AuDHD: When ADHD and Autism Occur Together

What Is AuDHD?

AuDHD is a word formed from the first two letters of Autism and the last three letters of ADHD. Bringing the two words together is meant to describe how aspects and traits of both also combine within one and the same person. In German, where ADHD is called ADHS, the term is written AuDHS — both mean exactly the same thing and are literal translations of each other.

Although “AuDHD” is treated as an internet trend — as ADHD and autism already were before it — it is in fact anything but.

How Does AuDHD Show Up in Everyday Life?

AuDHD shows up above all in the way your own abilities and needs can change a great deal from one day to the next — even from one moment to the next.

On many days, it may be easy to clean or tidy up and to take part in activities. On other days, it feels almost impossible. At times, it’s extremely hard to concentrate, and an inner restlessness drives you on — then suddenly it’s a small thing.

The wish for order is often undermined by the chaos you create. Or, on the way to setting up a new system that’s meant to bring order, the system itself becomes a special interest — and it never gets put into practice.

All of this shows up above all in how hard it is, both for the people affected and for family and friends, to know where you stand and where you will stand. It’s not unusual for others not to believe that on some days you can’t “perform” as usual — after all, you managed it before. This often leads to feelings of shame and guilt, which unfortunately often characterize the inner experience of people with AuDHD.

Do I Have AuDHD or “Just” ADHD?

Whether you have AuDHD or ADHD is a very common question. What it’s primarily about is whether you’re also autistic — that is, whether you experience the world through a primarily neurodivergent lens, in which language, relationships, and even thinking serve a different function than in the conventional sense.

There’s no definitive way to tell, but there are clues that are often mentioned. With AuDHD, the restlessness often comes from a different direction. With ADHD, it drives from within and seeks stimulation: too little is happening. When autism is added, it often arises after too much — after the open-plan office, after the family gathering. Both feel like fidgetiness. But ADHD wants more, and AuDHD wants less.

Another difference that people affected often name: the “social battery” works differently and has different costs. With ADHD, you talk too much, interrupt, put your foot in it — and notice afterward. When autism is added, the situation is usually read and translated the whole time. Afterward, you need hours or days, not just a break. For autistic people — and people with AuDHD — social interaction is like an additional world, separate from the inner world, that requires translation work.

Another indicator is how long special interests or fascinating topics last. With ADHD, the topic often changes. When autism is added, a topic usually stays for years; what fluctuates is access to it.

On the one hand, there’s the path of diagnostic assessment — it can identify autism spectrum disorder and regulate access to psychotherapy, accommodations, and so on. On the other hand, there’s also the path of understanding your own neuroprofile better. For this, there are dedicated methods that aren’t diagnostic, meaning they don’t measure disorders but are meant to map your own experience.

One scientific method for this is the Zensitively Neurodivergence Inventory (ZNI), which validly measures neurodivergence. You can take this test for free on our website.

AuDHD in Women

We know that both ADHD and autism are overlooked more often in women. Naturally, this means that AuDHD is still overlooked in women, too.

In women, ADHD shows up less often in behavior or in interrupting. It’s more the thoughts that won’t stand still. The forgetfulness, or the feeling of constantly lagging behind. Compared with men, women are often better at camouflaging, that is, hiding their symptoms. Eye contact is practiced, small talk is learned by heart, gestures are copied. Historically, this has made it harder to recognize autistic symptoms in women.

When both come together, the compensation strategies add up as well — and one suddenly covers the tracks of the other. On the outside, she seems organized because she has built herself systems. She seems engaged because she knows the lines. Both are work that no one sees.

What remains is often exhaustion, shame, and guilt. So she first ends up with other explanations: depression, anxiety, exhaustion depression, burnout. The point at which it comes to light is usually not an assessment but one of two things: a breakdown — after the birth of a child, after a job change, or when her own child receives a diagnosis and the description suddenly sounds familiar — or a neurodivergence test that friends, colleagues, or family point her to.

That’s why many women only learn at 30, 40, or later what has been there since childhood.

Why AuDHD Is Often Overlooked

There are three common reasons why AuDHD is often overlooked:

1. Formally, until 2013 the diagnostic criteria ruled out an AuDHD diagnosis. Anyone assessed back then could only receive one of the two — more on this below.

2. The bigger label swallows the rest and stands alone. Once autism is on the table, restlessness and distractibility are read as part of it. Once ADHD is on the table, withdrawing after a long day counts as exhaustion. Usually, the first label to be recognized wins.

3. The two patterns can balance each other out. People who have both often seem neither especially restless or driven nor especially withdrawn or lost in their own world. On the contrary: they seem exceptionally average. On many questionnaires, they stay just below the threshold for each dimension. Only a few tests look specifically for AuDHD (such as the ZNI); most were developed either for ADHD or for autism. Yet life still feels disproportionately exhausting.

What Our Data Show

The connection is clearly visible in the data we collected ourselves. For this, 155,609 complete profiles were analyzed.

Our test measures seven areas. Two of them matter here. One describes depth of processing, meaning how deeply someone sinks into something, how much detail they experience there, and how hard it is to come back out. This depth of processing is also called monotropism and is strongly associated with autism.

The other area describes how physically someone thinks and learns: Kinetic-Cognitive Learning Style. This learning style is often associated with ADHD.

The two are more closely linked than you might expect: people who score high on one often score high on the other as well. The people in whom we see autistic patterns are largely the same people in whom we also recognize ADHD patterns.

This matches what people with AuDHD say about themselves. And it says something about the categories themselves: AuDHD is not two things that happen to occur together. It’s rather one pattern that we cut straight through with two terms.

The History of AuDHD

In diagnostic thinking, autism and ADHD lived in separate worlds for a long time. Until 1980, autistic traits were mostly filed under “childhood schizophrenia,” before the DSM-III (a diagnostic and research manual) recognized autism as a diagnosis in its own right for the first time. That same year also saw the introduction of what we now call ADHD — back then still termed “attention deficit disorder” (ADD). Yet the DSM-IV contained an exclusion clause within its ADHD criteria, so that until 2013 it was structurally impossible to receive both diagnoses at once. If the symptoms occurred in the context of a “pervasive developmental disorder” — and autism counted as one — no ADHD could be diagnosed.1 So if a person was autistic, their restlessness, distractibility, and impulsivity were, by definition, attributed to the autism as well. For almost twenty years, then, AuDHD was an impermissible diagnosis.

The justification for this was the diagnostic hierarchy: a person’s symptoms should, wherever possible, be explained by a single, overarching disorder — and autism was considered the “more pervasive” disorder, one that absorbed all the overlapping symptoms. Disability research calls the consequence of this perspective diagnostic overshadowing: the most dominant label overshadows everything else that is also there.

In everyday practice, clinicians kept encountering people who fell almost equally well into both categories, and studies showed that the two groups could hardly be cleanly separated using the existing DSM-IV criteria. In 2013, the DSM-5 finally drew the conclusion and removed the exclusion.2 As a result, dual diagnoses — AuDHD, that is — have been possible since 2013.

The term AuDHD, however, is not a term from psychiatry, psychotherapy, or research. It arose as a self-description within the neurodiversity movement. AuDHD’s rapid spread as a self-ascription began around 2022 by way of social media. More and more people shared their stories of knowing both the autism and the ADHD worlds, and of the particular challenge of not knowing which of the two they will have to step into the ring with next.3

Research, too, now confirms what the community had already named: roughly 50 to 70 percent of autistic people also meet the criteria for ADHD4 — the reverse, incidentally, does not hold; most people with ADHD are not autistic. Twin and family studies also point to substantial shared genetic foundations.5 So AuDHD names something real, for which the official system simply had no box — and, for almost two decades, not even a permissible thought.

The Problems with the Term AuDHD

The term AuDHD, though, is not entirely unproblematic. Let it be said first of all that this critique is not meant to deny anyone the identity that is bound up with this term. In fact, the biggest problem with AuDHD is not caused by the term, or the idea behind it, at all. Rather, the term actually lays bare the absurdity into which we keep manoeuvring ourselves ever further.

One of the greatest limitations for neurodiversity is that most of the terms underlying it were shaped by deficit-oriented research and language. A great deal was viewed and described through a biological or medical model. This is how terms such as autism and ADHD came about.

The problem with this is that these terms — even when we wrest them from their originally strict diagnostic corset — are descriptive. They describe categories of symptoms that a person suffers from.

We do understand, of course, that what hides behind these symptoms is not disorders but merely a difference that is discriminated against. Yet the nervous system behind the symptoms remains hazy.

The biggest problem here is that not every one of these symptom clusters, which we then divide up as autism or ADHD, points one to one to a particular way of being or of experiencing.

That is to say, a highly sensitive nervous system in an unsupportive environment can give rise to autism symptoms, ADHD symptoms, or both (AuDHD symptoms). It can also be autism symptoms for two years and then, rather, ADHD symptoms.

The symptom level is not necessarily stable over time. It is therefore rather like trying to infer a person’s uniqueness from the series of illnesses they might come down with. A difficult undertaking.

Behind this, however, lies not arbitrariness but, above all, neuronormativity. For we do not regard neurodiversity — as diversity in information processing — as worth investing in per se. Only its appearance as a form of disability, or as strong, clinically conspicuous symptoms, turns it into a financially interesting field of research.

Thanks to researchers such as Prof. Dr. André Frank Zimpel of the University of Hamburg, who heads its Center for Neurodiversity Research; Nick Walker, who coined the distinction between the pathology paradigm and the neurodiversity paradigm; or Robert Chapman of Durham University (“Empire of Normality”), there are increasingly positions, too, that think and frame neurodiversity as “diversity” from the very outset. And with that comes a great deal of hope.

A Functional Perspective on AuDHD

The term AuDHD can be liberating above all for the people who shuttle back and forth between supposedly contradictory worlds of symptoms and who, until now, have never been recognized and seen within them.

For this reason, despite all the points of criticism, I am in favor of accepting the term — above all so long as such terms are seen as a kind of “initiation”; as an entry point into, or a deconstruction of, neuronormative self-images. Not as final destinations.

It is very important to keep reminding ourselves that descriptive umbrella terms like ADHD and autism do not serve to describe the nervous system of those affected. They serve only to describe the problems that those affected experience when their nervous system repeatedly meets an environment that is not attuned to it. In almost every case it is more important to understand how one’s own nervous system works — so as to navigate the environment better and help shape it — than to obtain an official diagnosis of which groups of symptoms happen to show up when the nervous system is overtaxed. For the sad reality is that, even with a diagnosis, the environment will make no move to meet the needs of one’s nervous system over the long term and in any lasting way.

So although the problem does not lie with the affected person, the responsibility for finding a way forward, unfortunately, often does lie with that person all the same. It is as if you woke up one morning to find that people had broken into your flat during the night, thrown a wild party there, and then quietly vanished again: broken crockery everywhere, stains, confetti, rubbish. And yet you had locked the door and could do nothing about it. Of course you are not to blame for the situation. But no one is going to come and tidy your flat for you regardless. So if you want to live in a clean flat, you have to tidy up yourself — even though you did not make the mess.

This is the situation in which a great many neurodivergent people with highly sensitive nervous systems find themselves — especially, too, those who can identify with AuDHD. The sooner they accept this situation, the faster and the better they can drive their personal development forward and improve their satisfaction with life.

The decisive point in personal development and unfolding is still shaped, as ever, by a comprehensive understanding of one’s own neuroprofile. This includes metacognition — above all, knowing how we process information, that is, how we learn; the deconstruction of our internalized neuronormativity, which produces self-rejection and auto-aggression; and creative life design, which calls for actively helping to shape everyday life and can ensure that our nervous system does not merely survive but thrives. One possible way to begin exploring your own neuroprofile is, for instance, our free neurodiversity test or, with a focus on autism, our autism test or, with a focus on ADHD, our ADHD test.