Autism and ADHD combined – also known as AuDHD

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are both neurodevelopmental conditions, and some people may experience both simultaneously. People often use the term AuDHD to co-occurrence of autism and ADHD. 

For many people, receiving a diagnosis of either autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) can bring clarity to lifelong challenges – it can be both daunting and liberating. But for some, the story is more complex, as both conditions can occur together.

Many people, including some clinicians, are still surprised by how much autism and ADHD can overlap, often making it difficult to distinguish one from the other. It is now widely recognised that these conditions frequently co-occur. It is estimated that one in 127 individuals is autistic, while around one in 20 may have ADHD. Recent research suggests that 50% to 70% of individuals with autism spectrum disorder (ASD) also have co-occurring attention deficit hyperactivity disorder (ADHD).

Each person’s experience is unique, and it can be deeply reassuring to know they are not alone living with both ADHD and autism. Unfortunately, most existing studies focus on children, as that is typically when symptoms first emerge. This highlights the need for more research into how these conditions present in adults, including the growing recognition of late diagnoses in adulthood. 

Diagnostic tools and criteria have only recently begun to reflect the reality of dual diagnoses. In fact, earlier editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) did not acknowledge that ADHD and ASD could be diagnosed together. Fortunately, the DSM-5 updated this position, allowing for a more accurate understanding and recognition of co-occurrence.

What does it mean to have both?

Both sides of autism and ADHD can be part of a person, but they may have different desires and needs. People with ADHD and autism – known as AuDHD – may experience a combination of symptoms from both conditions that can contradict or even conflict with each other. People can experience an internal clash between their ADHD and autistic traits, and may feel in constant conflict with their inner self, which can lead to feelings of frustration and confusion.

For instance, they may crave order, routine and a sense of calm (autistic traits), as part of their self-care, but find it difficult to maintain that structure, because they become bored with repetition and seek new, exciting and stimulating things (ADHD traits). 

They may also become just as overstimulated as they can be understimulated – sometimes even within moments of each other – which can be frustrating and confusing for both the person and those around them.

They may feel burned out by social interaction yet struggle to slow down and recharge. Depending on the context and situation, they might be more withdrawn or more social based on their energy levels or environment. They might also experience a wider range of special interests or hyperfixations than usual – some may be intense but short-lived, while others remain stable and enduring, potentially lasting a lifetime.

Living with both conditions can clearly be challenging. Some of my clients frequently use the word chaotic to describe how they feel. The combination of both conditions can make school, work, relationships, and even self-care feel like constant uphill battles. When ADHD and autism co-occur, their interaction can make daily life feel especially confusing or overwhelming. This often leads to feelings of being misunderstood, chronically exhausted, or unsure of how to ‘fit in’ socially. 

Why is it so confusing?

One reason this combination is hard to spot is that ADHD and autism can ‘mask’ each other. For instance, someone with ADHD might appear more social and spontaneous, which can make their underlying autistic traits less noticeable. Conversely, someone who appears highly focused or withdrawn might be assumed to be autistic, while their ADHD traits, such as impulsivity or emotional regulation challenges, go unnoticed. 

If someone has both autism and ADHD – or AuDHD – they may experience internal conflict between their differing traits from each condition, as well as a heightened experience of overlapping symptoms.

Clients often describe having both conditions as feeling like living a paradox. They may find it hard to work out what self-care looks like for them, because meeting their complex and contradictory needs can be difficult. For example, they might need a lot of alone time due to social exhaustion, yet also crave meaningful connection with others and the energy they get from being around others.

Additionally, while they might be very chatty and even dominate conversations or overshare – something they may later regret – they often feel drained after socialising. They describe being hyperaware of themselves: the words they use, difficulty interpreting social cues and intentions, and overanalysing every interaction they had with people, which can leave them feeling drained and ashamed. Due to their processing speed, they may speak before their brain can fully process what was said and how to respond, leading to regret about how they handled the conversation, when they later wish they had answered differently.

Figuring out the right level of social interaction often takes time, observation, self-awareness, and trial and error, to avoid feeling fatigued or overloading yourself. It is important to consider one’s unique circumstances, such as living situation (alone or with others), work environment (remote or in-person), and relationship status (single or partnered). For instance, some people find it helpful to schedule a set number of social interactions each week and practice self-control, rather than overcommitting with too many social engagements, which can lead to overwhelm, exhaustion, and with little time and capacity for self-regulation.

How can therapy help?

Many clients describe a lifelong sense of being different without understanding why. Receiving a diagnosis can bring clarity and open the door to deeper self-understanding and new or more effective strategies for managing life with both conditions.

Accurately diagnosing both ADHD and ASD requires a thorough history and ongoing observation over time. It is unlikely that both diagnoses will be made during a first appointment. Formal neuropsychological testing may also be recommended to improve diagnostic clarity, along with insights from a parent or loved one – people who know you well. 

No two people with a dual diagnosis of ASD and ADHD will experience the same set of symptoms, which is why adults need support that is tailored to their specific and unique challenges. These challenges may include anxiety, social isolation, or difficulties in the workplace. It is also important to know and understand that there is no ‘right’ way to be neurodivergent. Many people with autism and ADHD possess incredible creativity, empathy, and resilience.  

In therapy, clients with both diagnoses often express frustration. They may feel that standard treatment approaches don’t fit their needs, especially if those approaches only focus on one condition. Some may have spent years trying to ‘fix’ themselves using strategies that didn’t take their full neurodiversity into account. 

Understanding and validating the unique experience of living with both autism and ADHD is a crucial first step. Therapy or counselling can offer a safe space to explore identity, manage overwhelm, and develop practical tools for daily life. This might include working on executive function skills, self-advocacy, emotional regulation, or unlearning internalised shame. The goal of therapy is not to change who you are – it is to help you thrive as you are. Learning to live with both may be a continuous journey.

If you see yourself in this description, or if you are still unsure, know that you are not alone. The path to understanding your brain can be complex, but it is also empowering. Whether you are newly diagnosed or have been navigating this for years, support is available, and healing is possible.