I sat down with Akif on a cold morning.

I was calling in from Japan. He was in the mountains near Zermatt. I joked he must have a perfect Matterhorn view. He laughed. Not quite.

We go way back. School days in southern Germany. Back then, ADHD was not something we talked about. At least not in a way that would have applied to us.

Today, Akif works in Switzerland as a biochemist. He studied molecular biology and biochemistry, works in Big Pharma, and got diagnosed with ADHD at 38.

And very on brand, he is still technically finishing his PhD.

This conversation is an attempt to connect lived experience with what is actually happening in the brain. Not in a clinical way, but in a way that actually helps make sense of patterns many of us have lived for years without understanding.

Boris:
Maybe let’s start there. How did you get into the topic of ADHD?

Akif:
Pretty late. I got diagnosed three years ago, at 38.

It started in a very typical way. I was in the lab late at night with a friend who has ADHD. He was diagnosed very early, very obvious case. We got along extremely well.

At some point he said, “You feel similar to me.”

That stuck.

I always had this feeling that I was somehow different. But I never really followed it. So I went to a specialist. And then it became clear quite quickly.

Boris:
You already had a suspicion earlier, right?

Akif:
Yes. As a kid already. Around sixteen I even went to a doctor.

But back then, it was dismissed.

And this is important. I’m a German Turk. What I was told, more or less, was that boys like me are just louder, more active, more aggressive. That’s normal. That’s cultural.

So instead of asking, could this be ADHD, it was explained away.

And I trusted that. I liked the doctor. So I accepted it. And the topic disappeared for years.

During my studies, I could manage quite well. University gives you freedom. You can work at night, choose what interests you.

We didn’t think of it as coping or masking back then. It just felt like this is how we operate.

Looking back, a lot of it was just finding environments where the system didn’t break.

Until it did.

For me, the breaking point was becoming a father. Suddenly there was no recovery time anymore. No space to recharge.

And I realized I can’t show up the way I want to. Not as a father, not as a partner.
That’s when I knew I had to take it seriously.

ADHD rarely comes alone

Akif:
When we talk about ADHD, we also have to talk about comorbidities.

It means that one condition leads to others.

Imagine you break your leg and it heals badly. You walk differently. Then you get problems in your hip, your back, your neck.

Same with ADHD.

Because ADHD makes certain things harder, people often develop additional issues.

Depression is very common. Anxiety as well. Many people have digestive problems. Binge eating. Addiction.

And the tricky part is that these things reinforce each other.

So when someone comes in, it’s often not clear what is the root cause and what developed on top of it.

Boris:
So what is it now. Is ADHD overdiagnosed, or is it still underestimated?

Akif:
That question has two layers.

If you look at the general population, ADHD is probably still underdiagnosed. You usually hear numbers like two to seven percent worldwide. And that range already shows that we are not really capturing everyone properly.

But if you look at people who actively seek help, it can look different. In that group, ADHD may actually be overdiagnosed.

So when someone says, “ADHD is overdiagnosed,” they can make very good arguments. And when someone else says, “No, it’s still underdiagnosed,” they are also right.

It really depends on which group you are looking at.

And then there is the question of who gets seen at all.

Girls and women are still often missed. In childhood, boys are diagnosed much more often, and girls are much more likely to be overlooked. Later in adulthood, it evens out again, which tells you that many girls and women were simply not diagnosed earlier.

And there are other blind spots too.

We already talked about how, in my case, being from an ethnic minority played into it. The idea was basically: boys like you are just louder, more active, more aggressive by nature. So instead of asking whether there might be ADHD, it gets explained away as background, culture, or temperament.

So yes, overall I would still say ADHD is underdiagnosed. But depending on the group you look at, and depending on who gets taken seriously in the first place, it can also appear overdiagnosed.

Boris:
What always frustrated me is how circular the explanation is.

You can’t focus because you have ADHD.
And you have ADHD because you can’t focus.

It always felt like a closed loop.

That never really helped me understand anything.

So what is actually happening?

Akif:
The two key neurotransmitters are dopamine and noradrenaline.

People often say there is a lack. That’s not really correct.

It’s a misregulation.

At different times, the brain does not have the right amount available.

That’s why ADHD feels so inconsistent.

Sometimes you are completely blocked. No drive, no energy.

Sometimes you are extremely focused. You can work for hours.

Sometimes you are somewhere in between.

It’s not stable.

Akif:
You can think of the brain as having two modes.

Default Mode is when you are relaxed. Sitting on the sofa, mind wandering.

Activity Mode is when you are focused and doing something.

Neurotypical people can switch between these modes relatively easily.

With ADHD, that switch is difficult.

If something is not interesting enough, the brain does not release enough dopamine. So you stay in Default Mode.

Only when pressure becomes high enough, like a deadline, does the system switch.

That’s why many people with ADHD start when it’s almost too late.

Starting is often the hardest part. Not doing.

Akif:
There are also specific brain regions involved.

The prefrontal cortex and the striatum play a key role in regulation and decision-making.

In children with ADHD, these areas can be slightly smaller during development. They usually catch up later, but the regulation challenges remain.

So it’s not about intelligence. It’s about regulation.

Boris:
One thing that came up a lot from the community is rejection sensitivity.

Akif:
Yes. What people call RSD.

Even small negative comments can hit very hard.

For me, if someone said something slightly negative on a bad day, the whole day was gone.

And often you only realize it afterwards.

In the moment, it feels completely real.

Only later you think, what actually just happened there?

And this builds over time.

If you grow up constantly hearing that you are too much, too loud, too difficult, it accumulates.

I sometimes say, a neurotypical child might hear something negative 10 to 20 times a day.

For me, I can’t remember an hour where nobody told me to behave differently.

That shapes how your system reacts.

Akif:
The key is to interrupt the spiral early.

Once you are inside it, it’s very hard to get out.

You need to catch the moment where it starts.

That means actively telling yourself to stop. Creating distance.

That takes practice.

Boris:
How would you explain medication in simple terms?

Akif:
It increases dopamine and noradrenaline availability.

That raises the baseline level in the brain.

Two key effects.

First, you can start tasks more easily.

Second, you gain a bit of decision time.

Instead of reacting instantly, you get maybe half a second or one second.

That’s enough to pause and choose a different reaction.

Akif:
People often say ADHD is a Ferrari brain with bicycle brakes.

That’s actually a useful image.

The brain is fast. You see patterns quickly.

But the braking system is weak.

Medication improves the brakes.

You still have the fast brain. But you don’t crash into everything.

And it doesn’t mean higher intelligence.

What people with ADHD often have is strong pattern recognition.

But not necessarily higher IQ.

Boris:
In my diagnosis, working memory was clearly lower.

Akif:
That’s very typical.

You understand things quickly. But you struggle to hold and process information in the moment.

That gap explains a lot of everyday struggles.

Forgetting things. Losing track. Getting stuck in loops.

Akif:
You can also describe ADHD as a constant search for dopamine.

That shows up in behavior.

Risk taking. Addiction. Binge eating. Even picking arguments.

Anything that creates stimulation.

And sometimes it’s not even obvious.

You push a situation. You start a conflict.

Not because you want it, but because your system needs activation.

Boris:
We actually have a perfect example ourselves.

Do you remember when we randomly decided to drive to Amsterdam in the middle of the night?

Akif:
Yes. We were bored. It was like 2 or 3 a.m.

Boris:
Exactly. Instead of going home, we just said, let’s drive to Amsterdam.

From southern Germany.

No plan. No idea where exactly our friend lived. Just that he was somewhere in Amsterdam.

Akif:
We said we’ll figure it out. And if we get tired, we’ll sleep in the car and continue.

Boris:
And we actually did it. Drove through the night and somehow found him.

Looking back, it’s such a clear ADHD move.

Akif:
Yes. Pure dopamine.

Akif:
There is also something else happening today.

You can develop ADHD-like symptoms through behavior.

Phones, social media, constant stimulation.

You only really see the difference when treatment doesn’t work.

Then you realize it might not be ADHD, but a learned pattern.

Boris:
Yes, and you really see that with kids.

What people call iPad kids.

You give a child an iPad for half an hour. And afterwards, it’s like a completely different child.

More irritable. More reactive.

You think you’re buying yourself 30 minutes of peace.

But afterwards you often get an hour of a very difficult situation.

So in the end, you didn’t gain anything.

And with kids, you see it immediately.

But with adults, we’re doing the same thing all day. Just with phones.

Akif:
I have to say, I have quite a strong opinion on this.

I don’t really like how ADHD is often talked about as a superpower.

Yes, there are strengths. That’s true. But we have to be very careful.

Because we are speaking from a very privileged position.

If you look at us, we both managed. You have your companies, you’ve built things. I work in Switzerland in a well-paid job. We have our families.

From the outside, everything looks like it works.

So it’s easy for people like us to say, “ADHD is actually not that bad. It’s even a superpower. And if we now take medication and do a bit of therapy, we’ll be even better.”

But that’s a very specific perspective.

For a lot of people, ADHD is not like that at all.

Many people struggle massively with everyday life. With relationships. With stability.

You see much higher rates of addiction. Financial problems. Early parenthood. People ending up in prison. Get divorced.

And this is where it becomes a problem.

If we romanticize ADHD too much from our position, we might actually take away attention and resources from the people who really need help.

Because suddenly the narrative becomes, “It’s not that serious. It’s even a strength.”

But for many people, it is not a strength. It is a real burden.

So I think we have a responsibility to be honest about that.

ADHD is a reason. It explains behavior.

But it is not an excuse.

And it is treatable.

Boris:
And at the same time, even for us, there was a point where the pressure became too high.

Akif:
Exactly.

Boris:
We didn’t just casually get diagnosed. There was real Leidensdruck.

Akif:
Yes. For me, it got to a point where I felt I couldn’t be the partner or the father I wanted to be anymore. That’s when I knew something had to change.

Akif:
The school system is not built for ADHD brains.

It’s built for people who can sit still and focus.

If you can’t, you are the problem.

But often, the system just doesn’t fit your brain.

Akif shared a story from his extended family that made this very real.

There is a boy in his family. Extremely loving, very kind. But also extremely hyperactive.

Without medication, he cannot regulate himself at all.

If you are in a car with him, you have to constantly watch him so he doesn’t climb onto the dashboard.

If you are near a bridge, you have to be careful because he might jump. Not because he wants to harm himself, but because the impulse is just there.

It’s not manageable. It’s dangerous.

With methylphenidate, he is still clearly ADHD.

He still runs around. He is still very active.

But instead of doing something dangerous, he just runs back and forth.

He is still the same kid. Same energy. Same personality.

But he is no longer a danger to himself or others.

That difference is everything.

ADHD is not one thing.

It is biology, environment, behavior, and life history layered together.

It can stay invisible for years. Especially if you are able to compensate.

Until something shifts.

For both of us, that moment came later in life.

Understanding what is actually happening does not solve everything.

But it gives you a language for patterns that were always there.

And that alone can change a lot.