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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.
![](https://images.theconversation.com/files/604275/original/file-20240702-17-740wlj.jpg?ixlib=rb-4.1.0&rect=38%2C22%2C5049%2C3363&q=45&auto=format&w=754&fit=clip)
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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Small Changes For A Healthier Life
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
I am interested in what I can substitute for ham in bean soup?
Well, that depends on what the ham was like! You can certainly buy ready-made vegan lardons (i.e. small bacon/ham bits, often in tiny cubes or similar) in any reasonably-sized supermarket. Being processed, they’re not amazing for the health, but are still an improvement on pork.
Alternatively, you can make your own seitan! Again, seitan is really not a health food, but again, it’s still relatively less bad than pork (unless you are allergic to gluten, in which case, definitely skip this one).
Alternatively alternatively, in a soup that already contains beans (so the protein element is already covered), you could just skip the ham as an added ingredient, and instead bring the extra flavor by means of a little salt, a little yeast extract (if you don’t like yeast extract, don’t worry, it won’t taste like it if you just use a teaspoon in a big pot, or half a teaspoon in a smaller pot), and a little smoked paprika. If you want to go healthier, you can swap out the salt for MSG, which enhances flavor in a similar fashion while containing less sodium.
Wondering about the health aspects of MSG? Check out our main feature on this, from last month:
I thoroughly enjoy your daily delivery. I’d love to see one for teens too!
That’s great to hear! The average age of our subscribers is generally rather older, but it’s good to know there’s an interest in topics for younger people. We’ll bear that in mind, and see what we can do to cater to that without alienating our older readers!
That said: it’s never too soon to be learning about stuff that affects us when we’re older—there are lifestyle factors at 20 that affect Alzheimer’s risk at 60, for example (e.g. drinking—excessive drinking at 20* is correlated to higher Alzheimer’s risk at 60).
*This one may be less of an issue for our US readers, since the US doesn’t have nearly as much of a culture of drinking under 21 as some places. Compare for example with general European practices of drinking moderately from the mid-teens, or the (happily, diminishing—but historically notable) British practice of drinking heavily from the mid-teens.
How much turmeric should I take each day?
Dr. Michael Greger’s research (of “Dr. Greger’s Daily Dozen” and “How Not To Die” fame) recommends getting at least ¼ tsp turmeric per day
Remember to take it with black pepper though, for a 2000% absorption bonus!
A great way to get it, if you don’t want to take capsules and don’t want to eat spicy food every day, is to throw a teaspoon of turmeric in when making a pot of (we recommend wholegrain!) rice. Turmeric is very water-soluble, so it’ll be transferred into the rice easily during cooking. It’ll make the rice a nice golden yellow color, and/but won’t noticeably change the taste.
Again remember to throw in some black pepper, and if you really want to boost the nutritional content,some chia seeds are a great addition too (they’ll get cooked with the rice and so it won’t be like eating seeds later, but the nutrients will be there in the rice dish).
You can do the same with par-boiled potatoes or other root vegetables, but because cooking those has water to be thrown away at the end (unlike rice), you’ll lose some turmeric in the water.
Request: more people need to be aware of suicidal tendencies and what they can do to ward them off
That’s certainly a very important topic! We’ll cover that properly in one of our Psychology Sunday editions. In the meantime, we’ll mention a previous special that we did, that was mostly about handling depression (in oneself or a loved one), and obviously there’s a degree of crossover:
The Mental Health First-Aid That You’ll Hopefully Never Need
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Afterwork – by Joel Malick and Alex Lippert
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Regular 10almonds readers may remember that one of the key unifying factors of Blue Zones supercentenarians is the importance of having purpose, sometimes called ikigai (borrowing the Japanese term, as a nod to the Okinawan Blue Zone).
The authors are financial advisors by profession, but don’t let that fool you; this book is not about retirement financial planning, but rather, simply addressing a problem that was often presented to them while helping people plan their retirements:
A lot of people find themselves adrift without purpose at several points in life. Often, these are: 1) early twenties, 2) some point in the midlife, and/or 3) retirement. This book addresses the third of those life points.
The authors advise cultivating 10 key disciplines; we’ll not keep them a mystery; they are:
- Purpose
- Calendar
- Movement
- Journaling
- Faith
- Connection
- Learning
- Awareness
- Generosity
- Awe
…which each get a chapter in this book.
A note on the chapter about faith: the authors are Christians, and that does influence their perspective here, but if Christianity’s not your thing, then don’t worry: the rest also stands on its own feet without that.
The general “flavor” of the book overall is in essence, embracing a new period of enjoying what is in effect the strongest, most potentially impactful version of you you’ve ever been, as well as avoiding the traps of retirement “sugar rush” and “retirement drift”, to define, well, a more purposeful life—with what’s most meaningful to you.
The style of the book is self-help in layout, with occasional diagrams, flowcharts, and the like; sometimes we see well-sourced stats, but there’s no hard science here. In short, a simple and practical book.
Bottom line: if your retirement isn’t looking like what you imagined it to be, and/or you think it could be more fulfilling, then this book can help you find, claim, and live your ikigai.
Click here to check out Afterwork, and indeed live a future that’s worthy of dreams!
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Heart Smarter for Women – by Dr. Jennifer Mieres
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Dr. Mieres takes us through understanding our own heart disease risks as individuals rather than as averages. As the title suggests, she does assume a female readership, so if you are a man and have no female loved ones, this might not be the book for you. But aside from that, she walks us through examining risk in the context of age, other health conditions, lifestyle factors, and so forth—including not turning a blind eye to factors that might intersect, such as for example if a physical condition reduces how much we can exercise, or if there’s some reason we can’t follow the usual gold standard of heart-healthy diet.
On which note, she does offer dietary advice, including information around recipes, meal-planning, and what things to always have in stock, as well as what things matter the most when it comes to what and how we eat.
It’s not all lifestyle medicine though; Dr. Mieres gives due attention to many of the medications available for heart health issues—and the pros and cons of these.
The style of the book is very simple and readable pop-science, without undue jargon, and with a generous glossary. As with many books of this genre, it does rely on (presumably apocryphal) anecdotes, though an interesting choice for this book is that it keeps a standing cast of four recurring characters, each to represent a set of circumstances and illustrate how certain things can go differently for different people, with different things then being needed and/or possible. Hopefully, any given reader will find themself represented at least moderately well somewhere in or between these four characters.
Bottom line: this is a very informative and accessible book, that demystifies a lot of common confusions around heart health.
Click here to check out Heart Smarter For Women, and take control of your health!
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What you need to know about FLiRT, an emerging group of COVID-19 variants
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What you need to know
- COVID-19 wastewater levels are currently low, but a recent group of variants called FLiRT is making headlines.
- KP.2 is one of several FLiRT variants, and early lab tests suggest that it’s more infectious than JN.1.
- Getting infected with any COVID-19 variant can cause severe illness, heart problems, and death.
KP.2, a new COVID-19 variant, is now dominant in the United States. Lab tests suggest that it may be more infectious than JN.1, the variant that was dominant earlier this year.
Fortunately, there’s good news: Current wastewater data shows that COVID-19 infection rates are low. Still, experts are closely watching KP.2 to see if it will lead to an uptick in infections.
Read on to learn more about KP.2 and how to stay informed about COVID-19 cases in your area.
Where can I find data on COVID-19 cases in my area?
Hospitals are no longer required to report COVID-19 hospital admissions or hospital capacity to the Department of Health and Human Services. However, wastewater-based epidemiology (WBE) estimates the number of COVID-19 infections in a community based on the amount of COVID-19 viral particles detected in local wastewater.
View this map of wastewater data from the CDC to visualize COVID-19 infection rates throughout the U.S., or look up COVID-19 wastewater trends in your state.
What do we know so far about the new variant?
Early lab tests suggest that KP.2—one of a group of emerging variants called FLiRT—is similar to the previously dominant variant, JN.1, but it may be more infectious. If you had JN.1, you may still get reinfected with KP.2, especially if it’s been several months or longer since your last COVID-19 infection.
A CDC spokesperson said they have no reason to believe that KP.2 causes more severe illness than other variants. Experts are closely watching KP.2 to see if it will lead to an uptick in COVID-19 cases.
How can I protect myself from COVID-19 variants?
Staying up to date on COVID-19 vaccines reduces your risk of severe illness, long COVID, heart problems, and death. The CDC recommends that people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring.
Wearing a high-quality, well-fitting mask reduces your risk of contracting COVID-19 and spreading it to others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of COVID-19.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Blood-Brain Barrier Breach Blamed For Brain-Fog
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Move Over, Leaky Gut. Now It’s A Leaky Brain.
…which is not a headline that promises good news, and indeed, the only good news about this currently is “now we know another thing that’s happening, and thus can work towards a treatment for it”.
Back in February (most popular media outlets did not rush to publish this, as it rather goes against the narrative of “remember when COVID was a thing?” as though the numbers haven’t risen since the state of emergency was declared over), a team of Irish researchers made a discovery:
❝For the first time, we have been able to show that leaky blood vessels in the human brain, in tandem with a hyperactive immune system may be the key drivers of brain fog associated with long covid❞
~ Dr. Matthew Campbell (one of the researchers)
Let’s break that down a little, borrowing some context from the paper itself:
- the leaky blood vessels are breaching the blood-brain-barrier
- that’s a big deal, because that barrier is our only filter between our brain and Things That Definitely Should Not Go In The Brain™
- a hyperactive immune system can also be described as chronic inflammation
- in this case, that includes chronic neuroinflammation which, yes, is also a major driver of dementia
You may be wondering what COVID has to do with this, and well:
- these blood-brain-barrier breaches were very significantly associated (in lay terms: correlated, but correlated is only really used as an absolute in write-ups) with either acute COVID infection, or Long Covid.
- checking this in vitro, exposure of brain endothelial cells to serum from patients with Long Covid induced the same expression of inflammatory markers.
How important is this?
As another researcher (not to mention: professor of neurology and head of the school of medicine at Trinity) put it:
❝The findings will now likely change the landscape of how we understand and treat post-viral neurological conditions.
It also confirms that the neurological symptoms of long covid are measurable with real and demonstrable metabolic and vascular changes in the brain.❞
~ Dr. Colin Doherty (see mini-bio above)
You can read a pop-science article about this here:
Irish researchers discover underlying cause of “brain fog” linked with long covid
…and you can read the paper in full here:
Want to stay safe?
Beyond the obvious “get protected when offered boosters/updates” (see also: The Truth About Vaccines), other good practices include the same things most people were doing when the pandemic was big news, especially avoiding enclosed densely-populated places, washing hands frequently, and looking after your immune system. For that latter, see also:
Beyond Supplements: The Real Immune-Boosters!
Take care!
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- the leaky blood vessels are breaching the blood-brain-barrier
Super Gut – by Dr. William Davis
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You may be wondering: what sets this book apart from the other gut health books we’ve reviewed? For this one, mostly it’s depth.
This is the most scientifically dense book we’ve reviewed on gut health, so if you’re put off by that, this might not be one for you. However, you don’t need prior knowledge, as he does explain things as he goes. The advice in this book is not just the usual “gut health 101” stuff, either!
A particular strength of this book is that it looks at a wide variety of gut- and gut-related disorders, and ways certain readers may need to do different things than others, to address those problems on the path to good gut health.
The style, for all its hard science content, is quite sensationalist, and that may take some getting used to for non-Americans. However, it doesn’t affect the content!
Bottom line: if you just want simple basic advice, then probably best to skip this one. However, if you are sincerely serious about gut health (or just like reading this sort of thing because learning is satisfying), then this book is packed with relevant and detailed information.
Click here to check out Super Gut, and get to know and improve yours!
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