For those with Autism Spectrum Disorder and ADHD co-occurring diagnoses (AuDHD, as it is starting to be known), trying to navigate brain types that seem contradictory and constantly at odds with each other is extremely challenging. The Autistic brain thrives in consistency, stability, and predictability while the ADHD brain is attracted to new, exciting experiences and hates routine. Many people describe the combination as “a constant war.” Autism seeks to pull back from overwhelming experiences while ADHD likes to full-throttle its way through. Learning how to balance these two parts of the brain is the key to effective coping. In order to do that, we must first understand a little bit more about both the Autistic and ADHD brain and what parts they play in building the system as a whole. 

*Keep in mind that this article is a general and brief overview and not every aspect of these diagnoses can be addressed. It is intended to offer a new and cohesive way of viewing the interplay of parts and how respecting what they do in the system can help the brain function more effectively as a whole.*

Autism

While there is much that is not understood about autism spectrum disorder, scientific studies have come to understand that there seem to be some underlying neurological factors that impact functioning. One study has shown that people with Autism appear to have differences in the fibers connecting the cerebellum to the cerebrum: namely that they are thinner and less dense. These parts of the brain are largely responsible for processing sensory stimuli and helping a person to develop predicative capabilities in a new situation. When the fibers connecting these brain parts are thin, being able to predict new situations is challenging and every change in the environment takes more time and effort to process. 

This may explain why people with Autism are resistant to change, experience challenges in social situations, and need consistency and routine. Every extra bit of information involved in these skills requires more energy to process and leads to total system burnout, so minimizing the unexpected can help to lighten the cognitive workload.

Another thing that increases the cognitive workload is overall sensitivity to sensory input. This is where the autistic person may be more or less responsive to incoming stimuli and either avoid or seek sensory experiences. This includes being sensitive to light (especially fluorescent lighting), noises or certain pitches of sound, and certain textures, tastes or scents, to name a few. The processing of this type of information can be overwhelming and cause meltdown or shutdown. 

If we were to summarize the part that Autism plays in the system of an individual, we could compare the body to a car and describe Autistic responses as the brakes. Brakes are used to control the momentum of the vehicle and allow it to respond to obstacles in the road. Brakes also serve to keep the car from accelerating beyond a safe speed and to keep it from careening ahead. The most challenging aspect of Autism is when symptoms lead to Autistic shutdown or meltdown. These experiences are the brain’s way of telling the system that it is overwhelmed and needs to reduce sensory input. When sensory input is sent too quickly without sufficient processing time, the brain becomes overwhelmed and responds by shutting down or melting down. A shutdown is like slamming on the brakes of the car, killing the engine, and refusing to restart. A meltdown is like an engine overheating and spewing fluids all over the asphalt. Both are responses for when the car is going too fast for the conditions on the road or exceeding the designed parameters. 

The best way to drive is by reducing the load put on the system, refraining from driving too fast, and slowing down in response to things that are happening on the road ahead. With autism and the challenges of processing stimuli and data, the most effective functioning will be to recognize the limitations of the system, recognize early signs of overwhelm, and reduce sensory input until
the brain is caught up in processing. This can look like wearing headphones to reduce auditory overstimulation, limiting social engagement, creating a consistent routine, and minimizing the overall processing load on the brain. 

Now let’s take a look at ADHD before we discuss how to manage these parts together:

ADHD

While the name we ascribe to the symptoms is Attention Deficit/ Hyperactivity Disorder, it is actually more accurate and more helpful to view ADHD as a disorder in the ability to manage attention and activity. It’s not that people with ADHD are completely unable to pay attention; it’s that they are highly driven by dopamine and have difficulty sustaining attention with things that do not produce a dopamine response (read: things that are “boring”). People with ADHD are often able to sustain attention to a high degree and “hyperfixate” on anything that catches interest.  The ADHD, dopamine-dominant brain is able to think at an incredible pace and utilize large amounts of energy, but the challenge comes in having limited ability for executive functioning: initiating a task, planning ahead, building a routine, utilizing working and remote memory are all weaknesses within the ADHD brain. When you think about it, executive functioning skills are all skills that require the brain to slow down and sustain attention and energy on the task at hand, which is counter to how the brain prefers to operate. 

If we continue to utilize the analogy of the body as a car, the ADHD brain functions as the accelerator: it likes to keep things kicked into high gear, see how fast we can go, pedal to the medal until something makes us stop! And much like would happen in a car that is accelerating too quickly for too long, with ADHD impulses to drive as fast and hard as possible, there will eventually be something that makes us stop. ADHD results in burnout from overactivity, much the way that Autism leads to burnout with overprocessing. Finding ways to engage the accelerator while limiting the top speed is the prime directive of effective coping with ADHD.

Putting it All Together:

A car with a functioning accelerator and brake, operated by a skilled driver, is a highly effective machine. To be a skilled driver is to understand the parts of the machine and use each part in an appropriate timing. While it may take some time to learn how to engage both parts of the AuDHD brain, if we can learn to view each part as an integral piece of the system as a whole, we can respect the roles they serve to keep the body and brain functional and within more optimal operating limits. 

Viewing Autism as a part with an active and supporting role to play means acknowledging that there are limitations to the amount of processing that can happen in any given moment. It means allowing for the system to reign in its resources and limit stimuli until the brain is able to catch up on processing the information it has already taken in. When Autism is seeking to be heard, what it usually has to say is, “I’m working really hard and I need the system to let me catch up before we do anything new.” 

The ADHD accelerator can be a great tool to keep the system active and engaged, as Autism sometimes likes to leave the system idle for longer than is helpful. It uses its amazing tools of attention and activity to act on impulses that will engage the system and keep it rolling. What ADHD has to say is: “I’ve been sitting still for too long, I’m ready to re-engage.”

Part of being effective with the AuDHD combination is learning to listen to the wisdom each part
is trying to share: the wisdom of “I’m overstimulated, I need to pull back” and “I’m understimulated and need to engage.” To pull back from the overstimulation that is common in both Autism meltdown/shutdown and ADHD burnout can involve removing stimuli and unpredictability from the environment. This may mean limiting social interactions, utilizing a schedule and routines, or limiting overwhelming stimuli through the use of headphones, earplugs, sunglasses, or other devices. It may also mean moving to an environment that does not contain triggering sounds, smells, lights, or textures. There may be times when these adaptations cannot be made, and tools such as mindfulness, breathing exercises, and healthy distractions may allow the person to cope in the stressful and overstimulating environment. The wisdom of the ADHD part may also provide access to regulating stress in these moments by providing opportunities to engage in stimming (“self-stimulation” or intentionally drawing awareness to a supportive stimuli) such as rocking, fidgeting with clothing/accessories, hair, or fidget toys, utilizing aromatherapy with soothing scents, etc. 

There are also times where ADHD may present a challenge and lead to significantly disordered attention, difficulty initiating or prioritizing tasks. The wisdom of the Autistic part can help activate the system and move toward order by engaging in schedules and routines, or utilizing special interests to help initiate a task, such as viewing a cleaning task or errand as a quest (special interest of gaming or Cosplay). Engaging in a special interest may also help mobilize the individual to get out of the house or off the couch so that the system can shift into activity when it becomes stuck. Body doubling is another way to help initiate tasks, as having another person around can stimulate the ADHD brain into action and provide co-regulation to help moderate the nervous system. 

If you would like more help accessing or practicing these or other tools, seeking a therapist, psychologist, or psychiatrist with experience and expertise in neurodivergence is the best way to increase resources and gain support as you work to more effectively manage the challenges that come from having a brain that functions on a different wave-length.