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.

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.

If you didn’t have food allergies as a child, is it possible to develop them as an adult? The short answer is yes. But the reasons why are much more complicated.

Preschoolers are about four times more likely to have a food allergy than adults and are more likely to grow out of it as they get older.

It’s hard to get accurate figures on adult food allergy prevalence. The Australian National Allergy Council reports one in 50 adults have food allergies. But a US survey suggested as many as one in ten adults were allergic to at least one food, with some developing allergies in adulthood.

What is a food allergy

Food allergies are immune reactions involving immunoglobulin E (IgE) – an antibody that’s central to triggering allergic responses. These are known as “IgE-mediated food allergies”.

Food allergy symptoms that are not mediated by IgE are usually delayed reactions and called food intolerances or hypersensitivity.

Food allergy symptoms can include hives, swelling, difficulty swallowing, vomiting, throat or chest tightening, trouble breathing, chest pain, rapid heart rate, dizziness, low blood pressure or anaphylaxis.

IgE-mediated food allergies can be life threatening, so all adults need an action management plan developed in consultation with their medical team.

Here are four IgE-mediated food allergies that can occur in adults – from relatively common ones to rare allergies you’ve probably never heard of.

1. Single food allergies

The most common IgE-mediated food allergies in adults in a US survey were to:

• shellfish (2.9%)
• cow’s milk (1.9%)
• peanut (1.8%)
• tree nuts (1.2%)
• fin fish (0.9%) like barramundi, snapper, salmon, cod and perch.

In these adults, about 45% reported reacting to multiple foods.

This compares to most common childhood food allergies: cow’s milk, egg, peanut and soy.

Overall, adult food allergy prevalence appears to be increasing. Compared to older surveys published in 2003 and 2004, peanut allergy prevalence has increased about three-fold (from 0.6%), while tree nuts and fin fish roughly doubled (from 0.5% each), with shellfish similar (2.5%).

While new adult-onset food allergies are increasing, childhood-onset food allergies are also more likely to be retained into adulthood. Possible reasons for both include low vitamin D status, lack of immune system challenges due to being overly “clean”, heightened sensitisation due to allergen avoidance, and more frequent antibiotic use.

2. Tick-meat allergy

Tick-meat allergy, also called α-Gal syndrome or mammalian meat allergy, is an allergic reaction to galactose-alpha-1,3-galactose, or α-Gal for short.

Australian immunologists first reported links between α-Gal syndrome and tick bites in 2009, with cases also reported in the United States, Japan, Europe and South Africa. The US Centers for Disease Control estimates about 450,000 Americans could be affected.

The α-Gal contains a carbohydrate molecule that is bound to a protein molecule in mammals.

The IgE-mediated allergy is triggered after repeated bites from ticks or chigger mites that have bitten those mammals. When tick saliva crosses into your body through the bite, antibodies to α-Gal are produced.

When you subsequently eat foods that contain α-Gal, the allergy is triggered. These triggering foods include meat (lamb, beef, pork, rabbit, kangaroo), dairy products (yoghurt, cheese, ice-cream, cream), animal-origin gelatin added to gummy foods (jelly, lollies, marshmallow), prescription medications and over-the counter supplements containing gelatin (some antibiotics, vitamins and other supplements).

Tick-meat allergy reactions can be hard to recognise because they’re usually delayed, and they can be severe and include anaphylaxis. Allergy organisations produce management guidelines, so always discuss management with your doctor.

3. Fruit-pollen allergy

Fruit-pollen allergy, called pollen food allergy syndrome, is an IgE-mediated allergic reaction.

In susceptible adults, pollen in the air provokes the production of IgE antibodies to antigens in the pollen, but these antigens are similar to ones found in some fruits, vegetables and herbs. The problem is that eating those plants triggers an allergic reaction.

The most allergenic tree pollens are from birch, cypress, Japanese cedar, latex, grass, and ragweed. Their pollen can cross-react with fruit and vegetables, including kiwi, banana, mango, avocado, grapes, celery, carrot and potato, and some herbs such as caraway, coriander, fennel, pepper and paprika.

Fruit-pollen allergy is not common. Prevalence estimates are between 0.03% and 8% depending on the country, but it can be life-threatening. Reactions range from itching or tingling of lips, mouth, tongue and throat, called oral allergy syndrome, to mild hives, to anaphylaxis.

4. Food-dependent, exercise-induced food allergy

During heavy exercise, the stomach produces less acid than usual and gut permeability increases, meaning that small molecules in your gut are more likely to escape across the membrane into your blood. These include food molecules that trigger an IgE reaction.

If the person already has IgE antibodies to the foods eaten before exercise, then the risk of triggering food allergy reactions is increased. This allergy is called food-dependent exercise-induced allergy, with symptoms ranging from hives and swelling, to difficulty breathing and anaphylaxis.

Common trigger foods include wheat, seafood, meat, poultry, egg, milk, nuts, grapes, celery and other foods, which could have been eaten many hours before exercising.

To complicate things even further, allergic reactions can occur at lower levels of trigger-food exposure, and be more severe if the person is simultaneously taking non-steroidal inflammatory medications like aspirin, drinking alcohol or is sleep-deprived.

Food-dependent exercise-induced allergy is extremely rare. Surveys have estimated prevalence as between one to 17 cases per 1,000 people worldwide with the highest prevalence between the teenage years to age 35. Those affected often have other allergic conditions such as hay fever, asthma, allergic conjunctivitis and dermatitis.

Allergies are a growing burden

The burden on physical health, psychological health and health costs due to food allergy is increasing. In the US, this financial burden was estimated as $24 billion per year.

Adult food allergy needs to be taken seriously and those with severe symptoms should wear a medical information bracelet or chain and carry an adrenaline auto-injector pen. Concerningly, surveys suggest only about one in four adults with food allergy have an adrenaline pen.

If you have an IgE-mediated food allergy, discuss your management plan with your doctor. You can also find more information at Allergy and Anaphylaxis Australia.

Clare Collins, Laureate Professor in Nutrition and Dietetics, University of Newcastle

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