What Is AuDHD? Signs And Treatment Explained By Experts

When people describe their experience of both autism and attention deficit hyperactivity disorder (ADHD), they increasingly refer to a dual diagnosis known informally as “AuDHD”.

While it’s not an official diagnosis in itself, it’s a useful term people are increasingly using to describe the reality of living with these forms of neurodivergence, whose traits can often be at odds with one another.

There’s not a clear cut answer on how many people have AuDHD. But some research suggests 50 to 70% of individuals with autism spectrum disorder (ASD) also have ADHD, and a Healthwatch poll of 2,500 adults with suspected or diagnosed ADHD in England found 45% said they had autism as well.

Historically, the two were considered to be mutually exclusive – per The Guardian, up until 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) said a diagnosis of one ruled out the existence of the other.

“The conversation around ‘AuDHD’ – the co-occurrence of autism and ADHD – is indeed gaining much-needed traction in the UK,” Dr Mukesh Kripalani, a consultant psychiatrist at The ADHD Centre, told HuffPost UK.

He’s right. People – including celebrities like presenter and podcast host Sam Thompson – are increasingly taking to social media to share their experiences of life with a dual diagnosis. The #AuDHD hashtag on Instagram has 440,000 posts, while the same hashtag on TikTok has over 670,000 posts.

The psychiatrist added: “As a consultant psychiatrist, I see many patients who have spent years feeling profoundly misunderstood because their presentation didn’t neatly fit into a single diagnostic box.”

It looks like autism, which can be characterised by a strong preference for routine, predictability, and deep, stable interests; and it looks like ADHD, which introduces a need for novelty, stimulation, and spontaneity, alongside executive functioning challenges.

Jenny Lucas, founder of Audhdistically Me, has lived experience of both but was only diagnosed in her late thirties. “Having both [autism and ADHD] is like having two different brains pulling against each other inside your head,” she said.

Some describe themselves as a “living contradiction”, noted Dr Kripalani, saying conflicting neurological needs associated with AuDHD can look like:

• Routine vs. novelty: The autistic side may desperately want a structured, organised environment to feel safe, but the ADHD side struggles to maintain it, leading to chronic frustration.
• Socialising: The impulsivity and chattiness of ADHD might drive a person to seek out social interaction, but the autistic side can quickly become drained by the sensory input and the effort of reading social cues.
• Focus: An individual might hyperfocus intensely on a new (rapidly changing) interest to use up dopamine quickly (as seen in ADHD), which contrasts with or runs alongside the more stable, long-term special interests typically seen in autism.

Dr Alina Vaida, a consultant psychiatrist at Midland Health, which provides ADHD and ASD assessments, described the two conditions as pulling in opposite directions.

On top of that, which can be confusing enough for those experiencing it, ADHD can also “exacerbate” autistic-related challenges, added Dr Kate Lieberman, a clinical psychologist specialising in assessment of neurodivergence at George Washington University.

She offered the example of distractibility (a trait of ADHD) being compounded by significant sensory sensitivity to noise (a trait of autism), and the challenges that brings.

“In general, folks with AuDHD may feel unsure about their identity and have difficulty understanding their own areas of strength and challenge due to the push/pull across both aspects of their neurotype,” added Dr Lieberman.

Dr Kripalani suggested that this push-pull nature can result in mental health challenges for those experiencing it. “One of the key differences we see in AuDHD is that anxiety is often a much more significant part of the picture,” the psychiatrist added.

“The constant push-and-pull between these two neurotypes – craving predictability but being driven by a restless and thrill-seeking brain – creates a chronic state of internal tension and heightened anxiety that goes beyond what we typically see in either condition alone.”

Given the traits of each can be at odds with one another, it can make AuDHD difficult to diagnose. But diagnosis is vastly important for those living with the reality of these push/pull symptoms.

When Jenny Lucas’ dual diagnosis finally came, after “almost four decades of feeling like I was doing life wrong”, it was a huge turning point for her.

“I finally understood that I wasn’t just a broken human, I was literally experiencing the world in a different way than I was taught was ‘normal’,” said the author of Autism, ADHD and Me: Your No Bullshit Guide to Life After Late Diagnosis.

“It’s hard to describe how affirming that is and how it has completely shifted my outlook on how to live, be successful and thrive, frankly.”

Dr Kripalani suggests there is a “significant underestimation” of AuDHD, “largely because the complex nature of the traits often mask one another, leading to missed or delayed dual diagnosis”.

But securing an accurate AuDHD diagnosis “is vital”, he said, as it provides the framework to finally understand the many internal contradictions of the conditions.

Such a diagnosis can help reduce self-blame and lead to identifying and managing AuDHD burnout, “an intense physical and emotional crash caused by the unique effort of managing these competing demands”.

Dr Vaida noted a diagnosis is only the start of the journey, however. “Taking time to learn what AuDHD looks like for you personally and how to manage day-to-day life is just as important,” she said, noting this period might bring relief, but also grief for the years spent struggling without understanding or support.

Therapy with a neuroaffirming provider is beneficial, said Dr Leiberman, and can help with reframing how people with AuDHD see themselves.

Treatment can also involve identifying areas that are especially challenging (sensory input, social demands, work environments) and offering accommodations to manage them.

“This may look like leaning into wearing earplugs or tinted sunglasses indoors; having quiet, alone down time at the end of one’s day; alerting family and friends that one will not be attending social events where there will be large/loud groups of people,” said Dr Leiberman.

It can also look like building strategies to manage executive functioning challenges, like getting started on tasks, breaking multistep activities into written steps, creating external deadlines for work that does not have an immediate due date, estimating and allocating time, and following through on longer-term projects.

Dr Kripalani noted that in clinical practice, “there are sometimes advantages to slightly ‘under-treating’ the ADHD symptoms”.

“If we use interventions to entirely suppress the ADHD traits, the core autistic features – such as rigidity, sensory sensitivities, and difficulties with changes in routine – can suddenly become unmasked and feel much more disabling to the patient,” he added, so a nuanced approach is key.

Dr Vaida has also seen this play out: “From clinical observation, treating the ADHD symptoms can bring the autistic traits more to the front, which some people confuse with ‘worsening their autism’.”

She suggested medication interventions need to be tailored, “as autistic people tend to be more sensitive to the ADHD medications’ side effects, so it’s often started more gradually”.

Dr Kripalini stresses that, for people with AuDHD, a 24/7 treatment approach is key. “This does not necessarily mean high doses of medication around the clock; rather, it means utilising a comprehensive, all-day management strategy,” he said.

“Support must cover the patient not just for their working hours, but in their personal life, relationships, and downtime.

“By utilising careful pharmacological management, tailored therapy, and sensory accommodations, we can effectively manage the holistic picture – particularly the severe anxiety – and help individuals with AuDHD thrive across all areas of their lives.”