# 48 - Autism, ADHD & AuDHD: Challenging the Misconceptions

What if autism, ADHD, and AuDHD aren't interchangeable—and understanding the differences could change the way you see yourself forever?

In this episode, we explore what autism, ADHD, and AuDHD really are, why they so often overlap, and the misconceptions that continue to shape public understanding. We discuss neurotypes, executive functioning, masking, sensory processing, late diagnosis, and why an AuDHD brain isn't simply "a little autism plus a little ADHD." Whether you're questioning your own neurodivergence, supporting someone you love, or simply want to better understand these experiences, this conversation offers research-informed insights with compassion and curiosity.

Resources & Research Mentioned
• Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association)
• Porges, S. W. – Polyvagal Theory
• Milton, D. – Double Empathy Problem
• Raymaker, D. M., Botha, M., et al. – Research on autistic burnout
• Murray, D., Lesser, M., & Lawson, W. – Monotropism
• Research on the co-occurrence of autism and ADHD (e.g., Antshel & Russo; Leitner)

🎧 Follow Quietly Autistic at Last so you never miss an episode.

Instagram: @quietlyautisticatlastpodcast

Disclaimer: This podcast is for educational and informational purposes only and is not a substitute for medical, psychological, or mental health advice. Every autistic, ADHD, and AuDHD experience is unique. If you have concerns about your health, please consult a qualified healthcare professional.

💙 Need support? If you're in the United States or Canada and are experiencing emotional distress or a mental health crisis, call or text 988 to reach the Suicide & Crisis Lifeline. If you're elsewhere, please contact your local crisis services or a trusted mental health professional. You deserve support.

Transcript

SPEAKER_00 0:00

Welcome back to Quietly Autistic at Last, the podcast where we explore what it means to discover autism later in life, especially as women, and how understanding ourselves can change everything. I'm your host, Dr. Allison Sukamelli. And have you ever wondered if autism and ADHD are the same thing? Can someone really be both autistic and have ADHD? Or do those diagnoses contradict each other? And if autism often values routine and ADHD often craves novelty, what happens when one person experiences both? Or have you ever looked at someone who seems successful, organized, or outgoing in thought, they can't possibly be autistic or have ADHD? Or do people with ADHD simply have a little bit of both, or is their experience something entirely different? Why do some people with ADHD feel pulled in opposite directions, wanting predictability one moment and spontaneity the next? Have you ever wondered why someone can appear highly capable one day and completely overwhelmed the next? Are people with ADHD inconsistent or are they navigating a brain that responds differently depending on context, demands, and energy? What if many of the assumptions we've been taught about autism and ADHD are incomplete? And what if understanding ADHD isn't about choosing between autism and ADHD, but learning how two neurotypes can interact with the same brain? And today we are covering these important questions and addressing misconceptions. These are questions that should probably be asked more in a variety of contexts, or simply put as what's the difference between autism, ADHD, and ADHD? And aren't they basically the same thing? The short answer, no, they are not. They overlap in fascinating ways. They frequently occur together, and from the outside, they can sometimes look remarkably similar, but they are not the same neurotype, and we'll be digging into that in a few minutes. And understanding those differences can be life-changing, especially if you've spent decades wondering why one explanation always felt incomplete. And if you're late diagnosed or beginning to question your own neurodivergence or care about someone who is neurodivergent, this episode is for you. But before we really get into it, kind reminder: this podcast is for educational purposes only and is not a substitute for medical or psychological advice. Every autistic person is unique. Every person with ADHD is unique, and every AwDHD person is unique. There is no single correct experience or a one-size-fits-all experience. Some people will relate deeply to everything we discussed today, others may relate to only pieces of it. Both experiences are true and valid. Okay, let's get into this week's episode. So, first of all, why is all of this so confusing? Don't feel bad if that is your current feeling. I'm right there with you. And to be clear, about a year ago I was first diagnosed with autism and a bit later ADHD, and I've barely had time to grapple with first what it means for me to be autistic, and then ADHD got added in for a diagnosis of Audh. I don't have all the concrete answers, and again, every AudhD experience is going to be different, unique, and valid. But as I explore what this means for me, I know that others' experiences and interpretations have really helped me, or in some instances, clarified things that I do or do not struggle with. So here we are, trying to figure it all out together in a meaningful, life-enhancing way. And until recently, professionals weren't even allowed to diagnose someone with both autism and ADHD. Prior to the publication of the DSM V in 2013, which is well past most of our childhoods, clinicians generally had to choose one diagnosis or the other. And that doesn't sound right, does it? What that meant was thousands, probably millions of people, including some of us, were diagnosed with ADHD while their autism was overlooked. Or others received an autism diagnosis while their ADHD remained invisible, or several of us late-diagnosed women were missed altogether. And today we know something very different. Research consistently shows that these conditions overlap far more often than anyone once believed. And studies estimate that 30 to 70% of autistic individuals also meet criteria for ADHD, while approximately 20 to 50% of people diagnosed with ADHD also show clinically significant autistic characteristics depending on the population studied. In other words, co-occurrence is common. It is not rare that autism and ADHD co-occur. And autism isn't simply about social skills, it's a different way of experiencing the world. And many autistic people naturally notice patterns others miss, think deeply and systematically, process information intensely, experience sensory input differently, prefer predictability, communicate more literally, and or become deeply absorbed in specific interests. Many late diagnosed women spent decades masking these differences. And we've talked more in depth about this in previous episodes. But instead of appearing obviously autistic or being perceived as stereotypically autistic, they became experts at studying people by watching them, by copying their behaviors, and performing as neurotypicals. And the invisible exhaustion from doing so over extended periods of time, we're talking years or even decades, well, that came later. And exhaustion is now wanting to collect its toll. So now let's talk about ADHD, a brain that regulates attention differently. ADHD isn't actually a shortage of attention, it's difficult regulating attention. And attention moves towards novelty, urgency, interest, and emotion rather than simply following intention. And someone with ADHD may desperately want to complete a task, but wanting isn't always enough. Executive functioning or the brain's management system is inconsistent. This is why someone with ADHD can spend six hours researching medieval castles, yet forget to answer one text message. And it's not laziness or rudeness, it's regulation. Then we come to ADHD. So if we have autism and ADHD, then what is Aud? Is it autism plus ADHD to equal Audh? Let's find out. Audh simply means someone is both autistic and has ADHD. It's not halfway autistic or autism light, as I've been horrified to hear some people refer to it as. It's not ADHD with sensory issues. Both neurotypes exist simultaneously. And a neurotype is simply the way a person's brain is naturally wired to think, process information, learn, communicate, and experience the world. So to break it down in simple terms, the neurotype is your brain's natural operating system. And a neurotypical person has a brain that develops and functions in ways that are generally considered typical within their culture or society. And an autistic person has a neurotype characterized by differences in social communication, sensory processing, focused interest, and patterns of thinking. And a person with ADHD has a neurotype characterized by differences in attention regulation, impulsivity, activity level, and executive functioning. And an ADHD person has a neurotype that includes both autism and ADHD, meaning they experience characteristics of both, often in ways that interact with and influence one another. And if every brain were a computer, a neurotype would be the operating system it came with, not the apps installed later. It's not something a person chooses or catches, so to speak. It's a natural variation in how the brain is organized and functions. Take a moment to imagine three computers sitting side by side. They may all open documents, browse the internet, and play music, but one runs Windows, one runs Mac OS, and one runs Linux. And none is inherently better than the others. They simply process information differently, have different strengths, and sometimes require different settings or software to work at their best. And neurotypes are similar. They're different ways a human brain can be wired, not different levels of intelligence or worth. And one important caveat to understand is like any analogy, this one has limits. Human brains are far more complex than computers, and no neurotype is defined solely by a list of features. The analogy simply helps illustrate that neurotypes are different ways of processing the world, not something a person chooses or can switch on and off. Autism is a neurotype. Audhd is a neurotype or a term used when someone is both autistic and has ADHD. They're not just running one system or the other, so to speak, and their experience isn't just the sum of two labels. The characteristics of autism and ADHD overlap, complement, and sometimes even seem to contradict one another or fight with one another, which creates a unique neurodevelopmental profile. However, ADHD is yet to be recognized in the DSM. So for example, an autistic person may love routines and predictability. A person with ADHD may crave novelty and struggle to maintain routines. And an Aud person may deeply need routine while simultaneously finding it difficult to stick to one. And that internal tension is one example of how the two neurotypes can interact. So imagine or remember learning to drive a stick shift. Sometimes one foot is pressing the clutch while the other is reaching for the gas. If the timing is off, the engine stalls, not because the car is broken, but because two necessary systems are trying to work together. And an ADHD brain can feel similar. The autistic part may want predictability and structure, while the ADHD part seeks novelty and spontaneity. And sometimes they move in harmony and sometimes they compete for the wheel. There are many misconceptions about ADHD, largely because people often assume autism and ADHD are either mutually exclusive or that they simply cancel each other out. And in reality, ADHD is a valid neurodevelopmental profile in which autistic and ADHD characteristics coexist and interact. So please don't be stuck on the old research. And here are some of the most common misconceptions. First one, Aud is just autism plus ADHD. Not exactly. While an AudhD person meets the criteria for both autism and ADHD, the experience isn't simply additive. The characteristics interact, creating a profile that is often different from autism alone or ADHD alone. Misconception number two, autism and ADHD cancel each other out. They don't. Instead, they often create internal tension. For example, someone may desperately need routine, that would be the autism part, while struggling to maintain it, the ADHD part. They may crave predictability, yet also become bored by it. Third misconception: everyone with Aud looks the same. No two people with AudhD are identical. Traits vary in type, intensity, and frequency. One person may experience significant sensory sensitivities, while another's biggest challenge is executive functioning or emotional regulation. Misconception number four, you can't have both. As mentioned before, this was once reflected in older diagnostic manuals, but it is no longer the case. Since the publication of DSM V in 2013, autism and ADHD can be diagnosed together when criteria for both are met. Misconception number five, if someone is successful, they can't be Aud. And many Aud people excel academically or professionally. Success doesn't erase the effort behind it. Some spend enormous amounts of energy masking, compensating, and recovering from the demands of daily life. Misconception number six, they're just indecisive or lazy. What may look like indecision can reflect competing needs, executive functioning differences, or difficulty initiating tasks. It's not simply a matter of motivation or willpower. Misconception number seven, they don't know what they want. Often they know exactly what they want. The challenge is that two legitimate needs may be pulling in different directions. For example, wanting solitude while craving connection, wanting novelty while needing routine, or wanting to begin a project while feeling unable to initiate it. Misconception number eight, they should just pick one strategy. Advice that works well for autism may not always work well for ADHD, and vice versa. Many Aud individuals need flexible supports that can be adjusted depending on the situation. Misconception number nine, they're inconsistent. People may wonder why someone can focus intensely one day and struggle the next. Aud often involves fluctuating energy, sensory load, stress levels, interest, and executive functioning. So context matters. Misconception number ten, they're making excuses. Accommodations aren't excuses. They're tools that help someone work with their brain rather than against it, much like wearing glasses helps someone see more clearly. Misconception number eleven, they don't seem autistic enough. Many late diagnosed adults, especially women, have spent years masking their autistic characteristics. Outward appearance doesn't necessarily reflect internal effort or exhaustion. And misconception number twelve, it's just anxiety. Anxiety can certainly coexist with Aud, but it doesn't explain the lifelong patterns of attention regulation, sensory processing, social communication differences, executive functioning, and restricted or deeply focused interests that characterize autism and ADHD. And a simple way to summarize all of this is ADHD isn't two separate brains taking turns. It's one brain in which autistic and ADHD characteristics coexist, overlap, and influence one another. And sometimes they work together beautifully, sometimes they create tension. And understanding that interaction is often the key to understanding the person. And luckily, the research surrounding this is changing, but there is still a lot to be done. Modern neuroscience suggests autism and ADHD share some overlapping genetic influences while remaining distinct neural developmental conditions. And brain imaging studies have found areas of overlap involving executive functioning and attention networks, alongside meaningful differences in social cognition, sensory processing, and neural connectivity. And researchers increasingly view autism and ADHD as related but separate conditions that can coexist within the same person. And the growing recognition of ADHD has helped explain why so many people previously felt that neither diagnosis alone captured their lived experience. And perhaps the most important takeaway today isn't deciding which label fits, it's understanding why your brain works the way it does. Labels aren't meant to put people into boxes, they're meant to hand people the right map. Because when you finally have the right map, you stop blaming yourself for getting lost or feeling overwhelmed in certain contexts, with certain intensity levels, or at a high frequency for you. And whether you're autistic, whether you have ADHD, whether you're Aud, or whether you're simply curious about someone you love, I hope today's conversation reminds you that neurodivergence is not about being broken. It's about understanding a brain that developed differently. When we understand the differences, we stop comparing ourselves to minds that were never built the same way, yet are assigned the same expectations and environments without our operating systems in mind. Compassion begins not with certainty, but with understanding. Okay, so there you have it. If this episode helps you better understand yourself, someone you love, or someone who may need it, share it with them and follow the podcast so you don't miss an episode. And until next time, this is Dr. Allison Sukamelli. Be gentle with your nervous system, be curious about your mind, and remember, late doesn't mean broken. Sometimes it simply means you finally found the right language for the life you've already been living. Take care and I will see you next week. And if today's episode brought up difficult emotions, please remember that support is available. In the United States and Canada, you can call or text 988 to reach the Suicide and Crisis Lifeline anytime. If you're elsewhere, please contact your local crisis services or a trusted mental health professional. You deserve support and you do not have to navigate life's challenges alone. Okay, again, see you next week.