AuDHD Explained: A Beginner’s Guide to Dual Diagnosis

Introduction:

Have you ever stayed up all night switching between overthinking about the day’s events or feeling like you’re not paying enough attention all at once? If this situation applies to you, or someone close to you struggles with inattention or periods of hyper focus, then you might have come across the term AuDHD.

AuDHD is an abbreviation for Autism and Attention Deficit disorder (ADHD). Although an unofficial term, 80% of autistic people also have ADHD. It is a co-occurring neurotype in which both conditions exist.

Many people who experience a unique blend of traits such as overstimulation and emotional sensitivity often have to mask these behaviours on a daily in fear of being misunderstood by neurotypical people.

While many experience these symptoms, identifying and diagnosing AuDHD symptoms can be complex, especially in a neurotypical world that is not built to accommodate them. Thus leading to those with AuDHD to self-diagnosis using online resources instead of going through a myriad of comorbid conditions, in the search for self-acceptance.

In this guide, we will break down AuDHD, from recognising its traits to the assessment tools available to help those who need it the most.

Also, read about five essential ways to combat an identity crisis here.  

What does AuDHD mean? 

[1]WebMD defines AuDHD as a non-clinical term used to describe those who have both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Although it is not an official diagnosis, many psychologists and researchers take it very seriously due to the complex co-occurring nature of these conditions.

 Autism, also called autism spectrum disorder (ASD), is a complex developmental condition that affects the way people interact, communicate, learn and behave. People with ASD have differences in their brain function that can impact their behaviour and social interactions.

Attention Deficit/Hyperactivity Disorder, popularly known as ADHD, is a neurodevelopmental disorder which affects the way a person’s brain develops. The onset of ADHD symptoms begins before age 12 and includes symptoms such as fidgeting, difficulty paying attention and losing things.

The overlap in those with autism and ADHD is over 80% yet this overlap is not widely known. This is due to an exemption that was decided in 2013, before the publication of the 5th edition of the Diagnostic and Statistical Manual, that individuals could not be diagnosed with both despite having presented AuDHD symptoms such as impulsivity, inattention, masking, and overstimulation. 

AuDHD as an identity and its Misdiagnosis:  

Research before 2013 only conducted studies on Autism and ADHD as separate medical diagnoses. This means that individuals who received a formal diagnosis before 2013 may have only gotten one diagnosis, even though they fit the diagnostic criteria for both neurotypes. 

According to Embrace Autism[2], a website that provides ADHD and Autism assessment tools for adults worldwide, those with AuDHD are more likely to use identity-first language such as “I am AuDHD” instead of “I have AuDHD”. This reflects a larger, more accepting shift towards self-acceptance among neurodivergent people, as it shifts the view of it from being a disorder to fix to a natural variation in the way a person’s mind works in comparison to neurotypical standards.

Many neurodiversity advocates encourage identity-first language that is inclusive and non-judgmental. Even for those within the Autism Disorder community who prefer this kind of language, it is always important to ask directly about a person’s preferred language and how they want to be addressed. 

The usage of inclusive language also helps a trained professional to better help the mental and physical health of clients and encourage meaningful community support systems for those with comorbid conditions like social fatigue and hyper focus.

Have you been stuck in a loop of overthinking and can’t seem to help yourself? Read here about how to break overthinking patterns and start living in the moment. 

Symptoms of AuDHD:

Those with neurodivergent traits experience the world very differently compared to a neurotypical person’s life experiences. In the following section, the symptoms of ADHD, AuDHD, and Autism will be discussed, along with the strengths of being a neurodivergent person navigating a neurotypical world. 

Autism is usually characterised by differences in communication, behaviour, and sensory processing. Some of its symptoms are: 

• Struggling with small talk or unspoken social rules
• Repeating behaviours or movements
• Experiencing overstimulation from certain lights, sounds, touches, textures, or smells
• Having intense or focused interests

ADHD is marked by challenges with inattention, impulsivity, and executive function. Some of its symptoms are: 

• Having trouble focusing or choosing what to focus on
• Feeling constantly restless or fidgety
• Interrupting, oversharing, or blurting things out of habit
• Forgetting appointments, misplacing things, or losing track of time
• Procrastinating or feeling mentally scattered

 If you are a person who has experienced traits from both of these co-occurring neurodevelopmental disorders, then AuDHD fits the diagnosis. The presence of these traits might fit the criteria for one diagnosis or balance each other out.

Some common AuDHD symptoms are: 

• Having trouble starting or finishing tasks, even ones that you care deeply about
• Getting overwhelmed easily, but needing stimulation to concentrate
• Feeling intense emotions that are hard to control or explain
• Having a hard time switching tasks or shifting focus
• Feeling social fatigue after socialising, even if you did have fun

Other AuDHD symptoms:

•  Having a lot of energy to put into special interests
• Craving routine to feel calm, but getting bored easily
• Getting thrown off by unexpected changes, but wanting to try new things
• Going quiet when you’re around a stranger, but tend to talk a lot around close friends or family 

Unique strengths of AuDHD:

Although having two co-occurring disorders has its own set of challenges, many strengths come with being a neurodivergent person that the neurotypical world might not know of. Some of these are listed below: 

• Better Hyper focus with creativity. Those with neurotypical tendencies tend to have an energetic mind that helps them have fresh, innovative ideas. 
• Better adaptability to change, especially with unexpected changes
• Unique problem solvers with out-of-the-box solutions to life’s hurdles
• Those with both conditions can demonstrate deep enthusiasm for their hobbies and work as it helps drive exploration, while autism provides the intense focus needed to excel.
• Despite stereotypes in popular media, neurodivergent people with comorbid conditions like autism and ADHD can show strong empathy and concern.
• Those with AuDHD also tend to have a deep passion for topics that they are drawn to, especially when provided with community support and guidance from a trained professional with proper assessment tools, leading to self-acceptance. 

What’s it like to be AuDHD?

Autism and ADHD are both neurodevelopmental disorders, but there are many traits within each diagnosis that can overlap. 

However, the way these traits present themselves depends upon the person and how their mind develops, perceives, and processes information, that are often influenced by co-occurring traits like impulsivity, inattention, and overstimulation.

In the following section, the similarities and differences between the three will be discussed. You can also check out the Adult ADHD assessment tools available here for further guidance from a trained professional.

1. Differences in Socialising:

 Autism: Differences in social-emotional reciprocity

ADHD: Does not seem to listen when spoken to directly

AuDHD: Differences in social-emotional reciprocity and mind seemingly wander during conversations, quickly leading to social fatigue.

2.  Verbal communication:

Autism: Differences in non-verbal communication

AuDHD: Differences in non-verbal communication or masking in an attempt to fit into social settings

3.  Problems with focusing: 

Autism: Hyper focus

ADHD:  Difficulty in sustaining attention for longer periods

AuDHD: A Person can hyper focus but also experience a prolonged period of inattention 

4.  Problems with Interpersonal relationships:

Autism: Differences in developing, maintaining, and understanding relationships 

AuDHD: Differences in developing, maintaining, and understanding relationships, often feeling misunderstood amongst neurotypical people 

5. Patterns of Behaviours:

Autism: Repetitive patterns of behaviours like stimming and special interests

ADHD: Avoids/ dislikes tasks requiring longer mental effort

AuDHD: Finds special interests soothing, but needs to alternate between interests due to impulsivity

6.  Differences in Routine:

Autism: Routine-driven and consistent 

ADHD: Impulsive and a need for novelty 

AuDHD: Routines offer comfort and guidance, but a need to change tasks often arises due to overstimulation

7. Planning Based:

Autism: Meticulous planner 

ADHD: exhibits poor organisation

AuDHD: Driven to plan and organise, but faces difficulty following through due to co-occurring overwhelm 

8. Attention to detail:

Autism: Extreme attention to detail

ADHD: Makes careless mistakes or lacks attention to detail

AuDHD: Attention to detail, yet also prone to mistakes due to inattention

9. Sensory activities:

Autism: Sensitive to sensory stimulation 

ADHD: Sensitive to most activities but also needs stimulation

AuDHD: Severely sensitive to sensory activities, often including light sensitivity, but also needs stimulation, leading to daily overstimulation. 

10.  Daily Functioning:

 Autism: faces challenges in daily functioning

ADHD: Forgetful in daily activities and loses things necessary for tasks/ activities

AuDHD: Challenges in daily functioning and forgetfulness in daily activities 

11.  Follow through on tasks:

ADHD: Fails to follow through on tasks and instructions 

AuDHD: Fails to follow through on tasks and instructions, often due to internal conflicts on attention, impulsivity, or overwhelm

12. Analytical:

 Autism: Analytical and precise

ADHD: Lateral thinker, associative thoughts and can generate many ideas

AuDHD: Analytical, precise and lateral thinker, associative thoughts, idea generator, which can complicate self-diagnosis or lead to misdiagnosis without any proper community support

Also, read about the impact of childhood trauma and how it can carry into your adult life here.

How Different does AuDHD look in Women & Girls? 

In the following years, researchers have found that symptoms of Autism and ADHD show up differently in women or girls and men or boys. Women are more likely to mask their autism features or hyperactivity, such that it goes completely unnoticed to their families. This usually happens for social conformity and to fit into social interactions. 

 AuDHD symptoms in women and girls might look like:

• Masking behaviours: As mentioned above, both autistic women and those with ADHD are more likely to mask their symptoms in an attempt to hide their true selves from peers or in social situations wherein they wish to appear neurotypical. These masking traits could potentially lead to social fatigue, especially if done for long-term interactions.

• Distractibility: Women and girls who present the traits of both ADHD and autism are often associated with having issues with distractibility and inattention, especially when overwhelmed by overstimulation in loud, sensory-heavy environments. It is also often co-occurring within a unique neurotype person.

• Hyper focus: Those with both autism and ADHD can have intense focus for specific subjects, whether it is on a topic that the individual is skilled in, or simply enjoys learning about. Other issues with focusing are common in women with ADHD, but hyper focus is also common, which looks similar to the intense interests and obsessions experienced by autistic individuals.

This is common amongst those who undergo self-diagnosis and can later be confirmed by a trained professional using assessment tools.

• Challenges in emotional regulation: Women who are diagnosed with autism and have ADHD traits face great difficulty in regulating their emotions, resulting in extreme anxiety or mood swings.

An example of this is that those with both these conditions are more susceptible to rejection sensitivity dysphoria, which leads to individuals becoming very sensitive to any perceived criticism or rejection.

These experiences are often a result of underlying comorbid conditions, such as anxiety or depression, which Individuals can better power through with the help of community support and validation.

• Hormonal Challenges: One study by Birmingham City University found that women diagnosed with AuDHD received their diagnosis much later than men due to a gendered diagnostic criterion that favoured representations of ADHD and autism in men.

Historically, this isn’t new for women-focused research. Women who took part in the study reported a lifetime of misdiagnosis or dismissal, resulting in a later in life recognition of their neurotypical nature.

Hormonal change, especially when women are in the perimenopausal stage, catalyses seeking a diagnosis in neurodivergence when symptoms disrupt daily life. Later, these hormonal fluctuations were identified as fleeting ADHD and autism traits.

How to get a proper diagnosis:

[3]If you are looking for a proper diagnosis, clarity, or assessment tools from a trained professional, then this section will go into detail about the resources available that can help you get there.

First step: Begin with a visit to your primary doctor. Describe as in-depth as possible your daily experiences and the challenges you are facing, such as inattention, impulsivity, or overstimulation, which are common symptoms. 

Here are some questions that you can ask:

1. Could this be ADHD, autism, or something else?
2. How do I know if I have sensory sensitivities or social fatigue?
3. What’s the difference between autism and social anxiety?
4. Can you refer me to someone who works with adults who have ADHD or autism?

Second Step: After your first consultation with your primary doctor, they can provide you with a referral to a psychologist, psychiatrist, or a behavioural health clinic. Some people with co-occurring neurodevelopmental disorders often work with more than one health care professional to be able to assess both the comorbid conditions properly.

An evaluation test might look like:

1. Talking to your healthcare provider about your medical history and current challenges
2. Filling out checklists or questionnaires
3. Interviews with family members or people who know you well
4. Standardised tests that evaluate your thinking, memory, or social understanding

I. Test for AuDHD: 

While there isn’t one formal test for AuDHD specifically, there are other evaluation tests related to ADHD and Autism that are backed by science to help provide a starting point: 

Autism-Spectrum Quotient (ASQ): Measures social and sensory traits

RAADS-R: Screening test for Autism in Adults

CAT-Q: Test for masking and camouflaging behaviour

ADHD Self-report scale: (ASRS): Screening test for inattention, hyper focus, disorganisation and impulsivity

Please note that high scores on these tests do not mean a valid diagnosis. It is always best to consult a trained professional with experience in treating patients with co-occurring conditions before taking any other step in self-diagnosis.

2. Is there a treatment for AuDHD?

So far, there hasn’t been any one treatment for AuDHD, but there are strategies that can effectively support those with ADHD and Autism to navigate the neurotypical world more easily. 

Medication: Due to the lack of research towards AuDHD as a neurodevelopmental disorder, there haven’t been any medications that are FDA approved to treat the core symptoms of autism, but ADHD symptoms like impulsivity, inattention, overstimulation or hyper focus are more likely to respond to: 

• Stimulants
• Non-stimulants
• Antidepressants
• Mood stabilizers

Therapy: A trained professional in the mental health field who has experience working with neurodivergent adults can help guide you through better effective methods to manage symptoms of AuDHD. The different kinds of therapy that can benefit this are: 

• Cognitive Behavioural Therapy (CBT)
• Mindfulness-based stress reduction (MBSR)
• Dialectical Behaviour Therapy (DBT)
• Occupational therapy
• Social skills training

3. Non-medical treatment for AuDHD:

Having AuDHD does not mean a person has a mental health disorder that they necessarily have to ‘fix’. It just means that neurodivergent folks need to find other effective ways to keep their minds functioning by better understanding it, and creating routines and boundaries that support it better. 

Some of these routes are:

• Track hyper focus, energy, or sensory patterns
• Scheduling rest time for social fatigue after longer periods of socialising 
• Using routines or scripts that help you feel safer
• Permitting yourself to say no to things that increase overstimulation
• Engage in more activities that bring you joy
• Explore work or hobbies that align with your special interests
• Look for community support from people who understand and can hold space for what you’re going through
• Prioritise self-acceptance and learn how to emotionally regulate

There are also many online and offline communities full of neurodivergent people of all ages for those exploring their first self-diagnosis journey or looking for resources.

Some websites that advocate for neurodivergent folks and provide self-assessment tools:

Autistic Self-Advocacy Network

Autistic Women and Non-binary Network

Embrace Autism

ADDitude Magazine

Online communities:

Executive Dysfunction

Autism late diagnosis/ self-identification support and education

AuDHD and Neurodivergent support community

Conclusion:

AuDHD is a co-occurring neurotype in which Individuals have both autism and ADHD, and thus experience overlapping traits such as impulsivity, inattention, overstimulation, and social fatigue. When these traits do present themselves, they are often expressed differently than the standards of the neurotypical world, which is not built to accommodate neurodivergent folks. 

As a result many go undiagnosed or face several misdiagnoses before resorting to online assessment tools for a self-diagnosis. While there isn’t a single cure all test or treatment that exits, working with a trained professional or building strong community support can help make a big difference.

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