Ella Tabb shares their story of being diagnosed with both autism and ADHD as an adult, how they feel the two conditions interact, and their journey of self-understanding.

My story

I received a late diagnosis of autism in my mid-thirties and an even later diagnosis of ADHD in my forties. Prior to my diagnosis I struggled with poor mental health, and very low self-esteem from a lifetime of rejection, bullying and judgement. 

I recognised I was autistic after my eldest child was diagnosed at the age of 8.   - Five years later my youngest child was diagnosed with ADHD and I once again recognised myself in the descriptions of ADHD that I read. Now I realised that just as autistic difficulties could be masked, so too can ADHD traits. I had worked so hard all my life to fit in and to “fix” myself, but instead I needed strategies, understanding and support. I began accommodating my neurodivergence, not fighting against it. 

When I went searching for strategies and information about having both autism and ADHD, or “autiHD” as many of us have begun to call the dual diagnosis, I didn’t find a huge amount of information. Until 2013 it wasn’t possible to be diagnosed with both conditions. We now need more information, research and support. 

The clash of conditions

Prior to my ADHD diagnosis, I had tried to implement many of the things that my research told me would support my autistic brain. Though I had made a lot of progress, some things just didn’t work, and my subsequent ADHD diagnosis made sense of that for me. For example, I learned that I would likely feel less anxious, and more regulated, if I could live with a routine. So I would create a routine and maintain it for a day or two, while the newness of it felt exciting and fun. Then I’d start to feel restless, needing something new and stimulating to feel content and settled. This created a push pull situation where I became overstimulated by my dopamine-seeking ADHD, but bored, sad and restless when trying to live within too rigid a structure. 

Another challenge was making self-care work for me. I discovered that time with my special interests would benefit me as an autistic person. On the occasions I managed to make time for my special interests I definitely felt calmer and more settled. However, engaging in those interests is a challenge. I get distracted by other things and find myself, frustrated when I can’t commit. 

Socialising is massively impacted by the paradoxical nature of being an autiHDer. I have difficulties with social communication, and am easily overstimulated and exhausted by social contact. But at the same time, I crave the stimulation of being around other people, and engaged in social situations. I struggle not to overbook myself socially, because invitations sound fun and exciting. Plus, I have a hard time saying “no” because as a late diagnosed neurodivergent adult I’ve developed people-pleasing tendencies, which is common after a lifetime of trying to not upset people, or be rejected. Once in the social situation my ADHD means I find myself talking too much, struggling to not interrupt people, or overshare. This, for my socially anxious autistic side is intolerable, even in the moment as it happens. Then I get home, and overanalyse everything I’ve done and said, and feel anxious about further rejection. 

Strategies that I’ve been experimenting with

I’m not claiming to have the answers to living a calm and happy life with autism and ADHD, but I’ve been experimenting with new ways of doing things, and have had some success. 

In response to my difficulties establishing a daily routine I’ve created mini routines for certain times such as morning or bedtime. This approach gives me a looser structure than a whole day mapped out, leaving room for small changes and the spontaneity that my ADHD needs, whilst still providing some predictability.
 
I’ve found ways to cope with the ADHD dopamine-seeking behaviour that don’t exhaust me. Rather than always needing to go out, I have things that give me a similar feeling that I can do at home such as playing video games, online socialising, or listening to loud music. 

I have also learnt not to over commit myself or say “yes” when carried away in the moment. My work on unmasking, and learning to love and accept myself has been key. I’ll likely always be loud and chatty, but I’m trying to see myself as worthy of respect and acceptance the way I am. 

Finally, I wanted to mention my personal experience of ADHD medication, which I have found really helpful. When more focused and calm, I have the opportunity to work on the aforementioned strategies. Additionally, it’s given me what I call a pause point - a moment to decide how to respond to any situation, rather than responding impulsively I do feel my autistic characteristics are more apparent without the overly sociable, excitable ADHD me taking the lead, and more cautious in taking on new challenges rather than eternally optimistic. 

It’s been useful to receive both diagnoses and my life is now calmer and happier. I hope that in the future those of us with autiHD will be better accommodated and understood.

Further information

• A video about autism and ADHD need clashes
• A video about the difference between autism and ADHD