Autism and ADHD Together: Understanding Co-Occurring AuDHD
Autism and ADHD Together
Understanding Co-Occurring AuDHD
Autism Spectrum Disorder (ASD) | Attention-Deficit/Hyperactivity Disorder (ADHD) | Therapy in the San Francisco Bay Area | Evidence-based therapy
If you have ever felt that neither an autism description nor an ADHD description fully fits you or your child, you are not alone. Many people live with both. The informal term for this is AuDHD, a blend of “autism” and “ADHD” used widely in the neurodivergent community. This article explains what co-occurring autism and ADHD looks like, why it can be hard to recognize, and what support can help.
What Is AuDHD?
AuDHD describes the presence of both autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in the same person. It is not a separate diagnosis in the DSM-5. It is a shorthand for a common pairing.
For years, clinicians were taught that the two conditions could not be diagnosed together. The DSM-IV and ICD-10 treated them as mutually exclusive, and the DSM-5 changed this by acknowledging that they can co-occur (Hours et al., 2022). Because of this older thinking, many adults are only now discovering that both labels apply to them.
How Common Is Co-Occurring Autism and ADHD?
Researchers estimate that roughly 50 to 70 percent of autistic people also meet criteria for ADHD, although published rates vary widely depending on how studies define and measure each condition (Hours et al., 2022). The two conditions also share features, including differences in attention, executive functioning, and emotional regulation, which is part of why they are so often entangled (Gargaro et al., 2011).
AuDHD Symptoms: When the Two Pull in Opposite Directions
Autism and ADHD can look quite different from one another, and living with both can feel like an internal tug-of-war. Common experiences include:
Craving routine and novelty at the same time. Predictability feels calming, but boredom feels unbearable.
Difficulty starting and finishing tasks. Executive dysfunction can show up as struggling to begin, shift between tasks, or keep track of time.
Intense focus alongside distractibility. Deep interest in a topic can coexist with trouble sustaining attention on anything less engaging.
Sensory sensitivity and restlessness. Noise, light, or textures may overwhelm, while the body still seeks movement.
Social exhaustion. Many people want connection but find social interaction draining, and they may mask their differences to get through the day.
Emotional intensity. Big feelings and a slow recovery from overwhelm are common, and they often lead to burnout.
Why AuDHD Is Often Missed
When two conditions overlap, each can hide the other. Researchers note that diagnosing co-occurring ADHD and ASD is genuinely complex, because the symptoms overlap and the clinical picture can look different from either condition alone (Martinez et al., 2024). There is also ongoing scientific debate about whether some attention difficulties in autistic people are best understood as ADHD or as attentional traits of autism itself (Hours et al., 2022).
In practice, this means someone may receive one diagnosis, often ADHD in childhood or anxiety and depression in adulthood, while the full picture goes unrecognized. Women, girls, and adults who learned to mask their traits are especially likely to be overlooked.
Why the Distinction Matters for Treatment
Getting an accurate picture matters because strategies that help one condition can be a poor fit for the other. Research also cautions that treatment decisions in people with both conditions should be made carefully, since some ADHD medications can have unwanted effects in autistic people (Hours et al., 2022). A careful, individualized approach is essential, and medication questions belong with a qualified prescriber.
How Therapy Can Help
Therapy for AuDHD is not about changing who you are. It is about building skills and self-understanding in ways that respect how your brain works. Evidence-based approaches such as CBT and ACT can be adapted to support:
Executive functioning, planning, and daily routines
Anxiety, depression, and stress that often accompany undiagnosed neurodivergence
Burnout recovery and sustainable pacing
Self-compassion and a more accurate, less shame-based sense of identity
Communication and boundaries in relationships, work, and family life
AuDHD Support in San Francisco and Across California
At mindfulSF, our San Francisco therapy practice offers in-person sessions and telehealth across California for adults, couples, and children ages 10 and up. We provide evidence-based, neurodiversity-affirming care for ADHD, anxiety, depression, and stress and burnout, which often travel alongside autism.
If you recognize yourself or your child in this article, you do not have to sort it out alone. Contact mindfulSF to schedule a consultation with a therapist in the San Francisco Bay Area, or meet with us online from anywhere in California.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Gargaro, B. A., Rinehart, N. J., Bradshaw, J. L., Tonge, B. J., & Sheppard, D. M. (2011). Autism and ADHD: How far have we come in the comorbidity debate? Neuroscience & Biobehavioral Reviews, 35(5), 1081–1088.
Hours, C., Recasens, C., & Baleyte, J.-M. (2022). ASD and ADHD comorbidity: What are we talking about? Frontiers in Psychiatry, 13, Article 837424. https://doi.org/10.3389/fpsyt.2022.837424
Martinez, S., Stoyanov, K., & Carcache, L. (2024). Unraveling the spectrum: Overlap, distinctions, and nuances of ADHD and ASD in children. Frontiers in Psychiatry, 15, Article 1387179. https://doi.org/10.3389/fpsyt.2024.1387179
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