ADHDifference

S2E27: ADHD Undiagnoses, Comorbidities & High Achievers + guest Hufsa Ahmad

• Julie Legg • Season 2 • Episode 27

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Julie Legg speaks with Hufsa Ahmad (a licensed clinical social worker, scientist, and mental health advocate) about her journey navigating ADHD, bipolar disorder, addiction, and repeated misdiagnoses. Hufsa shares how being a high-achieving, internally motivated student meant her ADHD often went unnoticed, and how co-occurring conditions like bipolar disorder complicated her diagnosis and treatment.

This is a compassionate look at what happens when neurodivergent identities are misunderstood or dismissed and how curiosity, humour, and self-compassion can become essential tools for healing and growth. Hufsa’s insights as both clinician and lived-experience advocate offer validation for anyone living with multiple diagnoses or feeling unseen in traditional mental health narratives.

Key Points from the Episode

  • Hufsa's ADHD was repeatedly diagnosed and undiagnosed due to her high academic performance and non-stereotypical traits.
  • The challenges of co-occurring ADHD and bipolar disorder and how overlapping symptoms often lead to misinterpretation or mistreatment.
  • Why "undiagnosing" someone is still a form of diagnosis — and often a harmful one.
  • How high-achieving individuals with ADHD are often dismissed and the emotional toll that takes.
  • The tension between “is it ADHD or is it just me?” and how that impacts identity and self-compassion.
  • The impact of masking, internalised stigma, and imposter syndrome on neurodivergent people.
  • Self-regulation strategies: from meditation and cycling to going offline and reducing social media use.
  • Hufsa’s upcoming book, Same Shiite, Different Day, and how it reflects the nonlinear, multi-faceted nature of an ADHD brain.

Links

LINKEDIN: https://www.linkedin.com/in/hufsaahmad/

WEBSITE: https://hufsaahmad.com/speaker/

INSTAGRAM: https://www.instagram.com/hufsaahmad/

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ℹ️ DISCLAIMER: This podcast is for informational purposes only. The views expressed are those of the guests and do not necessarily reflect those of the host or ADHDifference. Read More

HUFSA: So, it was constantly like getting a diagnosis and telling someone and they're like, "No, you don't have it. Of course, you don't have it." And because I trust my loved ones and friends more than kind of a doctor, it was a repeated cycle of getting undiagnosed. And so, a big thing I tell people is like undiagnosing, like telling someone they don't have a diagnosis is also diagnosing that. 

JULIE: Welcome to Season 2 of ADHDifference. I'm your host, Julie Legg, ADHD advocate, author of The Missing Piece: A Woman's Guide to Understanding, Diagnosing, and Living with ADHD, and an unapologetic doer of many things. This season, we're turning up the volume with a global lineup of brilliant guests bringing their lived experiences, insights, research, strategies, and resources. And of course, along with a healthy dose of humour and humility. Whether you're neurodivergent yourself or just curious, there's something here for every curious brain. Let's dive in. Today, I'm joined by Hufsa Ahmad, a licensed clinical social worker, scientist, and award-winning mental health advocate. Hufsa is known for her rare ability to blend science, clinical experience, and stand-up comedy to help people reframe their struggles as pathways to resilience. But beyond her personal expertise, it's Hufsa's personal story that makes this conversation so important. She has lived experience with ADHD, bipolar disorder, addiction, and years of misdiagnosis, including being diagnosed and undiagnosed with ADHD all different times because her presentation didn't fit outdated stereotypes. Hufsa, welcome to the show. [Thank you. Julie, thank you so much for having me.] You're most welcome. You've spoken about being diagnosed and then undiagnosed with ADHD four different times because your presentation didn't match what people expected. Can you please take us back to that journey? 

HUFSA: Yeah, I think the main problem or I suppose not a problem is that I could study, that I was like internally motivated by learning. I loved reading. I started reading when I was two. And I was lucky to have adults constantly. I had a very huge Pakistani family, you know, there fostering me like my interest in reading and things like that. So, everyone thinks, if you have ADHD, you struggle in school. And my struggles in school were more behavioural. Like, I remember getting kicked out of class. I don't even remember why, but in 8th grade, I remember just feeling awful because I got kicked out. And then there were students outside that were like pointing at me and laughing and making fun of me and like making a Pakistaniish Indian accent or something. I don't really remember. I don't know why I got kicked out. I know I got a lot of detentions in high school. I was late. I talked a lot. I would blurt out things and it was really not really ill-intentioned and it was very much internalized like, why can't you be here on time? And it's something that like I couldn't really answer. And the undiagnosis came because I finally got the diagnosis in junior year of college. I went to Harvey Mud, which is a very good engineering college. And like back then, like 20-ish years ago, if you had ADHD and you took Adderall, you were considered a cheater. So, I didn't want to tell anyone. And then when I told my mom, she's like, "You don't have ADHD. You struggle. You're fine in school." So, it was constantly like getting a diagnosis and telling someone and they're like, "No, you don't have it. Of course, you don't have it." And because I trust my loved ones and friends more than kind of a doctor, it was a repeated cycle of getting undiagnosed. And so, a big thing I tell people is like undiagnosing, like telling someone they don't have a diagnosis is also diagnosing that. Like, we get annoyed like, "Why does everyone think they have ADHD? You don't have it." Congratulations. Your criticism is that we shouldn't diagnose ourselves. Yet, you have also presented a diagnosis. So, yeah, I think the fifth doctor it was sort of like, all right, I have ADHD, I can work, you know, that's fine. But, you know, like the hyperactivity, the blurting out is still a huge problem. Yeah. I mean, not too much of a problem. Like, don't not hire me, you know, but you know, it's definitely there. I meant to say along with that with the bipolar angle. 

JULIE: So you were diagnosed with bipolar as well. 

HUFSA: That came first. Yeah. It's an interesting thing because it was like the problem with having a comorbidity, right? Two co-occurring disorders is that there's not much research on ADHD and bipolar. There are certain studies, but it's also very hard to do those studies because where do you get people with both? Like how do you verify? A lot of bipolar studies are done in psychiatric units because it makes the most sense in the most controlled environment. And when you have these two things, like two things, it's like yes, ADHD symptoms and then bipolar symptoms, but then there's going to be symptoms that occur when those two are mixed and those aren't well understood. I think also what I feel sad about is that upon getting undiagnosed, my hyperactivity or like impulsivity, which is a huge like thing that I've struggled with, it's like, "Oh, you're manic. You're hypo-manic. Let's increase your bipolar medication." So, it's like I kept being told I have mixed episodes. Like, I'm so depressed and hopeless, yet I'm impulsive and have this energy. "Oh, it must be a mixed episode," when really it is more ADHD hyperactivity, that's it's always there. It's not just when mania but that's what happens whenever you're not diagnosed properly or there's not much research about it. 

JULIE: Now that's very, very interesting. So what would you like clinicians, families or even people with lived experience, what would you... what would you like them to better understand about this co-occuring conditions? 

HUFSA: Yeah, I would say leave it to the kind of doctors and the person. Like don't make the judgments for them like "Oh you know, you're manic" or "Oh you're ADHD," unless you're a trained professional and it's your patient. It is unethical to diagnose someone who you're not and if you are a random person on the street I don't think you should be assigned to the labels. But I think having a little bit more compassion, that it's also because it's not well understood. And it's... I imagine my bipolar ADHD is so much different than someone else's. Like a little bit of compassion that I am trying my best. And if I blurt something out or it doesn't make sense it's like for example, this recently happened. I think one or two nights ago, is that you know, I'm up late. I'm energetic, perhaps a little hypo-manic, like hyper focused ADHD. I don't know. But I got it in my head that I needed to send a message tonight. And in my opinion, I thought it was like fine. So I was like, "Okay, ChatGBT, give me a draft." And I was like, "ChatGBT, this is so mean." And I edited it. I spent like 20, 30 minutes and I sent it and to me it was fine. I wake up in the morning, this person is furious at me, says like, "I'm going to be direct with you." Gets very mad at me, proceeds to block me and remove me from many communities that I was part of. And it was hard because I didn't mean it. I didn't mean to say it that way. And at the time, it made sense. And it's like not an isolated thing that people get mad at me from when I say. And even though I have good intentions that like I know it's hard to tell someone like be empathetic when they're upset. But I think both people, like me, I must take accountability and correct things. But I think I appreciate the opportunity and a little bit of benefit of the doubt. Yeah. 

JULIE: And I think Hufsa, the more that we can openly talk about comorbidities, and the presentations are very different as you said. Different for everybody, and so we can't be put in a box and say "Well you don't do this so therefore this." And it's very, very different so thank you. The more we can talk about it I think the more alive the conversation is, and the more people know and understand and get that's not everyone is different. I also would like to talk to you about high achievers because you said something really powerful. You said "We matter too even if we can do homework." You know why are high achievers with ADHD so often dismissed or misdiagnosed and what are the consequences of that? 

HUFSA: So there's, have you heard of Healthy Gamer GG? He goes by Dr. K. He's on YouTube. So he's like a psychiatrist and Twitch streamer and he talks a lot about ADHD. And I saw this video, I think 2 years ago, that just resonated where he said, "A lot of people with ADHD are so smart that like we're kind of zoning out and the teacher calls on us, but we're so smart we blurt out the right answer that like we really are able to survive just by our intelligence." And then what I've noticed and seen is that once we get into adulthood and we don't have the structure of classes and college and like meals and stuff, that's where we start falling apart because we needed that structure to hold us together. And like I mean it's very, very hard. Me I'm a speaker, therapist, consultant, all independent work like doing it without structure was much harder than I thought. And so we kind of it's kind of like I don't know what to call it, kind of like coping or like maybe masking but we just kind of like make it seem like we're fine and we can do it until there's a point where we can't do it anymore. And I think it's one thing like I really also feel like "Oh you are a higher achiever. It doesn't, then your ADHD doesn't matter right ?" And like you know, I stopped taking ADHD medicine like a couple years ago because it's like all right, like I'm not going to say being a therapist is harder than an engineer college like I think I'm fine. But there are things like the impulsivity and like the mistakes that I make and the trouble organizing myself are still there, but there's not really much empathy or like consideration because it's like, well, there are people who can't graduate from high school with ADHD. And I think all of those viewpoints are valid. Like I can't say like, oh, you know, "I'm not that bad, therefore I don't need it." It's more like we're just different. And like I think it hurts a lot when I try to explain to someone like, you know, I am sorry. Like I did this, I aim to do this. I have a disability called ADHD. And people look at me like, are you just making excuses because it's like it's too hard to understand that someone who can like read and write and do work also has a disability. The results may be very academic and all this achievements but what goes hidden I think is the hours and hours and hours extra work and you know, extra effort to achieve those even though our intelligence may be up there already and that's great we can't just wing life you know. There's still a lot of hard work. And so whatever it is that distracts us we've got to go back on track. 

JULIE: And it is a bit tough and it's been said so often to many women also diagnosed as adults "You can't possibly have ADHD because you've got a PhD or you're..." you know whatever it is. "You're a CEO of a company." 

HUFSA: Very interesting well yeah I like that term. That was the one I was searching for and like yeah I think...oh gosh I was going to say something and I forgot, which I think is ironic because I'm on an ADHD podcast. I was like have a great point and I forgot it. So, I'll try to interrupt you if I remember. 

JULIE: Hold that thought and we can come back to that. You work with many high performing adults yourself who feel that they're constantly getting away with something, you know, we talk about imposter syndrome. So why does imposter syndrome hits neurodivergent high achievers so hard and how do you think they can begin to reclaim the confidence that actually fits who they are? 

HUFSA: Yeah. So I recently read a study about how people with like chronic PTSD like have very little self-compassion. And one thing that I try to speak on that I don't hear too much about is that having mental illness or neurodivergence or a disability is inherently traumatizing. Because what happens is that we have these behaviours and we don't know what it's from and so we internalize it like "Why can't I stop being late," you know, which is treatable. It is a challenge but like "Why can't I stop blurting things out? Why can't I stop saying..." to give you an idea like me saying things incorrectly has led to disciplinary action getting terminated. I even had to take an extra year in grad school because I piss people off when I don't even mean to. And so it's like something I've literally spent hours like just thinking about interactions trying to predict, but every situation is so different. So like the reason that we kind of interpret this and internalize it is because we don't know what's going on and we see the reactions other people have towards like we get the stigma. I think another thing is like you know, saying "Sorry I have ADHD." I don't think that's the best way to go about it because we shouldn't apologize for having a disorder. We should, you know, acknowledge what we've done and improve upon it. But a lot of things are happening now where it's like, "Oh, everyone has ADHD. You're making an excuse." And I think for people that are not making an excuse, I'm trying to explain, I didn't mean to. Like, I have a condition and I'm trying. This is what I'm going to do. I don't do it again. Like when people dismiss that way or don't believe you like that stigma from them becomes self stigma. It becomes our stigma. And I think also like the fact that there's not much awareness in the past couple years. ADHD we understand it differs by culture, by like gender, by so many different things, but we didn't know that before. So we didn't really have an answer. So, I think that's where like we lack the self-compassion. One, because we don't have the understanding of it. Two, we've definitely had bad stigmatizing reactions. And three, it's just I think we're just so hard on ourselves because like we want to do things, but we're we can't do everything we want to do because we have a disability. 

JULIE: And you know, even the word disability, or ADHD and disability, whether they're in the same box or not differs from country to country. In New Zealand, it's not considered a disability. The other thing too with the imposter syndrome, as you were talking before about not quite understanding why things may have been blurted out or why this happened or why that happened, a solely a diagnosis doesn't explain everything. I always say "Your journey begins once you have the diagnosis," because there's so much isn't there to unravel and not just be told XY Z but to really believe it and let that resonate and have some self-exploration I guess. How can I do that again without going through the hassle or the repercussions? 

HUFSA: I think one thing I see a lot in the people I work with is like, is it the ADHD or is it me? You know, like for example, it's like I was very bad at flowing through my emails. Like I would star them and I would literally never come back. So it's like, okay, was that ADHD or was that me not really taking the initiative to set a reminder or like do that? Because honestly, I didn't want to check those emails and I was procrastinating. So, one suggestion I give and like you would probably know better than me and your listeners would probably know, but one thing I'm trying to figure out is like, okay, is it part of like a condition that if I set up like a standard like, okay, I'm going to do this and I like use the executive hacks or whatever to do it and it's still can't be done. There's still a barrier that's beyond my control. That's when I think it might be more ADHD. And also I remembered what you, what I wanted to tell you that you talked about earlier. Can I say it now? Yes. Okay. So the amount of preparation. So I mean I didn't. So like because I stopped ADHD medicine like years ago I think a year and a half and then now this year as of like May, I just fully became me. My business, me, myself and I. That it took me several months to realize oh my god I don't have this all together because my mind is being pulled in different directions because I don't have that structure. Which is like I'm realizing, oh my god, this is much harder than I thought. So, like literally I've been setting up systems trying to figure it out where I got like an inersion like a what do you call a hardcover planner like a real life planner? And I had over 100 Google tasks and I sat there for hours like organizing things, putting in lists and like putting in the planner and stuff that like to do to get my life together, I have to spend so much time planning and it's like putting it in the calendar and everything gets it done, but it's so embarrassing because it's like, oh, if I don't do that, then I it's just like I have to put in so much work to like get work done and it's like no one really understands that. And it's like, yeah, it's hard. 

JULIE: Well, I'd say please don't be embarrassed with any strategy that works for you because our brains are so different and even the neurodivergent brains are very different even within that kind of category if you want to call it that, or that variation. You were talking about ADHD. Is it ADHD or is it me? And I think with strategies, there's not a one-size-fits-all strategy. And I think keep going, keep tweaking it, and keep making it your own and own it and invest in the outcome. So, going to take a bit of time and there might be post-it notes and pens and everything flying around, but you know, at the end of it, it will work for you. You keep at it. Keep at it. 

HUFSA: Yeah. It's so interesting. It feels like I'm reststigmatizing myself. Like it's like, "Oh yeah, I have ADHD. I can handle it.1' I used to say that like whatever. I know how to handle it. And I realized in the past like maybe month I was like, "Oh my god, this is much harder." And so like yeah, it's kind of like it feels like I'm getting diagnosed for the first time again because it's like oh yeah, there's so much that I still need to work on. And I really don't want to do the medicine because I, because of it. Stimulants for me personally, not saying everyone, the stimulants will trigger my bipolar symptoms and then the non-stimulants make me very sleepy. So, I've just been trying to figure out to the best of my ability like without doing medication because it's that's another thing about having bipolar ADHD is like you're already on so many medications. In my case that it's a lot. 

JULIE: Perhaps being diagnosed and then undiagnosed, diagnosed, undiagnosed, you have suggested you've got doubts whether it's me or whether... I don't blame you because that's a massive roller coaster to go through. Being told one thing and getting your head around that and then saying no, yes, no. So self-doubt creeping in is so understandable in your situation. Don't give yourself a hard time. 

HUFSA: Thank you. I needed this. This was my little personally therapy session. Thank you Julie. 

JULIE: You are so welcome. Now your work sits at a very sort of fascinating intersection of science and storytelling, comedy and mental health. So I'd love to know what's exciting you right now about your work. Is there a project or an idea or something that feels alive and kicking for you at the moment? 

HUFSA: Oh gosh. So I am working on my book. It's called Same Shiite, Different Day. A little alluding to my Muslim comedy background. And it's very multifaceted in that I decided because for so long I've been like what do I want to write about? I have so many things. I was like I'm going to write this book as if it's my ADHD brain. Like chapter 1 is going to be on this and then chapter 2 is probably going to be on something different. But it's going to be walking people through my brain and how I think because I have too many interests and specializations which isn't a bad thing. But rather than try to fit into this mold of like, oh, this is a standard book. It's like this is me and my book. I will talk about mental illness, mental health conditions. I'll talk about stigma. I'll talk about what it's like growing up with perfectionistic parents. I'll talk about, you know, engineer to therapist. I'll talk about, I don't know, some jokes. You know, it's just going to be like an exploration. And the reason that I like Same Shiite Different Day besides it being a pun, is that one thing is that, you know, life doesn't actually get better. Like it's sort of like in my life, I've always been like once I get my masters, it's going to get better. Once I get my license, once I start my private practice, and it's like, nah, it's you're still going to struggle. It's the same struggle. It's a different day. And because like I think our society feels, at least in America, we feel an aversion to struggle. We think something's wrong with us that I feel like if I can communicate like yeah, struggle is inevitable and like if it's going to happen, you might as well learn from it. And it sucks. It will always suck. It's been so painful. And we just have to keep going because struggle will bring strength. And like it's been very emotional because I've had a lot of unlucky things happen. Like my therapy cat died before he was two and then I faced such online harassment where people made like memes of my dead cat and like just it was very brutal. I've suffered a lot of like stigma and discrimination. But I still consider myself a very lucky person. Like I mean I have my current little kitty cat who's got a form of epilepsy no vet has ever escaped. Like that's how like "unlucky" quote unquote I have but she's so fluffy and cute and she takes care of me and I have friends and family. I'm here talking to you today Julie. So despite the objective unlucky things like you know same shiite different day, that's okay. It's just going to happen and I'm happy. So, my goal is by January 1st of 2027, it's out there and published. And I'm sure I could get a publisher or I could self-publish. 

JULIE: There's a way. And I wish you very, very well on that journey. Very exciting one. With ADHD and bipolar existing side by side in your life. What's a strategy, ritual, or a mindset that helps you stay grounded or organized on a daily basis? 

HUFSA: Self-regulation is very important. Like I was definitely the type of person like, "Oh, I'm upset. Let me call a friend." But the older you get, your friends get busy. They have kids. Like it's not so easy to rely on people and also it does run the risk of people getting burnt out which is not a reflection of you. It's not a reflection of them. Some people don't have endless wells of empathy and even therapists get burnt out. So if therapists get burnt out, yeah your boyfriend might get burnt out, type of a thing. So the self-regulation if I'm upset I have this app. It's called Balance. I'm not sponsored by them. I'd like to be but so Balance, if you hear this sponsor me please give me promo code! But like it's just been the only meditation like app you know, I've tried so many I don't want to list them. But like the one that's like consistent voice. There's no weird music. There's no "Hi how are you today?" you know like that weird stuff you find on YouTube. And it has 10-day plans of like 10 days to plan to sleep, 10 day plans and to  like work stress, 10 day plan for meditation, That it's become like a go-to thing every night I use it for meditating if I'm upset. I'll put it on it has a 5 minute like version for me to regulate. And biking is another thing. Like exercise I've always enjoyed. I can just go do that whenever I'm upset. So I would say yeah meditation and biking great. 

JULIE: So that's emotional and physical wellbeing all rolled into, yeah. into that. Well done. 

HUFSA: Oh, I have one more thing if that's okay. I lived on Twitter. That's all I did all day. I would think about what I was going to post or what I saw and stuff. But what ended up happening is that over a year ago, last September, I was on Twitter and my boyfriend and we recently started dating. He's like, "What are you doing? Are you on Twitter?" And I was like, I will not confirm or deny that. And then he hands me a package, like a gift. I open it. It's a book. And he said, when you feel like going on Twitter, read this because that thing is ruining your mind. So what ended up happening is that I quit all social media for about a year. And instead, I tried to read. And I could read maybe a page at a time. Like it was so hard to do it. But like now, like I can read for longer. I can finish a book in 3 days. Like it takes, it'll tell you it takes like 7 hours to finish a book. It's like okay well I was on social media 7 hours so I could just break it up over a week and my mind worked again. I became more creative. I could focus better. I was happier that like I didn't realize that like just the act of practicing focusing is really like enough. And like to stop doing something bad for you. If you can't start doing something good, stop doing something bad. It really transformed everything. And it's like I highly recommend anyone with ADHD, don't be on that stuff all day. It's not helping your attention span at all. For someone who is listening who has ADHD plus another diagnosis or is still wondering whether the pieces of their story make sense, what would you most want them to hear? So, I think one therapist I met who's getting a special edge in ADHD said people with ADHD very often have another thing. Like it's very rare to only have ADHD. So, I think one thing is like that's helpful is to not over-analyze and figure out what is the disorder, what is this, like do I have this, do I have this? That sometimes just accepting you have it and seeing how you can deal with it is a very good solution. Because if you sit there and try to figure out like is this a bipolar, this is ADHD or is it my anxiety? Like I do. Like I will lose my mind. Like I will not be able to really just deal with the problem because at the end of the day why you have the problem is helpful if you it helps to know why, but if you can't know why and it doesn't help, then it just detracts somebody being able to do what you need to do. So I always think like be solution-oriented. And also like I mean diagnosis... the DSM I don't know if that's do you guys follow the DSM in New Zealand? [Yes.] I'm very sure that the ADHD diagnostic criteria will change. Keep in mind people don't fit in boxes and a diagnosis can be helpful but it's it doesn't know everything. 

JULIE: The DSM. It was only in recent versions and I know they come out relatively often. It was only relatively recently that they read or had written down that ADHD and autism, that you could you could in fact have both as a comorbidity. Prior to that time they were very separate. So you had to choose is it this one or is it this one? And of course you add all the other neurodiversities in there too including bipolar, and it's just a... it's just a big soup of differences. Yeah. Hufsa it's been a joy chatting with you today. I really appreciate your honesty and insight and your humour too when it comes to looking at ADHD and bipolar and sharing your lived experience with us and the listeners. So thank you so much. 

HUFSA: Yeah, thank you, Julie. I think one thing I'll end on, if that's okay, is that as a scientist, we're always trying to prove ourselves wrong. It's sort of like, hey, I did this study, like I created a molecule, right, that never existed and then like, okay, do it again, you know? So, it's like we in science, like the shreddinger's cat principle is like nothing is certain, right? And I feel like with psychology and sometimes like that kind of stuff, it's more like, oh, this is too and this is fact when like 10, 15 years ago, there's no H in ADHD. They just called it ADD. So I think about having a level of healthy skepticism that it's like, you know, what we know now doesn't mean that it's correct and it might be like disproved and proved again. And at the end of the day, it's what's real and true and helpful to us and what we can do is most important.

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Julie Legg

Host
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Jel Legg

Co-host
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Hufsa Ahmad

Guest