If you've spent years feeling like you need a strict routine and also can't stand doing the same thing two days in a row, you may have come across the word AuDHD. It's a community term for being both autistic and ADHD, and for a lot of adults it's the first description that fits both halves of their experience at once.
This post covers what AuDHD means, why a combined diagnosis is newer than most people realize, how autism and ADHD can pull against each other in the same person, and what therapy for AuDHD adults involves.
What AuDHD means
AuDHD isn't a separate diagnosis in the diagnostic manuals; clinically, it means a person meets criteria for both autism and ADHD. People use the shorthand because living with both rarely feels like living with one condition plus another; the two interact, and the combination comes with its own set of strengths and struggles.
It's also more common than many people assume. A 2019 meta-analysis in The Lancet Psychiatry, pooling 96 studies, estimated that about 28% of autistic people also have ADHD, with higher estimates in studies of clinic patients than in population-based studies. A larger 2023 review of 340 publications on autistic children and adults listed ADHD among the most frequent co-occurring conditions.
Why you may only be hearing about it now
For a long time, the diagnostic manual didn't allow both diagnoses together. The DSM-IV treated an autism diagnosis as an exclusion criterion for ADHD, and the DSM-5 changed the criteria to allow a dual diagnosis. If you were evaluated as a child under the older criteria and diagnosed as autistic, an ADHD diagnosis was ruled out by definition, whatever your attention and energy looked like.
That history is part of why some adults go back to the question later in life. Someone who was told they were "just autistic" may still recognize themselves in descriptions of ADHD, and someone diagnosed with ADHD who didn't feel fully explained by it may start to wonder about autism.
How the two can pull against each other
People who are AuDHD often describe a tug-of-war inside their own day. A few of the patterns that come up most:
Routine versus novelty. The autistic side may want predictability, the same foods, and a plan for the day, while the ADHD side gets bored fast and goes looking for something new. A routine can feel safe on Monday and unbearable by Thursday.
Stimulation versus overload. ADHD can push toward noise, movement, and busy environments to stay engaged, while autistic sensory sensitivity means those same environments can tip into overload. You might seek out the coffee shop for focus and need a dark, silent room an hour later.
Executive function from two directions. ADHD tends to show up as trouble starting, staying with, and finishing tasks. In autism the difficulty is more often about switching gears, getting going without structure, and handling the friction of an open-ended day. When both are present, a plan can stall for more than one reason at once.
Masking twice. Many autistic adults learn to mask social differences, and many adults with ADHD learn to cover for missed details and lateness. Doing both all day can leave very little energy for anything else, and it can make autistic burnout and ADHD overwhelm hard to tell apart.
Why it can be hard to sort out
Even researchers debate where one condition ends and the other begins. A 2022 paper in Frontiers in Psychiatry asked whether some of the attention difficulties reported in autistic patients might be part of autism itself, and whether some restlessness might have a different cause than the restlessness typical of ADHD.
You don't need to settle that question to get help. What matters in therapy is how your attention, energy, sensory needs, and relationships work day to day, and what supports fit them.
What therapy for AuDHD involves
Therapy for AuDHD adults is neurodiversity-affirming: it focuses on the strain that piles up around both and on building a life that fits how you're wired, rather than on making you less autistic or less ADHD.
In practice that can include:
- Routines with room for change built in, such as a fixed structure for the day with a rotating set of tasks or foods inside it, so neither side has to lose.
- Sensory and energy planning, tracking what drains you and what restores you so recovery isn't always something you scramble for after the fact.
- Executive function support that targets the actual sticking point, whether it's getting started, switching tasks, or knowing what to do first.
- Unmasking where it's safe, sorting out which situations need the effort and where you can drop it.
- Relationships, including how AuDHD shows up with a partner or family. Our post on neurodivergent couples and partner burnout goes further into that side.
If medication is part of your plan, that's handled by a prescriber, and you can bring what you learn in therapy to those conversations. We don't provide formal evaluations, but we can help you think through whether one would be useful and refer you to providers who do them.
Who you'd be working with
Angelique St. Jean leads our autism-affirming work with adults, including AuDHD, and works with families adjusting to a new diagnosis. She is a Registered Associate Marriage and Family Therapist and Professional Clinical Counselor, completing doctoral work at Loma Linda University on systemic approaches to families navigating autism and other diagnoses, and she sees clients in English and Spanish. She is supervised by Christina Mathieson. Michelle Cortez also works with adult ADHD and neurodivergent clients, with a direct, structured style.
You can read more about our approach on the ADHD and autism therapy page, or in our post on autism therapy for adults.
Common questions
What does AuDHD mean?
AuDHD is a community term for being both autistic and ADHD. It isn't a separate diagnosis; clinically it means the two diagnoses apply to the same person.
Can you be diagnosed with both autism and ADHD?
Yes, the DSM-5 allows autism and ADHD to be diagnosed together. The edition before it, DSM-IV, treated an autism diagnosis as an exclusion for ADHD.
How common is it to be both autistic and ADHD?
A 2019 meta-analysis of 96 studies estimated that about 28% of autistic people also have ADHD, with higher estimates in clinic-based samples than in population-based ones.
Do I need a formal diagnosis to start therapy?
No, you can start therapy whether you have one diagnosis, both, or neither and are still figuring it out. Therapy can be a place to sort through what fits and decide whether a formal evaluation makes sense.
Does My Mental Climb diagnose autism or ADHD?
No, the practice doesn't provide formal autism or ADHD evaluations. We can help you think through whether one makes sense and refer you to providers who do them.
If this sounds like you
A free 15-minute consult with our intake coordinator is the next step. They'll listen to what you're working on and match you with the clinician who fits best. Sessions are online, by secure video from anywhere in California.
Further reading
- Lai, M.-C., et al. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. The Lancet Psychiatry, 6(10), 819–829.
- Micai, M., et al. (2023). Prevalence of co-occurring conditions in children and adults with autism spectrum disorder: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 155, 105436.
- Leitner, Y. (2014). The co-occurrence of autism and attention deficit hyperactivity disorder in children: what do we know? Frontiers in Human Neuroscience, 8, 268.
- Hours, C., Recasens, C., & Baleyte, J.-M. (2022). ASD and ADHD comorbidity: what are we talking about? Frontiers in Psychiatry, 13, 837424.
Common questions
- What does AuDHD mean?
- AuDHD is a community term for being both autistic and ADHD. It isn't a separate diagnosis; clinically it means the two diagnoses apply to the same person.
- Can you be diagnosed with both autism and ADHD?
- Yes, the DSM-5 allows autism and ADHD to be diagnosed together. The edition before it, DSM-IV, treated an autism diagnosis as an exclusion for ADHD.
- How common is it to be both autistic and ADHD?
- A 2019 meta-analysis of 96 studies estimated that about 28% of autistic people also have ADHD, with higher estimates in clinic-based samples than in population-based ones.
- Do I need a formal diagnosis to start therapy for AuDHD?
- No, you can start therapy whether you have one diagnosis, both, or neither and are still figuring it out. Therapy can be a place to sort through what fits and decide whether a formal evaluation makes sense.
- Does My Mental Climb diagnose autism or ADHD?
- No, the practice doesn't provide formal autism or ADHD evaluations. We can help you think through whether one makes sense and refer you to providers who do them.
Tagged
Last clinically reviewed: by Christina Mathieson, LMFT.
