Receiving a diagnosis of autism in adulthood, and later ADHD, can be a transformative experience. For many, like myself, these late diagnoses in my thirties and forties provided crucial explanations for a lifetime of challenges. Before understanding I was both autistic and had ADHD, I struggled significantly with my mental health and carried the heavy burden of low self-esteem, stemming from repeated experiences of rejection, bullying, and judgment.
My journey to self-discovery began with my eldest child’s autism diagnosis at age eight. Reading about autism, I recognized many of my own traits. Years later, when my youngest child was diagnosed with ADHD, the descriptions resonated deeply once more. It became clear that just as autistic traits can be masked, so too can ADHD. For years, I had exerted immense effort trying to conform and “fix” myself, unaware that what I truly needed were tailored strategies, understanding, and support. Instead of battling my neurodivergence, I began to accommodate it.
When I started seeking information and strategies specifically for individuals with both autism and ADHD, often referred to as “AutiHD” within the community, I found a noticeable gap in available resources. Historically, a dual diagnosis of autism and ADHD was not recognized until 2013. This underscores the urgent need for increased research, resources, and support for those of us navigating this dual neurodivergence.
The Complex Interplay of Autism and ADHD
Prior to my ADHD diagnosis, I had diligently tried to implement strategies recommended for autistic individuals. While some adjustments were beneficial, others simply didn’t align with my experiences. My subsequent ADHD diagnosis illuminated why. For instance, I learned that establishing a routine could reduce anxiety and promote regulation for autistic individuals. I would enthusiastically create detailed routines, managing to maintain them for a day or two, fueled by the novelty and initial excitement. However, restlessness would soon creep in, a craving for novelty and stimulation, leaving me feeling discontent and unsettled. This created a frustrating cycle: my dopamine-seeking ADHD pushed against the structure I craved for my autistic sensitivities, resulting in overstimulation and then boredom, sadness, and restlessness when adhering to a rigid schedule.
Self-care also presented unique challenges. I understood that engaging with my special interests was crucial for my autistic well-being, providing a sense of calm and contentment when I managed to dedicate time to them. However, the ADHD component made consistent engagement difficult. Distractions were frequent, and I often felt frustrated by my inability to commit and maintain focus on these interests.
Social interaction is another area profoundly affected by the paradoxical nature of AutiHD. As an autistic person, I experience challenges with social communication and am easily overwhelmed and drained by social contact. Simultaneously, my ADHD drives a craving for the stimulation and excitement of social environments and being around others. This internal conflict often leads me to overcommit socially, as invitations initially seem appealing and stimulating. Furthermore, a lifetime of masking and striving for acceptance has instilled people-pleasing tendencies, making it difficult to decline invitations for fear of upsetting or being rejected by others. Once in social situations, my ADHD tendencies surface, leading to talking excessively, interrupting others, or oversharing – behaviors that are acutely uncomfortable for my socially anxious autistic self, even as they are happening. Later, the post-social event analysis begins, replaying every interaction, filled with anxiety about potential rejection and social missteps.
Experimenting with Strategies for AutiHD
While I don’t possess all the answers for navigating life with both autism and ADHD, I’ve been actively experimenting with different approaches and have found some strategies to be particularly helpful.
Addressing the challenges of establishing routines, I shifted from rigid daily schedules to “mini-routines” focused on specific times of day, such as mornings or evenings. This offers a looser framework than a fully structured day, accommodating the need for spontaneity driven by ADHD while still providing a degree of predictability beneficial for my autistic needs. To manage the dopamine-seeking behaviors of ADHD, I’ve identified alternative activities that provide similar stimulation without leading to exhaustion or overwhelm. Instead of constantly seeking external excitement, I engage in activities at home that offer similar sensory input and engagement, such as playing video games, participating in online social communities, or listening to music at a higher volume.
Learning to manage overcommitment and impulsive “yes” responses has also been crucial. The journey of unmasking and cultivating self-acceptance has been fundamental. While I may naturally be talkative and energetic, I am actively working on recognizing my inherent worthiness of respect and acceptance just as I am.
Finally, I want to share my positive experience with ADHD medication. For me, medication has been genuinely beneficial. By promoting focus and calm, it provides the mental space to implement the strategies mentioned above more effectively. It has also created what I describe as a “pause point”—a moment to consciously decide how to respond to situations rather than reacting impulsively. Interestingly, with the ADHD “noise” reduced, I’ve noticed my autistic traits become more prominent. Without the more overtly sociable and excitable ADHD tendencies taking the forefront, my autistic characteristics, including a preference for caution when facing new challenges rather than unwavering optimism, are more apparent.
Receiving both autism and ADHD diagnoses has been incredibly valuable, leading to a more balanced and happier life. My hope is that in the future, individuals with AutiHD will benefit from greater understanding, acceptance, and tailored support.
