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You watched the ADHD video and felt like it clarified something for you. Then you watched the autism video and thought, "Well, that sounds like me, too. So, which one is it?" Well, the answer might be both. And when autism and ADHD show
Exploring AUDHD, the unique overlap of autism and ADHD, its challenges, masking, diagnosis gaps, and coping strategies.
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Key Takeaways
- AUDHD is a distinct condition with overlapping autism and ADHD traits that interact uniquely.
- Masking two sets of symptoms simultaneously leads to significant mental health challenges.
- Diagnosis gaps exist due to outdated clinical practices and masking behaviors.
- Sensory and emotional sensitivities are intensified in AUDHD, causing daily overwhelm.
- Awareness and tailored support can improve quality of life for those with AUDHD.
What the video covers
- AUDHD refers to the co-occurrence of autism and ADHD, creating a unique blend of strengths and struggles.
- Autism and ADHD traits interact, often producing contradictory behaviors like craving routine yet needing novelty.
- Masking in AUDHD involves managing two simultaneous social and executive function masks, leading to exhaustion.
- Many clinicians still diagnose only one condition, despite nearly half of adults with ADHD showing autistic traits.
- Research shows AUDHD has distinct brain connectivity patterns, supporting it as a unique neurodevelopmental profile.
- Sensory and emotional regulation challenges are amplified in AUDHD, intensifying distress in everyday situations.
- Executive function difficulties combine ADHD's trouble starting tasks with autism's rigidity, causing complex task management issues.
- Masking and diagnostic challenges contribute to mental health struggles, including anxiety, depression, and burnout.
- Women with AUDHD are often misdiagnosed with anxiety or depression, missing the underlying dual diagnosis.
- Effective coping involves recognizing triggers, reducing masking efforts, and advocating for comprehensive diagnosis.
Chapters
- 00:00Introduction to AUDHD and overlapping traits
- 01:11Contradictory behaviors in AUDHD brains
- 02:38Challenges in clinical diagnosis
- 03:56Research supporting AUDHD as unique profile
- 05:13Sensory and emotional regulation difficulties
- 06:35Double masking and social exhaustion
- 08:00Executive function challenges in AUDHD
- 10:28Impact of diagnosis order and misdiagnosis
- 13:27Coping strategies and self-advocacy
Full Transcript — Download SRT & Markdown
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up together, they don't just stack on top of each other, they create a unique mix of strengths, struggles, and contradictions. You might crave routine, but get bored by it. Need structure, but resist it. Want connection, but feel overwhelmed by it. That combination has
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a name. AUDHD. And despite how common it is, many people spend years being diagnosed with only one or neither.
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Today, we're talking about what AUDHD actually is, why it gets missed so often, and the signs that autism and ADHD may be showing up together.
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The interesting thing is that autism and ADHD don't just happen to occur in the same person sometimes.
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They actively interact in ways that make each one harder to spot. Take novelty and sameness, for example, okay?
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ADHD brains are wired to chase novelty. New information, new stimulation, new things to focus on.
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Autistic brains tend to find safety and regulation in routine and predictability. Put those two wirings in one nervous system and you get someone who feels real distress when their schedule gets disrupted and also goes stir-crazy when nothing changes for too long. And on
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paper, that looks contradictory. But in practice, it's the most consistent thing that AUDHD adults describe.
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Or take masking, another good example. ADHD traits like impulsivity, fast talking, jumping into conversations, can look a lot like easy, confident social engagement from the outside.
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That can actually camouflage autistic social differences that are like underneath it, because the energy reads as someone being outgoing, even when the underlying social processing is like working overtime to keep up with it.
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And researchers have started calling this bidirectional masking. Each condition can—it's like they cover for the other, which means clinicians screening for one frequently miss the second one entirely.
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You want to hear something wild? Until 2013, so 13 years ago, the diagnostic manual didn't even allow both diagnoses in the same person.
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That rule is gone. Okay, they fixed it. But a lot of clinicians, think of 2013. I mean, I graduated school in what, '09?
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So, a ton of clinicians still mentally sort people into one box instead of checking for both.
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And here's how big a gap that's left. Roughly 45% of adults with ADHD, so almost half of adults with ADHD, show clinically significant autistic traits.
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But in a recent analysis of nearly 2 million insurance claims, only 1.7% of adults with ADHD had an actual autism diagnosis on file.
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So, almost half of them have clinically significant traits, but only 1.7% of them are actually diagnosed.
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And that gap is why this video exists. A 2025 neuroimaging study found something that actually supports this experience, and don't you just love it when research is in line with what we already know is happening?
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People with co-occurring autism and ADHD showed distinct patterns of brain connectivity. Different from autism alone and different from ADHD alone.
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The researchers described it as its own neurodevelopmental profile, not simply an additive one. Your brain is running one program that neither diagnosis fully describes as its own. It's like AUDHD is its own third thing.
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I just thought that was really important to note and also, you know, what maybe why it's so hard for people to get properly diagnosed. I don't know.
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Okay, let's get into what this can actually feel like day-to-day. And the first experience I want to talk about is sensory and emotional regulation can be amplified, not divided.
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Like sounds, textures, lighting, crowded rooms, these can already cause a lot of distress for autistic people on their own.
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When you add ADHD's emotional intensity and rejection sensitivity on top of that, and small sensory irritations don't like stay small. They get amplified. Like picture this, okay?
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You're at a family dinner. The overhead light is like just slightly too bright. There's a fork scraping a plate somewhere down the table, and your sister just made a comment about your job that probably wasn't even meant as a
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dig, but it felt like a dig. For most people, any one of those things or even all of them together, it just kind of rolls off easily. We might not even notice.
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But for an AUDHD brain, all three of those things are landing in our nervous system at the same time, and there's no clean way to separate the sensory irritation from the emotional one.
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By the time dessert comes out, you're not just uncomfortable, you're done. And you have no idea how to explain to anyone at the table why a fork and fluorescent lighting and an offhand comment just took you from fine to
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overwhelmed in like 30 minutes. That's two regulation systems firing at once with no buffer in between them.
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Next up, let's talk about masking getting doubled, not split. If you're AUDHD, you're often running like two separate masking projects simultaneously.
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The effort to appear like socially fluent and easy to be around, which is the autism side of that mask. And then the effort to seem focused, organized, and in control, which is like that ADHD side. Both of
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those styles of masking are like full-time jobs and you're working both of the shifts at once. You're like doing double duty. So like think about a work meeting. You're tracking the conversation closely enough to respond at the right moments. That's
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kind of like an ADHD effort. You're fighting to stay like have your attention be more locked when it wants to drift.
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So we're doing that in the meeting while also monitoring our facial expressions, our tone, whether we're making the right amount of eye contact, whether our questions sound natural instead of rehearsed.
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All of that is the autism effort running right alongside the ADHD effort and neither project like we're running these two shifts and it's like we don't even get to clock out like they're running at the same time. And so by the time the
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meeting ends, you're completely exhausted because you've been performing your best focused and social self for over an hour.
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And camouflaging research has consistently linked higher masking to worse mental health outcomes. And that effect shows up most strongly in people managing both conditions together. And I don't say that to bum you out. I know that like sometimes
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research is not great, right? We're like, "Ugh, that sucks." But I say it instead to like validate the burnout and exhaustion that you might be feeling all the time because it's kind of telling us, "Yes, you have
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a right to feel that way. Yes, research supports that. Yes, it is harming your mental health." So if you've been feeling more depressed or more anxious or just more tired in general, that might be why.
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Next, executive function gets contradictory symptoms layered on top of each other. I know that's like a complicated thing that I just said, but just hang with me, okay?
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So, ADHD makes starting tasks and holding attention difficult, okay? Autism can add rigid, like all or nothing thinking about how a task gets approached once it does start.
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So, you might struggle to begin something and then once you finally do, you can struggle to stop. Like struggle to switch tasks or even to tolerate the plan changing midstream. It's like those two things working together, again.
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Like let's say you've been putting off a work project for two weeks. You finally sit down on a Saturday and something clicks. You know, the ADHD hyperfocus kicks in and you're like four hours deep into it without noticing the time has
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passed. Your partner reminds you that you have dinner reservations and asks, "Hey, you know, you want to get ready? Let's go to dinner." And that should be a simple switch.
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We should have known it was coming, right? But instead, it feels like being physically pulled out of something because the autistic side o
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And any deviation from the plan registers as disruption that your system has to fight through, not just a scheduling change. Like, "Oh, I didn't realize it's 6:00. We got to go." And so, what can happen is then you snap
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at your partner over dinner plans that you already happily made a few days ago.
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And they have no idea that what just happened wasn't really about dinner at all.
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People around you see inconsistency. Like, "Ugh, they can't start a task or can't stop a task." And depending on the day. But what's actually happening are two different executive function profiles competing for control of the same moment. Does that make sense? It's
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like they're both running alongside each other. And so, from the outside it looks like it doesn't make sense, but that's how our brain works.
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And finally, diagnostic overshadowing makes the whole thing worse. Again, fancy way of just saying that it's hard to get a proper diagnosis. This is the clinical term for when one diagnosis gets all the attention in an evaluation and the
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second condition's traits get explained away as being part of the first. Like an autistic child who can't sit still in class, who's inattentive and seems to drift off during instructions, often gets that behavior filed under sensory overload or social anxiety.
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Nobody screens for ADHD because the autism diagnosis is already there on file. And even if that explanation doesn't fully account for what's happening, they still just throw it under there.
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It could also be like an ADHD adult who needs rigid routines, becomes disregulated or upset by certain sensory environments, and struggles with unstructured social situations.
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All of those symptoms will get filed under anxiety because the ADHD diagnosis already exists and anxiety is kind of like the easiest catchall for whatever's left over. Nobody asks whether autism might be present, too.
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Whichever diagnosis arrives first in someone's life, for whatever reason, tends to become the lens that everything else gets interpreted through.
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Like the first label sticks and everything that doesn't quite fit gets quietly absorbed into it instead of getting its own evaluation.
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If you watch the autism video, you already know that diagnostic criteria for both ADHD and autism were built almost entirely around how young boys present.
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Annoying. Most of our as we're learning, I'm sure you guys have all gone down this rabbit hole, too, but if not, most of our research into any medical ailment has been done on men or boys. Like it's always looking at them. And the
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reasoning that they gave is that I think I might have mentioned this before, is that they always had said like, "Well, girls have their hormones and women can get pregnant and that would throw off the study." It's like, but
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shouldn't we have research on how this affects pregnant women also? Like, what? We're we're birthing all the humans.
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Anyways, back on back on point here, okay? They were always built like autism and ADHD and a lot of other things were built about how young boys present.
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Therefore, AUDHD, unfortunately, it it's like it compounds that problem. Women with AUDHD often get one diagnosis and it's usually anxiety or depression, sometimes ADHD on its own, and the autism that's been happening probably since we were a kid, right? It stays
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invisible because it's been compensated for so thoroughly that it doesn't look like autism to anyone watching from the outside. Like I kind of talked about in the video, like we're pretty good masks maskers and so we can be so good at it
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that nobody even knows or thinks even considers looking for it. And so here's how that actually plays out in an evaluation, right? I want to kind of walk you through what it would look like if you went in for to get
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checked for this. So a woman walks into a clinician's office describing burnout, social exhaustion, or maybe a pattern of feeling like, you know, I'm just kind of like acting my way through all these social interactions.
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The clinician, like the therapist or whoever, sees someone who makes eye contact, answers questions fluidly, seems engaged in the conversation, and reads that as socially intact.
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What the clinician doesn't see is that the eye contact is a rehearsed habit that she built in her 20s because someone once told her that she came across cold without it. They don't see that the fluid answers are the product
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of mentally drafting and discarding three responses before saying the fourth one out loud. And the social fluency that ADHD's impulsivity and talkativeness can provide becomes the perfect cover for the social struggles that can come along with autism.
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And the standardized screening tools, most of which were never designed to catch a masked presentation, they come back clean.
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So, she goes in to see the clinician, then she leaves with a diagnosis of anxiety, which isn't necessarily wrong, but it's just incomplete.
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And this is also where rejection sensitive dysphoria or RSD becomes relevant in a way that's specific to this combination. And I have an older video on RSD. If you want more information on it, I'll link in the description. But, RSD already
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makes ADHD brains read neutral interactions as rejection, right? Someone can look at us a funny way, and we automatically are like, "Oh my god, they hate me." Layer autistic social processing differences, right? Social situations, if we're autistic, are really hard to
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read. We're maybe not really sure. Maybe, you know, I'm sure we've been learning our whole lives, but it we're not always We don't feel very confident.
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So, you put that on top of it, where the rules of an interaction were never intuitive, and then you get this certain kind of exhaustion from any social interaction. Like, if a friend takes 4 hours to respond to a text, the
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ADHD side of your brain immediately registers that as a sign that something's wrong. And the rejection sensitivity flares before you've even confirmed there's anything to be rejected by.
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That's ADHD, okay? The autism side of your brain starts replaying the entire conversation that led up to that text.
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You scan for the moment that you said something wrong, because you were never confident that you read the social cues correctly in the first place.
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Now, these two systems are both convinced you've done something wrong, but neither one is really able to tell you what.
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And that can really suck. Make it really hard for us to feel connected to other people, and it we can honestly Like, I've heard from a lot of you that are AuDHD that it feels like you're almost like always at war with yourself,
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or like walking on eggshells with people you're in relationships with, because you just You just aren't sure. I feel like it When I was putting this video together, the thing that kept coming through to me was that it's like it's
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just this lack of confidence, this lack of feeling sure in ourselves and like our way of interacting because because of all the different components of autism and ADHD and how they play together.
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And so a lot of women with AUDHD describe spending decades believing that they were just too sensitive, too intense, too disorganized, or too much.
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When the real story was a misdiagnosis and the support that should have come along with it.
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This combination is its own profile entirely with its own internal logic. Right? It has its own way of working and once you understand that, a lot of the contradictions that made you feel broken or inconsistent start making sense
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instead. A proper evaluation for AUDHD needs to screen for both conditions specifically, not just whichever one presents first or is the loudest. If you've already been assessed for one and the picture never it just never quite fit, right? Like it
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it encapsulated a lot of things, but there's still stuff that doesn't work and you're like, wait, that doesn't make sense. It's worth bringing up directly with your therapist or doctor.
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Ask whether the evaluation covered both, not just the one that got flagged first. And if you spent years masking two things at once without knowing that that's what you were doing, give yourself some credit.
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First of all, for how much energy that took, but also that you did the best you could with what you knew at the time. And instead of judging any of it, we're always so quick to judge ourselves, right? I want
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you to recognize how hard you've been working and just pat yourself on the back for it cuz you survived. You did the best to manage it all.
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Next, let's get into a few things that actually help so that we can start feeling a little bit better right away, okay?
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First, let's build a transition buffer before you need one. That's the important piece, before you need one, okay?
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Remember the Saturday hyperfocus example where switching out of like a locked-in task felt I don't know. It felt It felt like getting like physically pulled out of something. I've had a lot of you tell me it's like you're It's almost like you
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you're being jerked away. You're like, "No, you don't want to let go of something." So, it's like you're pulled out. It's uncomfortable, and we hate it.
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Unfortunately, willpower alone isn't going to make that reaction go away. I know. So annoying.
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But what helps is is giving your brain a warning before the switch happens. Not in the moment that it does happen. So, let's say we set the dinner reservation, right? We talked about it with our partner a couple days ago.
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I want you to set a timer, so that even before we got in to that situation, like maybe in the morning, we set a timer for 10 minutes before we need to do something. So, in this case, you'd set
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it for let's say dinner is at 7:00. We need to leave the house at 6:30.
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I'm going to have to get ready. I'm going to have the timer go off at 6:00.
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So, you set a timer before you need to actually stop, not at the moment that you need to stop. Like, give yourself that 10-minute window, because it gives the autistic side of your brain time to register that the plan is about
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to change. Then instead of experiencing the change as a sudden disruption, you can kind of move through it. And I know that this sounds small, but for a lot of AUDHD adults, it's the difference between snapping at someone over dinner plans
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that you made a couple days ago and actually being able to just put the work down and go and enjoy a meal together.
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Next tool, we have to catch the RSD spiral before it ruins everything. It likes to ruin everything, right? I talked a while back about the the evidence collection method for separating your guilt from what actually happened. And the same approach works
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here. And it's especially useful for AUDHD because you're often dealing with two systems that are both insisting you did something wrong. The rejection sensitivity and the social replay.
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When a friend slow text reply sends you spiraling, we're going to stop. Pa pa pa pop pop. I want you to write down the actual evidence that something is wrong.
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I said evidence, like imagine it in a court of law. This is not the feeling that something's wrong. These aren't thoughts. Thoughts are not facts.
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Feelings are not facts. We're just going to write down the facts. That's it, okay?
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Because most of the time there aren't any. Like, what's the fact you have? They haven't texted me back. That's it.
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Separating the feelings from the facts. It Unfortunately, it doesn't really make the feeling itself smaller, doesn't make it go away, but it can stop you from acting on a story that your brain told you with no facts to support it.
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So, give it a try, okay? Another tool is to pick one place to stop masking on purpose.
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You can't drop both masks everywhere. That's not realistic for most of us. Not to mention that it probably doesn't feel safe either, right? Kind of can be kind of scary, especially if you've been masking for so long.
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But, running double duty in every context within our life is what wears us out. It's why a lot of us feel burnt out and overwhelmed. So, I want you to choose one relationship or one room or just one
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hour of your week where you choose to stop performing. Like, stop tracking your facial expressions. Stop pre-drafting your sentences. I know, it'll be hard at first. We're just going to try. Let your attention drift if drift if it wants to
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drift. Let it do it. The exhaustion from masking is like cumulative. So, even one regular space where you're not working so hard, it can be helpful.
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And you may even find yourself looking forward to it each and every week. You can also try and name your top sensory stressors and remove just those. You don't need to overhaul your whole environment. That would be awesome, but
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it's also expensive and a lot of work. But, most AUDHD adults have two or three specific sensory triggers doing most of the damage, not a hundred small ones. I know it can feel like that, but just hang with me, okay?
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Maybe one of the worst for you is overhead fluorescent lighting. I mean, who likes it anyway? It's horrible. And funny story, actually, Sean worked one holiday season at The Gap, and he told me that the most exhausting thing wasn't
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even the folding and refolding of all the clothes, it was the lighting. I think we should just ban fluorescent lighting, to be honest. Okay, back to the point.
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But what could be triggering you most? Again, fluorescent lighting. It could be background chatter in open offices.
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Maybe you're like in a cubicle kind of situation. Or having music playing too loudly in your space. Or maybe it's like tags on your clothing.
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Identify the two or three that bother you the most, and let's solve for those specifically. Like noise-canceling earbuds. I'm a huge fan of Loops brand ear plugs for this. If you haven't checked them out, check them out. Sean
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and I both have them. They're great. Or maybe we get a desk lamp instead of relying on overhead lighting.
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Maybe we remove all the tags from our clothing or only buying clothes that don't have fabric tags. Maybe at least not up in the neck, maybe on the side. I don't know.
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But these small targeted fixes do more here than trying to control everything at once. And it's also, I think, more manageable this way.
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Oh, and if you're pursuing an evaluation, ask for both by name. I know it can feel pushy. I've heard from a lot of you are like, I don't want them to think that I'm trying to get a diagnosis.
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This is your life. And given everything we've covered about the limits and blind spots in the diagnosis process, we don't really want to leave it to the clinician to think of the second condition on their own. So, if you're
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going in for an ADHD assessment, ask directly whether autism is also being screened for and vice versa.
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And bring specific examples from both lists. Like, "Hey, I think this is more ADHD. Hey, I think this is more autism, but I have both of these." You're allowed to advocate for the fuller picture instead of waiting for
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someone else to notice it. Like I've always said, you know your yourself and your experience best.
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And naming what you're experiencing is honestly part of getting an accurate assessment. That way your clinician can properly assess you and give you the right tools and resources.
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A few weeks ago, I talked about the autism signs that women learn to hide.
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And before that, I covered the ADHD signs that can get missed for decades. And if you watch both of those videos and found yourself thinking, "Wait, both of these sound like me." You're not alone. Trust me, I got a ton of messages
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and comments asking me about that, which is why I made this video. And the tricky thing about AUDHD is that it often looks contradictory from the outside. You crave routine but get bored by it. You want connection, feel overwhelmed by it.
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You seek stimulation and then avoid it at the same time. And for years, a lot of people assumed they must be getting something wrong because no single explanation seems to fit.
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But maybe the reason none of the pieces made sense on their own is because they were never meant to. Maybe what looks like inconsistency is actually two neurotypes interacting in real time.
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And for many people, learning about AUDHD is about finally finding the framework that explains what they've been experiencing all along.
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If this video resonated with you, make sure you watch my ADHD and autism videos from a few weeks ago because together, I feel like they paint a much fuller picture.
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And I'd love to hear from you in the comments. What's the most AUDHD thing you do? What's the contradiction that makes perfect sense to you but leaves everyone else confused? Let me know.
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Thank you so much for watching. Have a wonderful week and I will see you next time.
Topics:AUDHDautismADHDmaskingexecutive functionneurodiversitydiagnosismental healthsensory processingco-occurring conditions
