The term AuDHD refers to the co-occurrence of autism and ADHD. While autism and ADHD are distinct conditions, they share several overlapping traits, making the dual diagnosis challenging yet common. When I received my autism diagnosis in 2019, I began piecing together why certain things had always felt harder for me. But it was not until my ADHD diagnosis in 2024 that I realised how much these two conditions interact, often in ways that felt like they were working against each other. For years, I suspected ADHD, but having it confirmed brought both clarity and challenges as I tried to navigate how these diagnoses overlapped in my life. I am going to try my best to explain the experiences of having both conditions, and what can help to manage the often-conflicting traits, treatments, and characteristics!
Understanding AuDHD:
Autism and ADHD both impact executive functioning, emotional regulation, and sensory processing. For those with both conditions, these difficulties can be amplified, leading to challenges in everyday activities like time management, social interactions, and task completion (Kerns et al., 2022). However, while the conditions share similarities, there are important differences in how they present and how they can be managed. I often found myself overwhelmed by sensory input, like loud conversations or bright lighting, but also bouncing between hyper-focusing on tasks and completely losing track of time — a constant tug-of-war between the two conditions. It sometimes feels like having two brains that cannot agree on anything; one wants to hyper-focus on researching a niche topic for hours, while the other suddenly remembers I haven’t eaten lunch!
Common Challenges for Individuals with AuDHD
- Sensory Overload:
Individuals with AuDHD may experience heightened sensitivity to sensory stimuli, such as loud noises, bright lights, or certain textures. This can lead to sensory overwhelm, causing withdrawal or shutdowns in environments like busy workplaces or social gatherings. The combination of ADHD’s heightened sensory perception and autism’s strong sensory responses can make sensory overload particularly intense. For me, a trip to the supermarket can be overwhelming. The bright fluorescent lights and constant noise are overstimulating because of my autism, while my ADHD makes it harder to filter out distractions. Sensory overload can be managed by using tools like noise-cancelling headphones (personally, I prefer ear buds playing white noise or focus music), sunglasses, or fidget toys to reduce sensory input.
- Executive Dysfunction:
Executive dysfunction is a hallmark of both autism and ADHD, making it difficult for individuals to plan, organise, and prioritise tasks. Those with AuDHD may struggle with working memory, impulse control, and task switching, leading to difficulties in academic performance, employment, and daily life activities (Brown & Rees, 2023). I used to feel like I was constantly dropping the ball, whether it was forgetting appointments or starting a task only to leave it halfway through. Using schedules and breaking tasks into smaller chunks has been a lifesaver, though it is still something I must consciously pay attention to daily to stay on task! For example, I might spend hours perfecting a presentation, only to realise I have forgotten an important deadline for another task. Breaking tasks into smaller steps has been a life saver to keep me on track! I manage executive dysfunction by utilising visual schedules, reminders, and to-do lists to keep track of tasks as well as the aforementioned breaking down tasks into smaller, manageable steps to reduce overwhelm and improve focus.
- Emotional Dysregulation:
Emotional dysregulation is common in both autism and ADHD, making it harder for individuals to cope with stress and intense emotions. This can manifest as emotional outbursts, shutdowns, or heightened anxiety. The co-occurrence of both conditions can amplify these responses, making emotional regulation particularly challenging. There have been moments when I have gone from being perfectly calm to completely overwhelmed in minutes. Once, at work, I found myself near tears after a seemingly small criticism because it tapped into a cascade of emotions I could not regulate fast enough. Until my diagnosis, I was not even aware emotional regulation was “a thing” and I have had to learn to understand, process and manage my own emotions meanwhile. Before my diagnoses, I did not even know that emotional regulation was “a thing” let alone something I struggled with. Learning about it has helped me understand why I sometimes feel like small stressors hit like a tsunami. Ways to manage emotional dysregulation include practicing grounding techniques, such as deep breathing exercises, to help manage intense emotions, and seeking support from a therapist familiar with both autism and ADHD to develop tailored coping strategies.
Here are Some Overall Tips for Managing AuDHD:
- Create Structure: Use visual schedules, reminders, and to-do lists to help manage daily tasks. Consistent routines can provide a sense of predictability, reducing stress.
- Utilise Sensory Tools: Items like noise-cancelling headphones, fidget toys, or sunglasses can help manage sensory input and reduce overwhelm.
- Seek Specialist Support: Working with a coach or therapist experienced in both autism and ADHD can provide tailored strategies, combining techniques from cognitive-behavioural therapy (CBT), autism coaching, and ADHD management.
- Focus on Self-Compassion: Recognise that living with AuDHD can be challenging and allow space for self-compassion. It is important to acknowledge the effort involved in managing both conditions and to celebrate small victories.
When I started celebrating small wins – like finishing one task from my to-do list – I noticed a big shift in how I felt about myself and my abilities. Self-compassion makes all the difference!
Medication: ADHD vs. Autism
ADHD can often be managed with medication, which is commonly prescribed to help reduce symptoms like inattention, hyperactivity, and impulsivity. Medications such as stimulants (e.g., methylphenidate, known as Ritalin) and non-stimulants (e.g., atomoxetine) work by increasing the levels of neurotransmitters like dopamine and norepinephrine in the brain, which can help improve focus and executive function.
Why Medication Can Help with ADHD:
- Increases Dopamine and Norepinephrine: ADHD medications enhance the availability of dopamine and norepinephrine, neurotransmitters that are typically lower in individuals with ADHD. This helps improve focus, reduce impulsivity, and enhance task completion (Arnsten & Rubia, 2018).
- Improves Executive Function: By boosting neurotransmitter activity, these medications can help improve working memory, planning, and organisational skills, making it easier for individuals to stay on task and manage daily responsibilities.
However, autism does not have a specific medication treatment. While some medications may be prescribed to help manage co-occurring symptoms like anxiety or irritability, there is no standard pharmacological treatment for the core traits of autism (e.g., social communication differences, sensory sensitivities). This difference in treatment options can complicate the management of AuDHD. While I have not personally used ADHD medication, I have heard from others with AuDHD about the benefits and challenges it can bring. ADHD medication can significantly improve focus and executive function, making daily life more manageable. However, for individuals with both autism and ADHD, these medications can sometimes intensify sensory sensitivities or anxiety, which are already prevalent in autism.
For instance:
- Sensory Overload: Some people report that stimulants make them more aware of sensory input, like loud noises or bright lights, which can feel overwhelming.
- Heightened Anxiety: Increased dopamine levels may exacerbate feelings of restlessness or social discomfort, creating a balancing act for those managing both conditions.
Finding the right approach often involves working closely with healthcare professionals to tailor treatment plans, whether that means medication, therapy, or other strategies. For me, while I have not explored medication, I have relied heavily on non-pharmacological strategies, such as structure, sensory tools, and self-compassion, to manage the unique challenges of AuDHD.
Living with AuDHD presents unique challenges, but with the right support and strategies, we can THRIVE. Understanding the interaction between autism and ADHD — including the impact of medication — is key to managing symptoms effectively. By creating routines, allowing space for adjustments, and focusing on self-compassion, I have learned to embrace the nuances of both diagnoses. Although some days are tough, I am continuing to discover what works best for me and have the privilege of helping others do the same.
References:
Arnsten, A. F. T., & Rubia, K. (2018). Neurobiological mechanisms of ADHD and the role of dopamine in treatment response. Current Opinion in Behavioral Sciences.
Brown, T., & Rees, C. (2023). Executive dysfunction in co-occurring autism and ADHD. Developmental Neuropsychology.
Kerns, C. M., & Kendall, P. C. (2022). Sensory processing issues in children with co-occurring autism and ADHD. Journal of Autism and Developmental Disorders.