If you’ve been diagnosed with both ADHD and autism, or if your child has, you might recognise a particular kind of exhaustion. It’s not just about managing two separate conditions. It’s about living with two neurotypes that often want completely opposite things, creating an internal tug-of-war that can feel relentless.
This combination, increasingly referred to as AuDHD in neurodivergent communities, presents unique challenges that go beyond simply adding ADHD symptoms to autistic traits. The two conditions interact in complex ways, sometimes amplifying each other, sometimes directly contradicting each other, and always creating a lived experience that’s distinctly its own.
A Relatively New Understanding
It’s essential to acknowledge upfront: the recognition that ADHD and autism frequently co-occur is relatively recent in clinical practice. For decades, diagnostic criteria actually excluded the possibility of having both conditions simultaneously. It wasn’t until the DSM-5 in 2013 that dual diagnosis became formally recognised.
Therefore, we’re still developing a complete understanding of how these conditions interact, what effective support looks like, and how to help people navigate the unique challenges of having both. Research is ongoing, clinical understanding is evolving, and much of what we know comes from the lived experiences of autistic and ADHD individuals themselves.
If you’re feeling like existing resources don’t quite capture your experience, or that professionals sometimes seem uncertain about how to help, that’s not your imagination. We’re all learning together, and your insights about your own experience are valuable data points in this developing understanding.
The Tug of War: Where ADHD and Autism Conflict
The internal conflict of combined ADHD and autism manifests in numerous ways. Here are some of the most common battles people describe:
Routine and Novelty
Autism says: “I need predictability, routine and sameness to feel safe and regulated. Changes to my schedule create anxiety and overwhelm.”
ADHD says: “I need novelty, stimulation and variety to maintain focus and motivation. Repetitive routines feel suffocating and impossible to sustain.”
The result: You might create elaborate routines to satisfy your autistic need for structure, only to find yourself unable to follow them because your ADHD brain rebels against the monotony. Or you seek out constant change to feed your ADHD, then feel dysregulated and anxious from the unpredictability.
Sensory Seeking and Sensory Avoiding
Autism says: “I need to avoid or carefully control sensory input. Certain textures, sounds or environments are genuinely painful or overwhelming.”
ADHD says: “I need sensory stimulation to regulate my attention and arousal levels. I’m drawn to intense sensory experiences.”
The result: You might crave loud music to regulate ADHD symptoms whilst simultaneously finding certain frequencies unbearable. You may need fidget toys to maintain focus, but certain textures are intolerable. The sensory input that helps one aspect of your neurology can torture another.
Social Energy
Autism says: “Social interaction is cognitively demanding work. I need extensive alone time to recover from masking and processing social information.”
ADHD says: “I need social stimulation and external regulation. Isolation leads to understimulation, time blindness and task paralysis.”
The result: You might desperately need people around to function, then find social interaction utterly exhausting. You might isolate to recover, then struggle with executive dysfunction because you’ve lost external structure and accountability.
Hyperfocus and Executive Dysfunction
Autism says: “I can achieve intense, sustained focus on areas of special interest. I want to dive deep and master specific subjects completely.”
ADHD says: “I struggle to initiate tasks, sustain attention on non-preferred activities and often can’t choose what captures my hyperfocus.”
The result: You might experience incredible periods of focused productivity on passion projects, followed by complete inability to execute basic necessary tasks. The autistic capacity for deep focus helpfully meets the ADHD inability to direct that focus where it needs to go.
Detail Orientation and Big Picture Thinking
Autism says: “I naturally notice patterns, details and systematic thinking. I want to understand things thoroughly and completely.”
ADHD says: “I see connections across broad concepts but struggle with details, sequence and systematic follow-through.”
The result: You might be simultaneously meticulous about specific details whilst completely overlooking obvious information. You see both the forest and the trees, but can’t always coordinate between them.
Communication Styles
Autism says: “I prefer direct, literal, precise communication. I need clarity and hate ambiguity.”
ADHD says: “My thoughts move quickly, I interrupt, go off on tangents and struggle to organise my communication linearly.”
The result: You value clear communication but struggle to provide it. You want direct information from others but find your own thoughts tumbling out in chaotic, non-linear ways.
The Hidden Challenges of Combined Diagnosis
Beyond these internal conflicts, having both ADHD and autism creates additional challenges:
Misdiagnosis and Delayed Diagnosis
Many people, particularly women and girls, receive one diagnosis much later than the other, or have one condition missed entirely. Autistic traits might be attributed to social anxiety or personality. ADHD symptoms might be dismissed as part of autism or as character flaws like laziness or irresponsibility.
This delayed recognition means years of struggling without appropriate understanding or support, often internalising shame about difficulties that are actually neurological differences.
Camouflaging and Masking Exhaustion
Both conditions can lead to masking: consciously or unconsciously suppressing natural behaviours to appear “normal.” When you’re managing both, the cognitive load of masking multiplies. You’re not just hiding autistic traits or compensating for ADHD symptoms; you’re trying to present as neurotypical whilst managing two different neurotypes that are already in conflict with each other.
The exhaustion from this sustained effort is profound and often leads to burnout.
Conflicting Advice and Strategies
Standard advice for one condition often contradicts advice for the other. ADHD strategies might suggest increasing stimulation and variety; autism strategies might emphasise routine and reduced input. Navigating which approach to use when, or how to adapt strategies to accommodate both, requires constant trial and error.
Identity and Self-Understanding
Understanding yourself when your own brain seems to want contradictory things is genuinely challenging. You might struggle to distinguish between “this is ADHD,” “this is autism,” and “this is just me.” Building a coherent sense of self when your neurology pulls in different directions takes time and often requires professional support.
What This Looks Like in Daily Life
For adults with combined ADHD and autism, daily life might include:
- Creating detailed plans you can’t execute, then feeling anxious about the lack of structure
- Needing people around to function, but finding socialisation overwhelming
- Being incredibly productive in hyperfocus states, then unable to do basic tasks for days
- Craving routine while simultaneously sabotaging your own systems out of boredom
- Experiencing sensory overload from stimuli you’re simultaneously seeking out
- Understanding social rules intellectually but struggling to implement them in real time
- Excelling at work, requiring both systematic thinking and creative problem-solving, while struggling with basic organisation
- Feeling exhausted from internal contradictions that others don’t see
For parents, you might notice your child:
- Thriving with structure but resisting that same structure
- Seeking sensory input, then becoming overwhelmed by it
- Being highly articulate about special interests, but unable to organise their thoughts for homework
- Needing social connection but finding playdates exhausting
- Displaying intense focus on preferred activities, alongside the inability to start non-preferred tasks
- Experiencing meltdowns from both overstimulation and understimulation
How Storm’s Edge Therapy Can Help
We understand that combined ADHD and autism requires a nuanced, individualised approach. Here’s how we can support you or your child:
Comprehensive Assessment and Understanding
We take time to understand how ADHD and autism interact, specifically for you. This isn’t about checklists or treating conditions separately; rather it’s about understanding your unique neurological profile and the particular ways these conditions create internal conflict or unexpected strengths.
Developing Personalised Coping Strategies
We work collaboratively to develop strategies that acknowledge both conditions simultaneously. This might mean:
- Creating flexible routines that provide structure without monotony
- Identifying sensory environments that satisfy ADHD needs without overwhelming autistic sensory processing
- Developing communication tools that accommodate both direct autistic communication preferences and non-linear ADHD thinking patterns
- Building executive function support that works with both hyperfocus capabilities and attentional challenges
Managing Masking and Burnout
We help you recognise when you’re masking, understand the cost, and develop sustainable approaches to navigating neurotypical environments without exhausting yourself. This includes identifying which accommodations genuinely help versus which are compensations that drain your resources.
Supporting Identity Development
Therapy provides space to explore who you are beyond diagnostic labels, while also understanding how your neurology shapes your experience. We help you distinguish between traits you want to change, traits that are neutral differences, and traits that are actually strengths in the proper context.
Family and Relational Support
For parents, we offer guidance on understanding your child’s specific needs, recognising when contradictory behaviours reflect internal neurological conflict rather than defiance, and developing parenting approaches that support both conditions.
For adults, we can support relationship dynamics by helping partners and family members understand the unique challenges and strengths of ADHD and autism co-occurring conditions.
Practical Life Skills
We work on concrete skills tailored to AuDHD neurology:
- Time management that accommodates both time blindness and the need for structure
- Organisation systems that provide clarity without rigidity
- Social skills that honour autistic communication needs while managing ADHD impulsivity
- Self-care routines that address both conditions’ regulatory needs
Strategies for Adults with Combined ADHD and Autism
If you’re navigating AuDHD yourself, here are evidence-informed approaches:
1. Embrace “Structured Flexibility”
Create framework routines with built-in variation. For example, you might have a consistent morning routine structure (shower, breakfast, admin time) but vary the specifics (different breakfast options, rotating focus tasks during admin time). This provides autistic structure whilst accommodating ADHD’s need for novelty.
2. Develop Sensory Self-Knowledge
Map your sensory profile specifically: what inputs help ADHD regulation without triggering autistic overload? Your map will be highly individual. You might discover that certain types of background noise aid focus without causing distress, or that particular fidget textures satisfy both conditions. Likewise, you can map what kinds of social interaction, problems, projects, etc., stimulate you and which ones drain you. These maps will be absolutely personal to you, and it does not matter how common or popular your needs or interests are.
3. Use External Scaffolding Wisely
Body doubling (working alongside others), visual schedules, timers and accountability systems can provide ADHD structure without requiring a rigid routine that might feel constraining. Digital tools can offer reminders without becoming overwhelming if configured thoughtfully.
4. Practice Strategic Masking
Recognise that some masking is choice-worthy (professional contexts where it serves your goals) and some is automatic and draining. The goal isn’t to never mask, but to make conscious decisions about when, where and how much. Cultivating a genuine side of your personality that is tailored to a particular situation, is not internally experienced in the same way as masking, which is demanded of you by the external environment. We propose that, through genuine curiosity, you learn the best way to present yourself by exploring and experimenting. This will be long and hard with many messy moments where you do “get it wrong” in ways that Neurotypical natives probably would not have. But the alternative of being inauthentic through merely copying or pretending leaves you feeling empty and like an impostor. This is a viable option to escape the all too familiar dilemma of either failing to fit or feeling false.
5. Plan for Downtime and Recovery
Your nervous system needs both social regulation (ADHD) and solitary recovery (autism). Schedule both intentionally. This might mean social activities followed by guaranteed alone time, or alternating between stimulating and calm days. The key here is to give yourself permission to meet your needs and to then to communicate your plan to those around you.
6. Communicate Your Needs
Help others understand that you might need seemingly contradictory things: stimulation and quiet, company and solitude, structure and flexibility. The more you can articulate your specific needs, the more others can support you effectively.
7. Celebrate Your Strengths
Combined ADHD and autism often creates unique capabilities: creative problem-solving combined with systematic implementation, big-picture thinking with attention to detail, passionate expertise alongside broad curiosity. These aren’t contradictions to overcome; they’re genuine strengths to leverage.
Guidance for Parents
If your child has combined ADHD and autism, here’s how you can support them:
Validate the Internal Conflict
Help your child understand that their brain wants opposite things is real and makes sense. They’re not being difficult or contrary; they’re managing genuine neurological complexity. This validation reduces shame and builds self-understanding.
Offer Options and Choices
Since rigid routines might fail, but a complete lack of structure creates anxiety, offer structured choices. “We have morning routine tasks, but you can choose the order” or “Pick two activities from this list for today.”
Create Sensory Flexibility
Build a sensory environment that accommodates both seeking and avoiding. Quiet spaces and stimulating spaces. Multiple texture options. Noise-cancelling headphones alongside music access. Help your child map which types of music work best at different moments to support their changing needs.
Recognise Different Types of Meltdowns
Understimulation meltdowns (ADHD) look different from overstimulation meltdowns (autism), though both might involve emotional dysregulation. Learning to distinguish them helps you respond effectively: sometimes your child needs more input, sometimes less.
Don’t Force Typical Social Development
Your child might need social connection, but in different forms or doses than neurotypical peers. Support friendships that work for them, even if they look different from expected patterns. In particular, these might break norms related to gender or age; so this will mean you paying a great deal of attention to help all parties determine what is both meaningful and safe.
Work with Schools Thoughtfully
Advocate for accommodations that address both conditions: movement breaks (ADHD) in predictable patterns (autism), choice in assignments (ADHD) within clear frameworks (autism), sensory supports that aid regulation without causing distraction. To advocate effectively for your child, it will help to consider the impact of any proposed interventions on their environment, including peers and teachers.
Manage Your Own Expectations
Your child’s development might not be linear. They might excel in unexpected areas while struggling with “basic” tasks. They might need support in areas where they previously seemed capable, or suddenly demonstrate skills you didn’t know they had. Flexibility in your expectations reduces stress for everyone.
The Path Forward
Living with combined ADHD and autism means navigating genuine internal contradictions. There’s no one-size-fits-all solution, no perfect strategy that resolves all conflicts. What there is, however, is increasing understanding, developing support systems as well as growing recognition that this combination creates a distinct experience that warrants tailored approaches.
Whether you’re an adult learning to understand yourself, or a parent supporting a child, remember: the goal isn’t to eliminate the tug of war. The goal is to understand it, work with it, and find ways to honour both aspects of your neurology rather than constantly forcing one to override the other.
This is complex, challenging work. It’s also deeply worthwhile. People with combined ADHD and autism bring unique perspectives, capabilities and creativity to the world. With appropriate understanding and support, the internal tug of war can become less about conflict and more about dynamic balance.
We’re still learning about AuDHD together: clinicians, researchers and also the neurodiverse community alike. Your experience matters, your insights are valuable, and support that truly understands the complexity is possible.
Frequently Asked Questions
Can you really have both ADHD and autism?
Yes. While historically the diagnostic criteria excluded dual diagnosis, since 2013 it’s been recognised that ADHD and autism frequently co-occur. Research suggests that 50-70% of autistic individuals also meet criteria for ADHD, and many ADHD individuals have significant autistic traits. The co-occurrence is the rule rather than the exception.
How do I know if I have both, or just one?
Determining this requires a professional assessment, as the conditions can mask one another or present similarly. However, if you notice internal conflicts where you seem to need contradictory things (routine and novelty, solitude and stimulation, structure and flexibility), this would suggest that both conditions are present. A comprehensive evaluation by a clinician familiar with both ADHD and autism is essential.
Will medication for ADHD help if I’m also autistic?
ADHD medication can be effective for people with combined ADHD and autism, helping with attention, impulsivity and executive function. However, some autistic individuals are more sensitive to medication side effects or respond differently to typical doses. Working with a prescriber who understands both conditions is important for finding the right approach.
Is AuDHD a separate diagnosis?
No, AuDHD is a community term referring to having both ADHD and autism. Clinically, you would receive two separate diagnoses. However, the term reflects the understanding that having both creates a distinct experience that’s more than just the sum of two conditions.
Can children grow out of combined ADHD and autism?
Neither ADHD nor autism are conditions you grow out of, though how they present changes across developmental phases. Children don’t become neurotypical, but they do develop coping strategies, self-understanding and skills that make daily life more manageable. With appropriate support, many adults with AuDHD live fulfilling, successful lives while remaining neurodiverse.
Where can I get help?
Storm’s Edge Therapy offers specialised therapeutic support for individuals and families navigating combined ADHD and autism. We provide personalised strategy and ongoing therapeutic support tailored to the unique challenges of AuDHD. We do not do formal diagnostic assessments for ADHD, Autism or AuDHD.
To learn more about how we can support you or your family, or to schedule a consultation, visit stormsedgetherapy.co.uk or contact our team directly.
