444c-9936-c136fbd14d6e
Producer: Timon Woodward
Recorded by: Hamlin Studios
Trailer editor: Ryan Faber
DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.
Late ADHD diagnosis reframes shame, masking, burnout, and co-occurring autism
A.Late ADHD diagnosis often triggers grief for lost years, relief from self-blame, and anger that symptoms were missed earlier.
B.Repeated criticism and lifelong underperformance narratives can create chronic shame, low self-esteem, and the belief that you are “broken,” which diagnosis and self-understanding can reverse.
C.Rejection Sensitivity Dysphoria (RSD) can drive severe avoidance, isolation, and even self-harm when fear of criticism makes tasks feel emotionally unsafe.
D.High masking can look like “high functioning” success while privately causing exhaustion and burnout, especially when new stressors (kids, promotions, menopause) remove old coping strategies.
E.ADHD can co-occur with autism (AuDHD), where traits camouflage each other, complicating assessment, affecting medication experience, and increasing mental-health risks in some groups (notably autistic+ADHD females).
🧠 IDEAS WORTH REMEMBERING
5 ideas
1
A diagnosis can be an “instruction manual,” not just a label.
Mashru emphasizes the shift from “I am the problem” to “I have a brain difference that wasn’t managed,” which often unlocks self-compassion even if it can’t undo past relationship damage.
2
Undiagnosed ADHD commonly becomes a lifelong shame story.
The episode links years of missed deadlines, relationship strain, and repeated criticism (including the oft-cited “20,000 extra critical comments by age 12”) to entrenched low self-worth and self-criticism.
3
RSD can be clinically serious, not just “being sensitive.”
The university case illustrates how fear of negative feedback can cause paralysis, non-submission of work, isolation, and self-harm—improving with accommodations, coaching, medication, and emotional-resilience work.
4
“High functioning” can be a masking artifact that collapses under new load.
People may hold demanding jobs via last-minute coping, but life changes (children, increased responsibility, perimenopause/menopause) can overwhelm those strategies, revealing ADHD difficulties and precipitating burnout.
5
A simple masking screen is noticing rehearsal, over-agreeing, and post-social exhaustion.
He suggests questions like whether you rehearse conversations, habitually mirror/agree to fit in, and how depleted you are after work—since prolonged masking is described as exhausting and a pathway to burnout.
💬 WORDS WORTH SAVING
5 quotes
There was a shift from, "I am the problem," to, "I have a problem that hasn't been managed."
— Dr Shyamal Mashru
They said, "It's, it's like I've begun... given an instruction manual to my brain."
— Dr Shyamal Mashru
You've been blaming your character for what is actually your wiring.
— Dr Shyamal Mashru
When you have very strong RSD, it's like walking through an emotional minefield in your life.
— Dr Shyamal Mashru
One question which really cuts through people is, before you go to that event, do you rehearse conversations? That one-... people feel naked when you ask that question.
— Dr Shyamal Mashru
Emotional fallout after diagnosis (grief/relief/anger)Shame, self-esteem, and the “20,000 critical comments” effectRejection Sensitivity Dysphoria and avoidance/procrastinationMasking: causes, signs, and burnoutAddiction as maladaptive self-medication (alcohol/cocaine)AuDHD camouflage and combined assessmentsMedication concerns: personality changes and comorbid autism
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ADHD Chatter Podcast
