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ADHD Chatter PodcastThe AuDHD Expert: 3 Alarming Risks of Undiagnosed Female AuDHD | Dr Samantha Hiew, PhD
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WHAT IT’S REALLY ABOUT
Dr Samantha Hiew explains AuDHD as a distinct, fluctuating neurotype often missed in women
- Dr Hiew argues AuDHD is not simply autism plus ADHD but a different 'animal', with fluctuating neurotransmitters and brain networks that can make personality swing between structured and chaotic.
- She says overlap estimates range from about 20% to 80%, and she thinks the true figure is probably higher because of underdiagnosis and because dual diagnosis was not possible until 2013.
- Dr Hiew explains that women and girls are often missed because they mask, internalize traits, have more socially acceptable special interests, and are assessed with male-oriented criteria.
- She links mood and dopamine shifts to hormones, energy, sleep, light and diet, and suggests energy management can explain some patterns that get labeled as attachment issues.
- She closes with hope: radical acceptance, learning to anchor in yourself, and embracing both the structured autistic side and the adventurous ADHD side, including the mask.
IDEAS WORTH REMEMBERING
5 ideasAuDHD is its own neurotype, not a simple sum of two conditions
Dr Hiew says AuDHD involves fluctuating dopamine and other neurotransmitters across the frontoparietal control, default mode and salience networks, so the autistic or ADHD side can dominate depending on context.
Overlap figures are uncertain and likely understated
She cites estimates from 20% up to 70-80% depending on study design, and says underdiagnosis and the pre-2013 inability to diagnose both together mean the real figure may be higher.
Women are often missed because assessments suit male presentations
Dr Hiew says her own autism assessment relied on outdated male-oriented questions, such as stamp collecting and train spotting, while autistic ADHD women often have special interests like psychotherapy or nutrition.
ADHD traits often get noticed first while autistic traits are internalized
She says sensory sensitivities appear early, but children, especially girls, learn to hide traits to be accepted, developing perfectionist or people-pleasing personas with meltdowns in private.
Hormones and lifestyle shift dopamine and mood
Dr Hiew describes estrogen changes across the menstrual cycle, testosterone dips, and sleep, morning light and nutrition as factors affecting energy and neurotransmitter levels.
WORDS WORTH SAVING
5 quotesI always say that being an AuDHD-er, you are a mystery wrapped in an enigma to yourself and to other people.
— Dr. Samantha Hiew
I think the most important thing really is to understand yourself first before you expect others to understand you.
— Dr. Samantha Hiew
What if that mask is just an adaptation of who you decided to be because of what you have to deal with?
— Dr. Samantha Hiew
In order to be truly free, you need to feel safe within yourself, and it's to look for how to anchor in yourself.
— Dr. Samantha Hiew
Maybe a lot of us owe our power to darkness.
— Dr. Samantha Hiew
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SPEAKERS
Dr. Samantha Hiew
guestPhD-level AuDHD (ADHD + autism overlap) expert who discusses female presentation, masking, comorbidities, and regulation strategies.
Alex Partridge
hostHost of "ADHD Chatter with Alex Partridge" who interviews guests about ADHD-related topics.
High quality AI-generated summary created from speaker-labeled transcript.
