Iāve seen it referenced on TikTok but Iām curious about the evidence. It seems pretty plausible. The same gene is involved apparently. Thereās very high ācomorbidity.ā Even in non āAuDHDersā many of the symptoms of one (that an individual ādoesnāt haveā) are present. Autists can be very different from eachother and it seems like they may sometimes have more in common with some ADHDers than eachother. Dividing things into specific labels like this is kinda lib and undialectical anyway. People already realizing Aspergers and other things were just autism. āPathological Defiant Disorderā (allegedly) seems to basically just be a common presentation of AuDHD. Thereās also the monotropism theory that both tend to be high in.
This is just my uneducated opinion on something Iāve been fixated on and pondering for a little while. Iām curious if anyone has any serious evidence or more interesting thoughts. Thereās probably also connections to other neurodivergences.
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Short version, no, they have radically different neurological differences. Leading edge research on autism shows that thereās a pattern of an overabundance of neurons in the brain at birth and an over-correction of nero pruning. Whereas the psychiatric science is settled on ADHD - several brain structures either underdevelop or develop much more slowly.
The proof is in the results, stimulants are life changing for people with ADHD, but doesnāt help with autism.
Thank you for writing this trans Karen so that I didnāt have to.
Sure thing! I try to educate on things I know well.
Cool. Unqualified speculation: what if the autistic neuro pruning results in damage to executive function, dopamine receptors, whatever else ADHD can be underdevelopement of? In that logically possible scenario ADHD is autism.
Good question! My understanding is that these things are different developments heading in different directions. Autism being pre-over developed brain parts, and ADHD starting with less neurological tools to work with and building slower.
This doesnāt mean that both canāt occur in the same person, the human brain is wildly complex. But also, if both conditions left the same part of the brain in a similar physical/neurological configuration, Iām sure thereād be some crossover traits.
Sure. But, continuing to speculate, what if these are two routes that can lead to the same place? Itās said that many grow out of it, so suppose if someone with adhd also is also slower at picking up social skills and other autistic traits and thus appears to have AuDHD, but then looks the same over time as an autist who learns to mask. Or, I find highly realistic being autistic and not held back in executive function and dopamine receptors and whatever, but simply never developing to near neurotypical levels. I donāt know if I explained that well, but basically AuDHDers could have kind of similar things in different ways - a different mechanism and process- or, of course one could have both in both ways. Some parts permanently limited or extra, some developing slower and making its way toward normality.
Btw, do you have any good further reading recommendations?
I suppose anything is possible with the complexity of our brains, but it might be too specific (and maybe rare?) to have any research that targets this specifically. Your best bet would honestly be to reach out to a psychiatry department at a research university. Maybe see if their research assistants can help you find something, or if thereās a psychiatrist who could talk with you. Youāre going to want to talk to psychiatrists specifically, theyāre medical doctors specializing in the brain, not psychologists.
As for further readingā¦ Hit the stacks lol! Iām not sure youāll find many good books on this granular of a question, so you might need to dig into research papers. One specialist in ADHD that I know of is Dr. Russell Barkley, look him up for a good primer.
Sounds daunting. I will try to read more papers and more of Barkleyās stuff.
Daunting questions require daunting research to answer lol!
The thing I tell people most of the time is that theyāre not the same thing, but theyāre close cousins.
True. I do feel an obligation to do more research before contacting a university tho.
To speculate wildly, that would make more sense than the disorders being a spectrum of one another.
Itās important to think about this stuff with a scientific perspective as well. These theories to the underlying mechanism are working understandings based on available evidence. Theyāre far from being proven fact, or even consensus, and itās entirely possible that there are confounding factors that arenāt being taken into account because of Donald Rumsfeld reasons. It might seem appealing to do, but connecting one working understanding to a second separate working understanding and then trying to synthesize novel conclusions from that doesnāt really work.
We know a lot of the symptoms that present with both disorders, we know that the symptoms share a significant amount of overlap, we know that they co-present at a higher level than the baseline (if you have one youāre more likely to be a person who has the other compared to regular-brained people), so itās highly likely that they have similar underlying physiology, but our understanding of that physiology isnāt anywhere near complete enough to make a definitive guess.
I cannot agree with the idea of them being the āsame thingā. Potentially related? High cormorbidity? Sure.
I have AuDHD and the two have been in conflict my entire life. Since I began medication for ADHD Iāve finally begun to understand how my autism actually presents and that I can comfortable live with it.
Before this I constantly encountered executive dysfunction because the two have been completely opposed.
A special interest? A desire to understand something on an extremely detailed level? An important work project that Iām both motivated to complete and will help advance my career?
Nope hereās an overwhelming urge to do literally anything else, we got the happy brain feeling from starting that, itās been 5 minutes and itās time to chase a new one.
Even sensory overload or uncomfortable feelings. Hey you want to be reminded of the time you touched something gross when youre trying to fall asleep? Or the time you ate something and it made you feel sick. Or the most anxiety inducing sound on loop in your brain. Since I started medication these intrusive thoughts have stopped almost entirely. ADHD was turning the most uncomfortable aspects of my autism against me for absolutley no personal gain.
I get that, I tend to find a lot of internal conflict in myself and explain it as those two sides fighting. Still, gotta give every idea serious though.
For me, the average ADHDer is way too different compared with me. I donāt relate to most AuDHDers here either. I relate the most to āpureā autists. One defining thing that is very noticeable to me compared with NTs and ADHDers/some AuDHDers is that Iām very prone to ritualized behavior and show complete distress when Iām forced to not perform that ritualized behavior. A lot of classic experiences ADHDer place like forgetting where they put their car keys isnāt particularly common with me because āplacing car keysā would be part of some elaborate ritualized behavior for me:
On the return home, Assortedbiscuits shall walk three steps, starting with their left foot first, and they shall reach their right pants pocket with their right hand, and they shall hold the car keys with their right thumb, right index finger, and right middle finger, and they shall remove said car keys from their right pants pocket, and they shall place the car keys in the designated car keys cornerTM of the table, and with the placing of said car keys on said car key cornerTM of the table, Assortedbiscuits shall verbally make a declaration of the placement of the car keys in the car key cornerTM of the table to conclude the placement of the car keys in the car key cornerTM of the table.
This by itself isnāt that strange. But the ritual has many prerequisites (functional right hand, right pants pocket, table, being able to walk three steps) and if those prerequisites were messed if, then the ritual canāt be completed and I will feel distress. No, using my left hand doesnāt count because the ritual demands that I use my right hand. No, I canāt walk four steps. It has to be three steps, no more and no less. If someone were to saw off the car key cornerTM of the table, I would 100% short-circuit lol
Itās not just having ritualized behavior, but rigid and elaborate ritualized behavior. I donāt see this at all in ADHDers.
Yeah, as an audhder thereās a ton of stuff I have to do in a certain way, but I also am purely spontaneous in other situations, itās weird.
Having autism does make you at increased risk for ADHD, bipolar, major depression, and schizophrenia, but not 100% of autistic people have ADHD. Also, most people with ADHD do not have autism.
That said, Iāve only met 1 autistic person (out of many) who does not also have ADHD.
Iāve only met 1 autistic person (out of many) who does not also have ADHD
Make it 2
Three?
Four
I donāt think theyāre the same thing. Bipolar, adhd, and autism all have a great deal of overlap in symptoms, and people with autism are more likely to have adhd than gen pop, but afaik they likely have distinct underlying organic causes.
People already realizing Aspergers and other things were just autism.
Same thing with ADD and ADHD being combined into one with just different subtypes. Just lumping autism and ADHD together and being aware of the diversity is fine imo.
Sib, I thought the same thing multiple times. I have no clue why it didnāt end up in the post, Ty. Dialectically we cannot cleanly cut ourselves up and decide this characteristic goes in one box and this goes in another. My neurodivergences donāt start one place and end another. I am a specific presentation of humanity and there is no one the same as me and I am not the same as myself. āPureā inattentive vs āpureā impulsive itās not clear it should be one box āADHD.ā But there are a lot of people with combined type. What if ADHD and Autism are like that, a binary of types, while a large fraction are ācombined type.ā
Thereās some research into it, but until DSM-6 we wonāt know what the canonical response will be.
Maybe I should read 5. Funny to imagine getting hyped about such a thing dropping, but that might be me. You got any of the research on hand, or do I gotta improve my use of search terms and look on pubmed rather than healthline?
I donāt have any on hand, no. Iāve read some of the papers, though, so I know they exist.
I donāt know if I totally buy this? My lived experience tells me that even if it is, the delineation would still be necessary because there are people like me who tick almost every box there is for ADHD and practically nothing-but-the-overlap with regards to autism.
Regardless, Iāll wait for the DSM/consensus judgement regarding this. Iām just skeptical as someone who is very-much-not comorbid
Totally reasonable, but I imagine an inattentive-only adhder wouldnāt feel they have much in common with someone who is only hyperactive. Or āhigh iqā hyperverbal autistic vs intellectually disabled and non-verbal. Generally, labels are stupid and include people who donāt have much in common, but also divide people who do have things in common. You canāt assume anything but people have experiences in common and language helps. I donāt know if Iām getting anywhere, my logic gets jumbled because truth isnāt objective but I want it to be.
Thereās so many differences in genome, phenotype and what comes out of the epigenetic wash that labels are only sort of helpful to a point.
Instead of getting rid of Aspergerās they could have developed more (sub) categories for autism, which has its own advantages and disadvantages.
I would be surprised if the DSM combined them because as categories theyāre still quite distinct and useful - below is a chart on the contribution of particular genetic sites to the likelihood of being diagnosed with ADHD or autism (and others)
good post I think, I am frequently bothered by how overly granular and non dialectical the classification of a lot of neurodivergences is. especially when it comes to stuff like personality disorders, very much looking at different flavors of the same few things imo. not meaning this as pushback but anecdotally I am autistic but would never meet the criteria for an ADHD diagnosis. just to share my personal experience:)
