Living with AuDHD (Autism and ADHD)

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Imagine having a brain that is at constant war with itself. Desperate to fit in, yet determined to escape social situations. Obsessively creating complex structures for stability, but just as predictably smashing them all up. Chronically overwhelmed, yet unable to say no.

That’s the reality of living with both ADHD and autism. The two conditions might seem at odds with each other but can, as experts are increasingly realising, coexist and lead to non-stop internal conflict.

Until 2013, autism and ADHD couldn’t be diagnosed in the same person. Today, researchers have found that there is a 50 to 70 per cent crossover between these neurodevelopmental conditions, which is increasingly being referred to as AuDHD.

I was diagnosed with ADHD at the age of 25 after spending a year ruminating daily over the best way to end my life, moving to a different country every month and quitting any job that I started. The diagnosis helped me make sense of my life, but it didn’t seem to fully fit with my experience.

Now, six years later, I finally have the missing piece of the puzzle: an autism diagnosis.

It might sound like a diagnosis too far for most people, but I was relieved. It explained an awful lot about my life to date and why I’ve always struggled with social situations.

Relationships have always confused me
As a child, I questioned why we had to visit family at Christmas just because we share DNA. The answer of “because they’ll always be there for you” felt transactional and has shaped how I have approached every relationship since.

I’ve spent my life figuring out how to be useful to people in a relentlessly exhausting trade for companionship. I constantly regulate everything – from forcing myself to make the “right” amount of eye contact, to saying the “right” things – but I never stick to my own pre-planned script. ADHD impulsivity sees me veering off course, often saying the wrong thing and then beating myself up over it for hours afterwards.

I’ve lost count of how many people have stopped talking to me for reasons I’ll never know. Group settings are even worse, as competing demands overwhelm me to the point where I often hide in the bathroom, my brain ready to explode.

Turning off the ADHD ‘noise’ with alcohol
After moving abroad at the age of 13, I discovered a way to turn off the constant AuDHD radio of thoughts blasting in my head. Getting paralytically drunk seemed to turn my brain off, at least temporarily. This coping strategy lasted until I was diagnosed with ADHD; I would kick social interactions off with a tequila shot wherever possible.

The lack of inhibition associated with ADHD saw my teenage self drinking cocktails abandoned by strangers and picked up off the tables in bars. The loud, crowded clubs left me chronically overstimulated because of my autism. The sensory overload was so intense that I’d often fall asleep right in the middle of the noise – a shutdown response when my brain simply couldn’t cope. It wasn’t unusual for my friends to find me curled up next to a thumping speaker.

However, this didn’t just happen in clubs. One time my friends spent an entire night looking for me in a pub before eventually finding me passed out under a pile of coats. It doesn’t matter whether it’s noise, lights or simply the intensity of being around people; any of this can lead to overstimulation – then shutdown. I often fell asleep in class, in the cinema and even whilst out for dinner.

I hated modelling, but I was unable to quit. My autism thrived on the predictability of receiving a daily email at 6pm that outlined my schedule for the next day. The routine provided both the structure that my mind craved and kept my ADHD brain engaged with dopamine, novelty and adrenaline.

Outsourcing my personal agency could be relaxing because it meant that someone else was in control of my life and, therefore, the “small” decisions that caused me so much stress because of my ADHD, such as what to eat for lunch. On jobs, I usually just had to do or mimic whatever the people around me said, and I wasn’t expected to talk.

However, it was also extremely stressful because my ADHD struggled with the monotony of being a human coat hanger. I had to hide the hyperactivity of my internal experience and force my face to stay calm as my mind felt like it was on fire, exploding with racing thoughts.

It was only when I was diagnosed with ADHD that everything changed. It felt like I finally had the guide to life that everybody else seemed to have. The diagnosis enabled me to access medication, which, in turn, enabled me to stop self-medicating with alcohol. After completing a law degree, I eventually got a job in law; I was determined to “hack” my ADHD by getting ahead of it.

Struggling with office life
Getting to the office was a hurdle in itself, and so I rented a flat that was over the road from it so that I didn’t have to travel every day. Although I didn’t know I was autistic at the time, I did know that I couldn’t cope with public transport during rush hour; I regularly had panic attacks if I thought I was going to be late. AuDHD impacts executive functioning skills, such as time management, which meant that I was often late, and so a flat opposite the office felt like the most sensible option, even if the rent was extortionate.

However, I wasn’t prepared for how stressful I’d find working in an office. The lights, the noise and the open-plan environment made me constantly on edge. On top of that, I was constantly worrying about making a mistake. I would beg my bewildered manager not to fire me and provide her with 15-page reports detailing everything I’d done that week for our catch ups.

I struggled to say the right thing and had difficulty regulating my behaviour. For example, one colleague used to speak very loudly in the kitchen next to my desk, which I found very distracting. One day, I snapped and impulsively emailed them to ask them to stop talking so loudly because no one cared about their weekend, only realising that this was a mistake once I’d pressed send. The mortification when they responded, cc’ing in both of our managers and the Culture Code, was like nothing I have ever experienced. It’s no excuse, but it’s an example of how undiagnosed AuDHD can contribute to these situations. Eventually, two and a half years later, I quit to become an ADHD coach and write a book.

Women are far less likely to be diagnosed with autism or ADHD
When I told my therapist that I thought I was autistic, she dismissed it because I was nothing like the autistic children that she worked with. I accepted this at face value, just as I accepted doctors telling me that I was fine (before I was diagnosed with ADHD) because I had a law degree – a symptom of autism is literal thinking.

Autism makes all relationships harder to navigate and also makes you more vulnerable to abuse. Like nine out of 10 autistic women, I have been a victim of sexual violence, including being groomed at the age of 15 by a man 10 years older than me.

When I contacted the police after being harassed by an ex-partner, they asked me a list of mandatory questions that they ask about relationships that could involve coercive and controlling behaviour. I answered “yes” to every single one. I’d been in a relationship where I’d been told what to wear, do and see, whether I could take medication, and even whether I could drink coffee, and yet I hadn’t realised that this was wrong.

Thanks to societal conditioning, women are far less likely to be diagnosed with autism or ADHD than men. Women tend to mask symptoms so that our struggles are less noticeable to others.

This is the truth of living with AuDHD, especially for women like me, who’ve spent their entire lives hiding their symptoms as a way to survive. I felt like I had to monitor every part of who I was, terrified of unintentionally doing something wrong because I could never understand the rules that everybody else seemed to know.

Our society is increasingly stigmatising neurodivergence, associating it with people seeking disability benefits and using it as a justification for poor behaviour. However, the reality is that these labels enable people to take responsibility for themselves, reclaim agency over their lives and contribute meaningfully to our society.

It is easy to view AuDHD as a convenient excuse for personal failings. However, if I’d had this diagnosis earlier when I was growing up, I would have been far less vulnerable to the harm inflicted by others. Instead of shaming the individuals seeking help, we should focus on the broken systems that allow so many people to go undiagnosed for so long. AuDHD isn’t an excuse, but it can be a life-changing lens to explain our experiences.

Ultimately, these labels enable people to “name it to tame it” – far from marking themselves as victims, they’re survivors of a world that wasn’t designed for them.

I’ve lived with ADHD and autism all my life – this is what it’s like to have both


A very enlightening article. While I knew it is common that people have both conditions I have never seen and article about what it is like to be neurodivergent in this way and I did not know it had a name.

For many individuals, the journey to understanding their neurodivergent identity takes unnecessarily long, winding through misdiagnoses and confusion. Or worse still, it doesn’t happen at all, leaving them feeling different, misunderstood, incompetent, or like they’re failing at life.

AuDHD—the co-occurrence of autism and attention deficit hyperactivity disorder—represents a unique neurological intersection that frequently eludes detection by medical professionals. While once treated as entirely separate neurological differences, research increasingly reveals these neurotypes naturally overlap for many people, creating complex presentations that defy traditional diagnostic criteria and often remain hidden beneath layers of learned masking behaviors and societal expectations, particularly in women and girls.

When two neurotypes coexist.
When I was 41, a close family member was diagnosed autistic. After learning about the genetic links of autism, and doing a very deep dive into the literature, I realised I shared a lot of the same traits, such as decades spent struggling with social anxiety, difficulty with change, getting fixated on things, and sensory overwhelm. Yet I’d also experienced lifelong persistent impulsivity and distractibility, that didn’t quite fit the autism profile and was more indicative of ADHD, which I also have a family history of. I felt like with my traits combined, I didn’t fit the strict criteria for autism or ADHD, yet I knew deep down that I wasn’t quite neurotypical either.

Research suggests that this experience isn’t unusual. Current studies indicate that 50-70% of individuals who have a diagnosis of autism will also present with ADHD. And that’s those who actually manage to get a diagnosis. These staggering statistics reveal not a coincidence but a neurobiological relationship that scientists are only beginning to understand.

The co-occurrence happens for concrete neurological reasons. Both autism and ADHD involve differences in executive functioning, sensory processing, and social communication—though these manifest differently depending on whether the autistic or ADHD traits are most predominant and the individual’s unique neurological makeup. Genetic studies have identified overlapping hereditary factors, with certain gene variations appearing in both populations, suggesting shared neurobiological underpinnings that explain why these two neurological differences so frequently appear together.

What makes AuDHD particularly significant isn’t merely the presence of both neurological differences but how they interact within the same person, creating experiences that are more than just the sum of each part.

The masking effect: how AuDHD traits conceal each other.
Deep within diagnostic shadows lurk countless unidentified AuDHD individuals, their dual neurotypes effectively canceling each other’s most obvious presentations.

Hyperactivity from ADHD might obscure the repetitive movements or stereotypical behaviors associated with autism, appearing more as general restlessness than autism-specific stimming. Conversely, autistic tendencies toward routine and order might partially compensate for ADHD disorganization, creating a person who struggles enormously with executive function yet manages to maintain enough structure to fly under the diagnostic radar.

Social difficulties present particularly complex manifestations in AuDHD individuals. The impulsivity and chattiness often seen in ADHD can mask the social challenges associated with autism. Someone might talk excessively but struggle with reading neurotypical social cues—appearing engaged in conversation while missing its subtext. Meanwhile, autistic social caution might temper ADHD impulsivity in certain contexts, creating inconsistent social behaviors that confuse both the individual and outside observers.

The Autistic Girls Network, a charity dedicated to supporting autistic women and girls in a neuroaffirming way describes it as follows:

”This can feel like a tug of war in an AuDHD-er’s mind, and it can feel impossible trying to balance two completely opposing needs. Because of this, AuDHD can appear like a different presentation altogether. An individual may feel they don’t relate wholly to autism or to ADHD. The two can mask each other, either compensating for each other’s difficulties or making those challenges even harder. For example, the organisation and focus from the autistic brain may compensate for the disorganisation and chaos of the ADHD brain. Or, the mess and chaos from the ADHD may leave the person in a constant state of overwhelm, feeling unable to function because there is no order.

Beyond stereotypes: non-traditional AuDHD presentations.
The situation is even more complicated when we look at non-stereotypical presentations of autism and ADHD.

Internalized traits create silent struggles that evade detection for years. Many AuDHD individuals, particularly those socialized as female, experience their neurodivergence primarily as internal chaos rather than the external behaviors and struggles we are used to seeing portrayed in mainstream media and popular culture.

Rather than visible hyperactivity, a person might experience relentless mental restlessness alongside intense sensory sensitivity. Without obvious external behaviors triggering evaluation, these individuals often receive diagnoses only after seeking help for anxiety or depression—conditions that developed from years of unrecognized neurodevelopmental differences.

The quiet ADHD presentation combines with masked autism to create particularly elusive profiles. Someone might appear thoughtful and reserved rather than hyperactive, struggling privately with both sensory processing issues and executive function challenges while presenting as merely “shy” or “dreamy” to the outside world. This presentation often results in comments like, “You don’t seem autistic” or “Everyone gets distracted sometimes” when they eventually seek evaluation.

Social expectations radically alter how AuDHD manifests across genders. Those socialized as girls often develop elaborate compensation strategies—studying social interactions like academic subjects, developing scripts for conversations, or creating extensive organizational systems that partially offset executive function challenges while generating enormous hidden stress.

Women who are AuDHD often become masters of appearing neurotypical. They’ve spent years observing and mimicking socially “acceptable” behaviors, creating a façade that can fool even experienced clinicians who rely on outdated diagnostic criteria based primarily on male presentation patterns.

It’s now clear from research, that the cost of this masking is significant. It manifests as chronic exhaustion, anxiety, and identity confusion. Many AuDHD-ers report feeling like perpetual impostors, constantly performing a neurotypical role while lacking intuitive understanding of why they struggle with tasks others find simple.

Cultural intersections and diagnostic disparities complicate things further.
Dominant cultural narratives about neurodivergence dramatically influence who receives accurate identification and support. When autism research primarily focuses on white male children, the resulting diagnostic criteria inevitably fail to capture diverse presentations.

Cultural differences in communication styles, emotional expression, and behavioral expectations create additional layers of complexity. In communities where direct eye contact signals disrespect, reduced eye contact—often considered an autism indicator—might represent cultural adherence rather than neurodivergence. Conversely, cultural norms emphasizing respect for authority might suppress the hyperactive or impulsive behaviors that typically trigger ADHD evaluation.

Socioeconomic factors further complicate access to appropriate diagnosis. Comprehensive neurodevelopmental assessments often require substantial financial resources, time off work, transportation, and advocating within complex healthcare systems—barriers that disproportionately affect marginalized communities.

Refugee and immigrant experiences introduce further complexities. Trauma responses can resemble certain aspects of both autism and ADHD, leading to misdiagnosis or missed diagnosis. Meanwhile, cultural differences in understanding neurodivergence may determine whether families seek evaluation at all.

Research confirms these disparities.

Serious issues with the diagnostic process.
Multiple assessment hurdles create winding paths to accurate identification. Clinical fragmentation represents a primary obstacle—psychiatrists may evaluate for ADHD while remaining unfamiliar with subtle autism presentations, while autism specialists might miss co-occurring ADHD traits

Diagnostic criteria continue evolving but lag behind current research understanding. The DSM-5 still maintains autism and ADHD as separate, despite mounting evidence of their neurobiological overlap. Clinicians working strictly within these frameworks may hesitate to diagnose both autism and ADHD simultaneously.

Financial barriers compound these difficulties. In the US, insurance coverage often limits assessment scope or requires sequential rather than comprehensive evaluation. In the UK, assessments for autism and ADHD are rarely combined and NHS waiting lists are around 4+ years in some areas. Private assessments are costly. Assessing for one at a time fragments the diagnostic picture, making it harder to recognize how traits interact.

Gender biases persist throughout diagnostic processes. Research demonstrates that clinicians interpret identical behaviors differently, based on perceived gender.

Personal stories I hear every day from the neurodivergent community reveal common experiences despite these varied barriers. Most late diagnosed AuDHD adults report multiple misdiagnoses before accurate identification—typically anxiety, depression, or personality disorders—addressing symptoms rather than underlying neurological differences.

Moving forward: support and understanding for AuDHD individuals.
Self-understanding ultimately provides the foundation for effective support. Many AuDHD adults report that simply learning about their neurological differences offers immense relief and context for lifelong struggles previously attributed to personal failing.

Support communities specifically for dual-diagnosed individuals continue growing, offering spaces where people can discuss unique experiences that might not resonate in spaces focused on either autism or ADHD alone.

Professional understanding continues evolving as well, but not fast enough, in my opinion. But some forward-thinking clinicians increasingly recognize the need for comprehensive assessment approaches that capture the full neurodevelopmental picture rather than focusing narrowly on single diagnostic categories.

To navigate life as an AuDHD-er, accurate identification represents not an end point but the beginning of authentic self-understanding—a foundation for developing personalized strategies aligned with your unique neurological makeup rather than exhausting yourself trying to be something you’re not: neurotypical.

Wowwwwww. That was needfully validating. My experiences have a lot in common with what the author shared. The alcohol, the mental shutdowns, the difficulty with "small" decisions, the controlling partners, the dismissive doctors, all of it. Thanks for sharing!

I'm gonna read the next one later.