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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  • Rebuilding Milo – by Dr. Aaron Horschig

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  • Wholewheat Bread vs Seeded White – Which is Healthier?

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    Our Verdict

    When comparing wholewheat bread to seeded bread, we picked the wholewheat.

    Why?

    First, we will acknowledge that this is a false dichotomy; it is possible to have seeded wholewheat bread. However, it is very common to have wholewheat bread that isn’t seeded, and white bread that is seeded. So, it’s important to be able to decide which is the healthier option, since very often, this false dichotomy is what’s on offer.

    We will also advise checking labels (or the baker, if getting from a bakery) to ensure that visibly brown bread is actually wholewheat, and not just dyed brown with caramel coloring or such (yes, that is a thing that some companies do).

    Now, as for why we chose the wholewheat over the seeded white…

    In terms of macronutrients, wholewheat bread has (on average; individual breads may vary of course) has 2x the protein and a lot more fiber.

    Those seeds in seeded bread? They just aren’t enough to make a big impact on the overall nutritional value of the bread in those regards. Per slice, you are getting, what, 10 seeds maybe? This is not a meaningful dietary source of much.

    Seeded bread does have proportionally more healthy fats, but the doses are still so low as to make it not worth the while; it just looks like a lot of expressed as a percentage of comparison, because of the wholewheat bread has trace amounts, and the seeded bread has several times those trace amounts, it’s still a tiny amount. So, we’d recommend looking to other sources for those healthy fats.

    Maybe dip your bread, of whatever kind, into extra virgin olive oil, for example.

    Wholewheat bread of course also has a lower glycemic index. Those seeds in seeded white bread don’t really slow it down at all, because they’re not digested until later.

    Want to learn more?

    You might like to read:

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    Bill Hall, 71, has been fighting for his life for 38 years. These days, he’s feeling worn out.

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    This slice of the older population is expanding rapidly. By 2030, the number of LGBTQ+ seniors is expected to double. Many won’t have partners and most won’t have children or grandchildren to help care for them, AARP research indicates.

    They face a daunting array of problems, including higher-than-usual rates of anxiety and depression, chronic stress, disability, and chronic illnesses such as heart disease, according to numerous research studies. High rates of smoking, alcohol use, and drug use — all ways people try to cope with stress — contribute to poor health.

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    Embracing aging isn’t easy for anyone, but it can be especially difficult for LGBTQ+ seniors who are long-term HIV survivors like Hall.

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    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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  • Dates vs Raisins – Which is Healthier?

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    Our Verdict

    When comparing dates to raisins, we picked the dates.

    Why?

    There are benefits for each fruit, but we say dates come out on top. See what you think:

    In terms of macros, while they’re both dried fruits, dates contain more water (unless you leave them sitting open for a while), which will tend to mathematically lower the relative percentages of other components because they’re being held against water weight too. However, even though this is the case (i.e. dates are being mathematically disadvantaged), dates contain more than twice the fiber that raisins do (8g/100g compared to raisins’ 3.7g/100g).

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    That’s more than we usually write about macros, but in this case, both fruits are ones especially often hit with the “aren’t they full of sugar though?” question, so it was important to cover the critical distinctions between the two, because they really are very different.

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    In the category of vitamins, raisins get a tally in their favor. Raisins are higher in vitamins B1, B2, C, E, K, and choline, while dates are higher in vitamins A, B3, B5, and B9, giving raisins a 6:4 lead here. In dates’ defense, the difference in vitamin K is marginal, and it’d make it a 5:4 lead if we considered that within the margin of error (because all these figures are of course based on averages), and the vitamins that dates are higher in, the margins are much wider indeed, meaning that both fruits have approximately the same overall levels of vitamins when looked at in total, but still, we’ll call this category a nominal win for raisins.

    When it comes to minerals, dates have more magnesium, selenium, and zinc, while raisins have more copper, iron, phosphorus, and potassium. Nominally that’s a 4:3 lead for raisins, but if we consider that raisins also contain more sodium, it’s more like a tie here. If we have to pick one though, this is a very slight win for raisins.

    Adding up the sections, we have one huge win for dates (macros) with two very marginal wins for raisins—hence, we say that dates win out.

    Still, of course enjoy both; diversity is good for the health.

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  • Nicotine pouches are being marketed to young people on social media. But are they safe, or even legal?

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    Flavoured nicotine pouches are being promoted to young people on social media platforms such as TikTok and Instagram.

    Although some viral videos have been taken down following a series of reports in The Guardian, clips featuring Australian influencers have claimed nicotine pouches are a safe and effective way to quit vaping. A number of the videos have included links to websites selling these products.

    With the rapid rise in youth vaping and the subsequent implementation of several reforms to restrict access to vaping products, it’s not entirely surprising the tobacco industry is introducing more products to maintain its future revenue stream.

    The major trans-national tobacco companies, including Philip Morris International and British American Tobacco, all manufacture nicotine pouches. British American Tobacco’s brand of nicotine pouches, Velo, is a leading sponsor of the McLaren Formula 1 team.

    But what are nicotine pouches, and are they even legal in Australia?

    Like snus, but different

    Nicotine pouches are available in many countries around the world, and their sales are increasing rapidly, especially among young people.

    Nicotine pouches look a bit like small tea bags and are placed between the lip and gum. They’re typically sold in small, colourful tins of about 15 to 20 pouches. While the pouches don’t contain tobacco, they do contain nicotine that is either extracted from tobacco plants or made synthetically. The pouches come in a wide range of strengths.

    As well as nicotine, the pouches commonly contain plant fibres (in place of tobacco, plant fibres serve as a filler and give the pouches shape), sweeteners and flavours. Just like for vaping products, there’s a vast array of pouch flavours available including different varieties of fruit, confectionery, spices and drinks.

    The range of appealing flavours, as well as the fact they can be used discreetly, may make nicotine pouches particularity attractive to young people.

    Two teenage girls vaping on a blanket in a park.
    Vaping has recently been subject to tighter regulation in Australia.
    Aleksandr Yu/Shutterstock

    Users absorb the nicotine in their mouths and simply replace the pouch when all the nicotine has been absorbed. Tobacco-free nicotine pouches are a relatively recent product, but similar style products that do contain tobacco, known as snus, have been popular in Scandinavian countries, particularly Sweden, for decades.

    Snus and nicotine pouches are however different products. And given snus contains tobacco and nicotine pouches don’t, the products are subject to quite different regulations in Australia.

    What does the law say?

    Pouches that contain tobacco, like snus, have been banned in Australia since 1991, as part of a consumer product ban on all forms of smokeless tobacco products. This means other smokeless tobacco products such as chewing tobacco, snuff, and dissolvable tobacco sticks or tablets, are also banned from sale in Australia.

    Tobacco-free nicotine pouches cannot legally be sold by general retailers, like tobacconists and convenience stores, in Australia either. But the reasons for this are more complex.

    In Australia, under the Poisons Standard, nicotine is a prescription-only medicine, with two exceptions. Nicotine can be used in tobacco prepared and packed for smoking, such as cigarettes, roll-your-own tobacco, and cigars, as well as in preparations for therapeutic use as a smoking cessation aid, such as nicotine patches, gum, mouth spray and lozenges.

    If a nicotine-containing product does not meet either of these two exceptions, it cannot be legally sold by general retailers. No nicotine pouches have currently been approved by the Therapeutic Goods Administration as a therapeutic aid in smoking cessation, so in short they’re not legal to sell in Australia.

    However, nicotine pouches can be legally imported for personal use only if users have a prescription from a medical professional who can assess if the product is appropriate for individual use.

    We only have anecdotal reports of nicotine pouch use, not hard data, as these products are very new in Australia. But we do know authorities are increasingly seizing these products from retailers. It’s highly unlikely any young people using nicotine pouches are accessing them through legal channels.

    Health concerns

    Nicotine exposure may induce effects including dizziness, headache, nausea and abdominal cramps, especially among people who don’t normally smoke or vape.

    Although we don’t yet have much evidence on the long term health effects of nicotine pouches, we know nicotine is addictive and harmful to health. For example, it can cause problems in the cardiovascular system (such as heart arrhythmia), particularly at high doses. It may also have negative effects on adolescent brain development.

    The nicotine contents of some of the nicotine pouches on the market is alarmingly high. Certain brands offer pouches containing more than 10mg of nicotine, which is similar to a cigarette. According to a World Health Organization (WHO) report, pouches deliver enough nicotine to induce and sustain nicotine addiction.

    Pouches are also being marketed as a product to use when it’s not possible to vape or smoke, such as on a plane. So instead of helping a person quit they may be used in addition to smoking and vaping. And importantly, there’s no clear evidence pouches are an effective smoking or vaping cessation aid.

    A Velo product display at Dubai airport in October 2022.
    A Velo product display at Dubai airport in October 2022. Nicotine pouches are marketed as safe to use on planes.
    Becky Freeman

    Further, some nicotine pouches, despite being tobacco-free, still contain tobacco-specific nitrosamines. These compounds can damage DNA, and with long term exposure, can cause cancer.

    Overall, there’s limited data on the harms of nicotine pouches because they’ve been on the market for only a short time. But the WHO recommends a cautious approach given their similarities to smokeless tobacco products.

    For anyone wanting advice and support to quit smoking or vaping, it’s best to talk to your doctor or pharmacist, or access trusted sources such as Quitline or the iCanQuit website.The Conversation

    Becky Freeman, Associate Professor, School of Public Health, University of Sydney

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

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