Receiving a diagnosis of autism in my mid-thirties and ADHD even later in my forties was a pivotal point in my life. Before these diagnoses, I navigated a landscape of poor mental health and cripplingly low self-esteem, the result of enduring years of rejection, bullying, and judgment. It wasn’t until my eldest child’s autism diagnosis at eight years old that the pieces began to fall into place for me personally. Five years later, when my youngest was diagnosed with ADHD, the descriptions resonated deeply once more. I came to understand that, much like autistic traits, ADHD characteristics could also be masked. My life had been a constant effort to conform, to “fix” perceived flaws. However, what I truly needed was understanding, support, and coping strategies. Instead of battling my neurodivergence, I began to accommodate it.
My quest for information and strategies specific to individuals with both autism and ADHD – often referred to as “autiHD” within the community – revealed a significant gap. Until 2013, dual diagnoses were not even officially recognized. We are in dire need of more research, resources, and understanding surrounding this co-occurrence.
Navigating the Complexities of Co-occurring Autism and ADHD
Prior to my ADHD diagnosis, I diligently attempted to implement strategies recommended for individuals with autism. While some approaches yielded positive results, others simply didn’t align with my experience. My subsequent ADHD diagnosis illuminated these discrepancies. For instance, I learned that establishing a routine could alleviate anxiety and promote regulation for autistic individuals. Enthusiastically, I would create structured daily schedules, maintaining them for a day or two, initially fueled by the novelty and excitement. However, restlessness would soon creep in, a craving for novelty and stimulation to achieve contentment and a sense of calm. This created an internal conflict: the dopamine-seeking tendencies of ADHD led to overstimulation, yet adhering to a rigid routine resulted in boredom, sadness, and a persistent feeling of unease.
Self-care also presented unique challenges. I understood the benefits of engaging with special interests as a means of self-care for autistic individuals. When I managed to dedicate time to these passions, I undoubtedly experienced increased calmness and centeredness. However, initiating and maintaining engagement with these interests proved difficult. Distractions were frequent, and frustration mounted when I struggled to remain focused.
Socialization is profoundly impacted by the paradoxical nature of “autiHD.” On one hand, I experience challenges with social communication and are easily overwhelmed and drained by social interactions, typical of autism. Conversely, the ADHD aspect of me craves the stimulation and excitement of being around people and participating in social settings. This often leads to overcommitting socially, as invitations initially appear fun and appealing. Moreover, saying “no” is difficult, a people-pleasing tendency developed over years of trying to avoid upsetting others or facing rejection as a late-diagnosed neurodivergent adult. Once in social situations, my ADHD manifests as talking excessively, interrupting others, and oversharing. This behavior, acutely perceived by my socially anxious autistic self, feels intolerable even as it unfolds. Later, I find myself replaying social interactions, overanalyzing every word and action, and experiencing heightened anxiety about potential rejection.
Experimenting with Strategies for AutiHD
While I don’t possess definitive solutions for living a perfectly serene life with both autism and ADHD, I have been actively experimenting with alternative approaches and have achieved some encouraging results.
Addressing the difficulties with establishing daily routines, I shifted to creating “mini-routines” for specific times of the day, such as mornings or evenings. This provides a less rigid structure compared to a fully mapped-out day, allowing for spontaneity and minor adjustments to accommodate my ADHD needs while still offering a degree of predictability. I’ve also explored methods to manage the dopamine-seeking behavior associated with ADHD in ways that are less draining. Instead of constantly needing external stimulation, I’ve identified at-home activities that provide a similar sense of reward, such as playing video games, engaging in online social interactions, or listening to music at high volume.
Furthermore, I’ve consciously worked on avoiding overcommitment and resisting impulsive “yes” responses in the moment. My journey of unmasking and cultivating self-acceptance has been crucial. While I may always be naturally talkative and outgoing, I am learning to recognize my inherent worthiness of respect and acceptance, just as I am.
Finally, I want to share my personal experience with ADHD medication, which I have found to be genuinely beneficial. When I experience increased focus and calmness, it provides a foundation for implementing the strategies mentioned earlier more effectively. Additionally, medication has given me what I call a “pause point”—a brief moment to consciously decide how to respond to situations, rather than reacting impulsively. I’ve observed that my autistic traits become more pronounced when the more outwardly sociable and excitable ADHD aspects are less dominant. I also find myself approaching new challenges with more caution, rather than unwavering optimism.
Receiving both autism and ADHD diagnoses has been invaluable, leading to a more peaceful and fulfilling life. My hope is that in the future, individuals with “autiHD” will receive greater understanding, support, and tailored accommodations.
