What is AuDHD? 5 important things to know when someone has both autism and ADHD

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You may have seen some new ways to describe when someone is autistic and also has attention-deficit hyperactivity disorder (ADHD). The terms “AuDHD” or sometimes “AutiADHD” are being used on social media, with people describing what they experience or have seen as clinicians.

It might seem surprising these two conditions can co-occur, as some traits appear to be almost opposite. For example, autistic folks usually have fixed routines and prefer things to stay the same, whereas people with ADHD usually get bored with routines and like spontaneity and novelty.

But these two conditions frequently overlap and the combination of diagnoses can result in some unique needs. Here are five important things to know about AuDHD.

Kosro/Shutterstock

1. Having both wasn’t possible a decade ago

Only in the past decade have autism and ADHD been able to be diagnosed together. Until 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) – the reference used by health workers around the world for definitions of psychological diagnoses – did not allow for ADHD to be diagnosed in an autistic person.

The manual’s fifth edition was the first to allow for both diagnoses in the same person. So, folks diagnosed and treated prior to 2013, as well as much of the research, usually did not consider AuDHD. Instead, children and adults may have been “assigned” to whichever condition seemed most prominent or to be having the greater impact on everyday life.

2. AuDHD is more common than you might think

Around 1% to 4% of the population are autistic.

They can find it difficult to navigate social situations and relationships, prefer consistent routines, find changes overwhelming and repetition soothing. They may have particular sensory sensitivities.

ADHD occurs in around 5–8% of children and adolescents and 2–6% of adults. Characteristics can include difficulties with focusing attention in a flexible way, resulting in procrastination, distraction and disorganisation. People with ADHD can have high levels of activity and impulsivity.

Studies suggest around 40% of those with ADHD also meet diagnostic criteria for autism and vice versa. The co-occurrence of having features or traits of one condition (but not meeting the full diagnostic criteria) when you have the other, is even more common and may be closer to around 80%. So a substantial proportion of those with autism or ADHD who don’t meet full criteria for the other condition, will likely have some traits.

3. Opposing traits can be distressing

Autistic people generally prefer order, while ADHDers often struggle to keep things organised. Autistic people usually prefer to do one thing at a time; people with ADHD are often multitasking and have many things on the go. When someone has both conditions, the conflicting traits can result in an internal struggle.

For example, it can be upsetting when you need your things organised in a particular way but ADHD traits result in difficulty consistently doing this. There can be periods of being organised (when autistic traits lead) followed by periods of disorganisation (when ADHD traits dominate) and feelings of distress at not being able to maintain organisation.

There can be eventual boredom with the same routines or activities, but upset and anxiety when attempting to transition to something new.

Autistic special interests (which are often all-consuming, longstanding and prioritised over social contact), may not last as long in AuDHD, or be more like those seen in ADHD (an intense deep dive into a new interest that can quickly burn out).

Autism can result in quickly being overstimulated by sensory input from the environment such as noises, lighting and smells. ADHD is linked with an understimulated brain, where intense pressure, novelty and excitement can be needed to function optimally.

For some people the conflicting traits may result in a balance where people can find a middle ground (for example, their house appears tidy but the cupboards are a little bit messy).

There isn’t much research yet into the lived experience of this “trait conflict” in AuDHD, but there are clinical observations.

4. Mental health and other difficulties are more frequent

Our research on mental health in children with autism, ADHD or AuDHD shows children with AuDHD have higher levels of mental health difficulites than autism or ADHD alone.

This is a consistent finding with studies showing higher mental health difficulties such as depression and anxiety in AuDHD. There are also more difficulties with day-to-day functioning in AuDHD than either condition alone.

So there is an additive effect in AuDHD of having the executive foundation difficulties found in both autism and ADHD. These difficulties relate to how we plan and organise, pay attention and control impulses. When we struggle with these it can greatly impact daily life.

5. Getting the right treatment is important

ADHD medication treatments are evidence-based and effective. Studies suggest medication treatment for ADHD in autistic people similarly helps improve ADHD symptoms. But ADHD medications won’t reduce autistic traits and other support may be needed.

Non-pharmacological treatments such as psychological or occupational therapy are less researched in AuDHD but likely to be helpful. Evidence-based treatments include psychoeducation and psychological therapy. This might include understanding one’s strengths, how traits can impact the person, and learning what support and adjustments are needed to help them function at their best. Parents and carers also need support.

The combination and order of support will likely depend on the person’s current functioning and particular needs. https://www.youtube.com/embed/pMx1DnSn-eg?wmode=transparent&start=0 ‘Up until recently … if you had one, you couldn’t have the other.’

Do you relate?

Studies suggest people may still not be identified with both conditions when they co-occur. A person in that situation might feel misunderstood or that they can’t fully relate to others with a singular autism and ADHD diagnosis and something else is going on for them.

It is important if you have autism or ADHD that the other is considered, so the right support can be provided.

If only one piece of the puzzle is known, the person will likely have unexplained difficulties despite treatment. If you have autism or ADHD and are unsure if you might have AuDHD consider discussing this with your health professional.

Tamara May, Psychologist and Research Associate in the Department of Paediatrics, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Science and Technology of Growing Young – by Sergey Young

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    There are a lot of very optimistic works out there that promise the scientific breakthroughs that will occur very soon. Even amongst the hyperoptimistic transhumanism community, there is the joke of “where’s my flying car?” Sometimes prefaced with “Hey Ray, quick question…” as a nod to (or sometimes, direct address to) Ray Kurzweil, the Google computer scientist and futurist.

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    Our author, Sergey Young, is not a scientist, but an investor with fingers in many pies. Specifically, pies relating to preventative medicine and longevity. Does that make him an unreliable narrator? Not necessarily, but it means we need to at least bear that context in mind.

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  • The Best Menopause Advice You Don’t Want To Hear About

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    Nutritionist and perimenopause coach Claudia Canu, whom we’ve featured before in our Expert Insights segment, has advice:

    Here’s to good health

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    Or at least, cut back, and manage the effects by ensuring good hydration, having an “alcohol curfew” and so forth.

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  • 4 ways to cut down on meat when dining out – and still make healthy choices

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    Many of us are looking for ways to eat a healthier and more sustainable diet. And one way to do this is by reducing the amount of meat we eat.

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    So what are your best options at a cafe or restaurant? Here are some guiding principles to keep in mind when cutting down on meat.

    Mikhaylovskiy/Shutterstock

    Health benefits to cutting down

    Small amounts of lean meat can be part of a healthy, balanced diet. But the majority of Australians still eat more meat than recommended.

    Only a small percentage of Australians (10%) are vegetarian or vegan. But an increasing number opt for a flexitarian diet. Flexitarians eat a diet rich in fruits and vegetables, while still enjoying small amounts of meat, dairy, eggs and fish.

    Our recent research looked at whether the average Australian diet would improve if we swapped meat and dairy for plant-based alternatives, and the results were promising.

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    Including more fibre and less saturated fat helps reduce the risk of heart disease.

    Achieving these health benefits may be as simple as swapping ham for baked beans in a toastie for lunch, or substituting half of the mince in your bolognese for lentils at dinner.

    A hand holding a plate filled with vegetables and pita bread.
    Filling your plate with fibre-rich foods can help lower cholesterol. Wally Pruss/Shutterstock

    How it’s made matters

    For a long time we’ve known processed meats – such as ham, bacon and sausages – are bad for your health. Eating high amounts of these foods is associated with poor heart health and some forms of cancer.

    But the same can be true of many processed meat alternatives.

    Plant-based alternatives designed to mimic meat, such as sausages and burgers, have become readily available in supermarkets, cafes and restaurants. These products are ultra-processed and can be high in salt and saturated fat.

    Our study found when people replaced meat and dairy with ultra-processed meat alternatives – such as plant-based burgers or sausages – they ate more salt and less calcium, compared to eating meat or healthy plant-based options.

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    Tofu can be a great option. But we recommend flavouring plain tofu with herbs and spices yourself, as pre-marinated products are often ultra-processed and can be high in salt.

    What about when dining out?

    When you’re making your own food, it’s easier to adapt recipes or reduce the amount of meat. But when faced with a menu, it can be difficult to work out what is the best option.

    Two people eat noodles from takeaway bowls.
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    Here are our four ways to make healthy choices when you eat out:

    1. Fill half your plate with vegetables

    When cutting down on meat, aim for half your plate to be vegetables. Try to also eat a variety of colours, such as leafy green spinach, red capsicum and pumpkin.

    When you’re out, this might look like choosing a vegetable-based entree, a stir-fry or ordering a side salad to have with your meal.

    2. Avoid the deep fryer

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    This could mean choosing vegetarian dumplings that are steamed not fried, or poached eggs at brunch instead of fried. Ordering a side of roast vegetables instead of hot chips is also a great option.

    3. Pick wholegrains

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    4. If you do pick meat – choose less processed kinds

    You may not always want, or be able, to make a vegetarian choice when eating out and with other people. If you do opt for meat, it’s better to steer clear of processed options like bacon or sausages.

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    Laura Marchese, PhD candidate at the Institute for Physical Activity and Nutrition, Deakin University and Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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    Firstly, let’s note that this book was published in 2018, so the “radical new” approach is more like “tried and tested and validated” now.

    Of course, inflammation in the brain is also linked to Alzheimer’s, Parkinson’s, and other neurodegenerative disorders, but that’s not the main topic here.

    Dr. Bullmore, a medical doctor, psychiatrist, and neuroscientist with half the alphabet after his name, knows his stuff. We don’t usually include author bio information here, but it’s also relevant that he has published more than 500 scientific papers and is one of the most highly cited scientists worldwide in neuroscience and psychiatry.

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  • Making Friends With Your Gut (You Can Thank Us Later)

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    Gut Health 101

    We have so many microorganisms inside us, that by cell count, their cells outnumber ours more than ten-to-one. By gene count, we have 23,000 and they have more than 3,000,000. In effect, we are more microbe than we are human. And, importantly: they form a critical part of what keeps our overall organism ticking on.

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    Our trillions of tiny friends keep us alive, so it really really pays to return the favor.

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    Probiotics and fermented foods

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    Read from the NIH: Probiotics: What You Need To Know

    As for fermented foods, not every fermented food will boost your microbiota, but great options include…

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      • You’ll often hear kimchi mentioned; that is also pickled vegetables, usually mostly cabbage. It’s just the culinary experience that differs. Unlike sauerkraut, kimchi is usually spiced, for example.
    • Kombucha (a fermented sweet tea)
    • Miso & tempeh (different preparations of fermented soy)

    The health benefits vary based on the individual strains of bacteria involved in the fermentation, so don’t get too caught up on which is best.

    The best one is the one you enjoy, because then you’ll have it regularly!

    Feed them plenty of prebiotic fibers

    Those probiotics you took? The bacteria in them eat the fiber that you can’t digest without them. So, feed them those sorts of fibers.

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    Sugar and (and, counterintuitively, aspartame) can cause unfortunate gut microbe imbalances. Put simply, they kill some of your friends and feed some of your enemies. For example…

    Candida, which we all have in us to some degree, feeds on sugar (including the sugar formed from breaking down alcohol, by the way) and refined carbs. Then it grows, and puts its roots through your intestinal walls, linking with your neural system. Then it makes you crave the very things that will feed it and allow it to put bigger holes in your intestinal walls.

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    The usual five things

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    2. Good exercise (yes, really)
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    5. Don’t smoke (it’s bad for everything, including gut health)

    One last thing you should know:

    If you’re used to having animal products in your diet, and make a sudden change to all plants, your gut will object very strongly. This is because your gut microbiome is used to animal products, and a plant-based diet will cause many helpful microbes to flourish in great abundance, and many less helpful microbes will starve and die. And they will make it officially Not Fun™ for you.

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    1. Do it anyway, and sit it out (and believe us, you’ll be sitting), get the change over with quickly, and enjoy the benefits and much happier gut that follows.
    2. Make the change gradual. Reduce portions of animal products slowly, have “Meatless Mondays” etc, and slowly make the change over. This—for most people—is pretty comfortable, easy, and effective.

    And remember: the effects of these things we’ve talked about today compound when you do more than one of them, but if you don’t want to take probiotics or really hate kombucha or absolutely won’t consider a plant-based diet or struggle to give up sugar or alcohol, etc… Just do what you can do, and you’ll still have a net improvement!

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  • The Fiber Fueled Cookbook – by Dr. Will Bulsiewicz

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve previously reviewed Dr. Bulsiewicz’s book “Fiber Fuelled” (which is great), but this one is more than just a cookbook with the previous book in mind. Indeed, this is even a great stand-alone book by itself, since it explains the core principles well enough already, and then adds to it.

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    Genesis (what is the etiology of your problem)

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    Click here to check out The Fiber Fueled Cookbook; your gut will thank you later!

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