What is AuDHD? Autism and ADHD Together, Explained

A word you won’t find in a textbook

AuDHD isn’t a diagnosis. You won’t find it in the DSM or the ICD. It’s a word that autistic people with ADHD came up with themselves, because nobody else had given them one.

I’ve started hearing it in my clinic room more and more over the past couple of years. Usually from adults in their thirties and forties who have just worked out, or just been told, that the two things they’ve been struggling with for their whole life are actually two things. Not one thing they were bad at.

If that’s you, or your child, this post is for you.

Two conditions that were never supposed to overlap

Until 2013, you couldn’t officially have both. The diagnostic manual said if you were autistic, your attention problems were part of the autism and that was that. A lot of clinicians who trained before then still think that way, which is one reason so many people get half a diagnosis.

The rule changed because the evidence didn’t fit it. Depending on which study you read, somewhere between a third and two thirds of autistic people also meet the criteria for ADHD. Go the other way and roughly one in five people with ADHD are also autistic. Those aren’t small numbers. Having both is closer to the norm than the exception.

Why it feels like a tug of war

Here’s the bit that people with AuDHD recognise instantly and everyone else finds hard to picture.

Autism, broadly, wants sameness. Routine. Predictability. Knowing what’s coming. Deep focus on the things that matter to you and not much patience for the things that don’t.

ADHD, broadly, wants novelty. Stimulation. Movement. It gets bored, it gets restless, and it drifts away from a task the moment the task stops being interesting.

Now put both in one nervous system.

You crave routine and can’t stick to one. You plan your week in detail and abandon the plan by Tuesday, then feel awful about it in a way that goes far beyond ordinary disappointment. You need quiet to function and you also can’t sit in quiet without going up the walls. You hyperfocus on something for nine hours, forget to eat, and then can’t start a five minute job for three days.

One client described it to me as having a foot on the accelerator and a foot on the brake at the same time, all day, every day. That’s about right. And it’s exhausting in a way that people who have only one of the two conditions don’t always understand.

Why it gets missed

The two conditions hide each other.

The ADHD side can make someone look sociable, chatty, impulsive. That doesn’t fit the picture most people carry of autism, so nobody looks for it. The autistic side can produce enough structure and rule following to hold ADHD together, at least on the surface, so nobody looks for that either.

Women and girls get missed most. They tend to mask harder, they’re taught earlier to sit still and be agreeable, and the diagnostic criteria were written mostly around boys. I see a lot of women who reached their late thirties with a file full of anxiety and depression diagnoses before anyone asked the more basic question.

The other thing that gets missed is what the person has been doing to cope. Years of white knuckling through school and work leaves a mark. By the time someone gets to me, the AuDHD is often the smaller problem. The bigger one is the anxiety, the low self worth and the sheer tiredness that have grown up around it.

What it looks like in children

Parents usually notice the contradiction before they have a name for it.

A child who lines up their toys and melts down if the route to school changes, but who also can’t sit through a meal, interrupts constantly and loses everything they’re given. Teachers report a child who is clearly bright and clearly not doing the work. Bedtimes are a battle because the body won’t wind down and the brain won’t stop.

Sensory stuff tends to be big. Labels in clothes, hand dryers, the texture of certain foods. And sleep is almost always a problem.

Some of what I see in these children overlaps with retained primitive reflexes, which I’ve written about elsewhere on this site. A retained Moro reflex, for example, keeps a child’s nervous system on high alert and makes sensory overload and emotional outbursts far more likely. That’s not the same as autism or ADHD, but it can sit underneath both and make everything louder. It’s one of the first things I check, because it’s one of the few things that can be directly worked on.

Getting assessed in the UK

I’ll be honest about this. I don’t diagnose autism or ADHD. That needs a psychiatrist, a clinical psychologist or a specialist multidisciplinary team, and I’ll always point you towards one if I think a formal assessment would help.

The NHS route is slow. Adult autism and ADHD waiting lists in Cheshire and North Wales run to years in places. If you’re in England, the Right to Choose scheme lets your GP refer you to an approved private provider at no cost to you, and it has cut the wait dramatically for a lot of people. Ask your GP about it by name. If you’re in Wales, that option doesn’t exist yet, which is a frustration I share with a lot of families across the border.

Whether you go through the NHS or privately, ask for an assessment that covers both conditions. Plenty of people go for an ADHD assessment, come out with a diagnosis, start medication, and only later realise the medication has made the autistic traits more visible because the ADHD was masking them. It’s better to look at the whole picture from the start.

What actually helps

The label matters less than what you do with it. Here’s what I see making a difference.

Stop trying to fix the contradiction. Most of my AuDHD clients have spent years trying to force themselves into one mode or the other. It doesn’t work. The job is to build a life that lets both sides have what they need. Predictable structure with variety inside it. Same time, same place, different task.

Get the nervous system calmer first. If you’re running on adrenaline all day, no strategy will stick. For children that often means reflex work and sensory changes at home. For adults it might mean sleep, movement, a serious look at what’s keeping you wired, and sometimes medication for the ADHD side.

Then deal with what’s grown up around it. This is where CBT earns its keep. Not to make you less autistic or less ADHD, which isn’t the goal and isn’t possible, but to take apart the anxiety, the shame and the “I’m lazy and useless” story that decades of struggling have written. I adapt the therapy to the person in front of me. Shorter sessions if needed. Written summaries. Concrete tasks rather than abstract reflection.

And expect it to take a while. Undoing thirty years of being told you’re not trying hard enough doesn’t happen in six weeks.

If this sounds like you

You don’t need a diagnosis to get in touch. Most of the people I see with this profile come to me for anxiety, low mood or a child’s behaviour, and we work out the rest together.

Read more about how I work with ADHD and autism, or about CBT for anxiety if that’s the thing keeping you up at night.

Sessions are £60. The first phone consultation is free and takes 15 minutes. Concessions for veterans, serving personnel, and blue light workers.

Call 07469 870 295 or use the contact form. If you’ve spent years feeling like two people in one body, you’re not broken. You’re just running two operating systems, and nobody handed you the manual.