Josephine Knechtli, who was diagnosed with AuDHD aged 25 (Credits: Jo Thorne)
‘I never really fit in with people that just had ADHD or were just autistic. So for me to find other people that live with both was a real lifeline.’
Harry Rutter, 25, from Cambridgeshire, is one of the many people who, in recent years, have been diagnosed with ‘AuDHD’.
Otherwise known as co-occurring autism and ADHD, they’re both neurological conditions, and until 2010, you could only be diagnosed with one or the other.
While Autism Spectrum Disorder (ASD) affects the way people communicate, behave, and interact with the world, Attention Deficit Hyperactivity Disorder (ADHD) impacts people’s ability to focus and regulate specific behaviours like inattentiveness, impulsivity, hyperactivity, and executive function.
Though it’s been 14 years since medical guidelines changed to allow people to get a dual diagnosis, it’s only recently that ‘AuDHD’ has gained popularity as a term, especially in neurodivergent online spaces.
The #AuDHD Instagram tag has been used over 70,000 times while the #AuDHD TikTok tag is even more widespread, with 2.6 billion views.
Most of this online content centres around navigating life with AuDHD and the uptick in interest is encouraging some to seek a formal diagnosis.
For therapist Josephine Knechtli, getting diagnosed with AuDHD aged 25 opened up a whole new world for her.
‘AuDHD provided the language to discuss, explore and create connections I had been sorely missing for so long,’ the now-27-year-old tells Metro.co.uk.
‘The mystery of my actions were lovingly lit up, providing a framework so I could better support myself – and ask for support too.’
Harry Rutter, 25, was also diagnosed in his twenties (Picture: Supplied)
As someone who’s been diagnosed with both, take it from me: living as an autistic person with ADHD means existing in a constant paradox.
My brain runs at 100mph, yet I need extra time to process things; I crave the dopamine hit of spontaneity, but am highly resistant to change; I’m chronically disorganized, but categorize everything in my life into lists.
Before the change in the Diagnostic and Statistical Manual of Mental Disorders, you could be autistic with ADHD traits or vice versa, but this rule meant that doctors were forced to choose one or the other.
The implication of trying to fit a square peg in a round hole is that people who are both autistic and ADHD only got 50% of the support they need.
I, for example, was diagnosed with ASD aged 10, but a lot of my very clear ADHD traits were overlooked, attributed to ASD, or, quite simply, ignored.
ADHD I was never tested for because I was ‘quiet’ and ‘good at school’, but I got diagnosed in June 2021 at 23 years old, after saving up for a private diagnosis.
Dr Pablo Jeczmien, a psychotherapist, tells Metro.co.uk that ‘there is a significant overlap in symptoms between both conditions which can create confusion for individuals seeking a diagnosis or self-diagnosing.’
Despite the overlap in symptoms, in other ways the two conditions are contradictory, he added.
‘For example, an autistic brain tends to need the same structure and routine, and carefully plan things before they happen; whereas an ADHD brain easily gets bored, favoring spontaneity and novelty.’
He also noted that ‘managing these contradictory elements can prove challenging for people living with AuDHD as techniques that work to manage one condition might worsen another, leading to an internal tug-of-war which can be debilitating.’
Charli Clement, 23 from Birmingham, is a neurodivergent author and activist. And when it comes to AuDHD, they struggled to access they support they needed as a child.
‘I am not the stereotype of ADHD, so it’s not surprising,’ they explained.
‘I am amongst one of many who was labelled with “mixed anxiety and depression” in CAMHS [Child and Adolescent Mental Health Services]. But this diagnosis actually encompassed my extremely busy brain and my Rejection Sensitivity Dysphoria that often causes extreme emotional responses like suicidal ideation for me.’
Charli Clement has struggled to access relevant support (Picture: Supplied)
As for Harry, AuDHD can feel like a ‘constant battle.’
‘You’ll be adamant on sleeping to maintain your nightly routine, ensuring you sleep enough hours, but ADHD will keep your mind awake on the next obsession, song, TV quote, film scene,’ he explains.
‘It’s exhausting! You’ll be hyperactive and keen to go to new places and explore new cities, but anxious about socialising and the obstacles in the way, a constant conflict that never seems to end.’
Research shows 30-80% of autistic children meet the threshold of ADHD, while 20-50% of ADHD children have co-occurring autism. Of course, autism and ADHD aren’t conditions you should strive to ‘cure,’ but having a better understanding of how your brain works can help day-to-day management.
For instance, Charli says that the hyperactivity related to their ADHD is ‘primarily internal,’ and that their other ADHD traits manifest in impulsive money spending and issues with executive functioning.
‘This all interacts significantly with my autistic traits, as my need for structure and routine battles with a brain that prefers to break structure or simply can’t keep up with it,’ Charli adds.
Blogger Abi Owen from Wales says she doesn’t use the term ‘AuDHD’ often unless she’s ‘talking to someone in the know.’
Abi Owen believes it’s important to recognize the two conditions (Picture: Supplied)
‘I feel like it’s easier to relate each label (ADHD or Autism) whenever it applies. I think it’s because it’s an amalgamation of two words, I’m worried people will assume I’ve misspoken, or that they’ll just discount the autism altogether.’
Still, she maintains that its ‘very important to [her] that people recognise BOTH elements, as when they come together it’s a whole different condition.’
‘I need people to understand the turmoil AuDHD produces which sets me apart from those with just one or the other,’ the 24-year-old adds.
‘Having both does not change how one or the other affects me.’
So, how do you navigate life with AuDHD?
Take it from me: it certainly has its challenges, but it ultimately all comes down to two things: self-forgiveness and patience. Just because you experience the world a different way to most people, that doesn’t make you somehow ‘lesser’ or deficient.
You might have a different way of doing things, or different energy levels to neurotypical people, but that’s okay! Embracing who you are is the first step to not living with AuDHD, but thriving with it.
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It’s like existing in a constant paradox.
