r/AutisticWithADHD • u/Ok-Tour7131 • 1d ago
š¬ general discussion Neurodiversity as a spectrum vs. categories
About four years ago I (22, AFAB) got diagnosed with ASD. And about two years ago I got diagnosed with ADHD inattentive type. The psychologist told me that I actually portray signs of the ADHD combination type, but that my fidgeting and constant moving can be explained by my previous ASD diagnosis.
As someone who is a social scientist themselves and who has done hours and hours of (unofficial) research on neurodiversity, I personally believe that it is pretty bizarre that such a clear line is drawn between diagnoses. My brain is ONE thing, and so is my neurodiversity. Sure, my neurodiversity differs from that of others, and I am glad to be diagnosed with both ASD and ADHD. But this "oh your autism caused this ADHD symptom, so it's actually not an ADHD symptom" seems so oversimplified and straight up lazy to me. What if I was diagnosed with ADHD first? Would they have revised this diagnosis if I later got diagnosed with autism? Maybe my constant movement is a symptom two disabilities that can, and often do, overlap.
What are your opinions on this demarcation between diagnoses?
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u/lovelydani20 17h ago edited 17h ago
I completely agree with you, and this is a topic that I recently engaged in if you look at my post history.
Basically, I have all the ADHD inattentive traits, but I don't have ADHD because they're "better explained" by autism.
I actually agree with my neuropsychologist because although I struggle with inattention, it seems to be for a different reason than a classic ADHDer. I think the difference probably comes down to how I wouldn't benefit from ADHD meds. That being said, I follow ADHD subs, and I learn a lot that I think is helpful to me.
I doubt that autism and ADHD will be separate categories in the same way they are now in the next 10 years. And I think the AuDHD diagnosis may have some conceptual problems since I think autism, in fact, mirrors ADHD in many cases. For example, if I'm super into only a few interests, then of course, it's hard for me to pay attention to a lot of things that fall outside of those interests. So, in my opinion, ADHD needs to be diagnosed based on etiology instead of symptoms to get a more accurate demarcation between autism and ADHD.
Right now, a lot of people with all kinds of brains are just being given both diagnoses based on their symptoms even though the root cause behind their inattention and hyperactivity may not have been determined.
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u/snow-mammal ASD 1 | ADHD-C | L/MSN | 30mg Vyvanse 6h ago
Do you think itās possible to have both? For me I sometimes struggle to pay attention to anything, even things I really like. And then I get bored and either depressed or I go out drinking and have a hookup or some other exciting thing because Iām restless.
Itās a lot easier for me to focus on things I love, especially my two special interests. Sometimes it feels like I got a focus-supercharge when Iām learning about them. But over time my brain gets used to it and even though I love those topics they can become hard for me to keep paying attention to, even though I want to and love those things. Usually what I do is combine them with other things I like (draw anatomy instead of study it, play Skyrim while watching TV instead of by itself) so that way thereās some novelty and I can continue to engage and maintain my focus. And then eventually I just get sad and stop or I have something exciting planned and can go back to doing what I love.
Definitely also have issues with social cues but itās not from just being distracted like I see people say is more common in ADHD, even on my meds I just donāt spot them and literally canāt pick up on stuff even if I try as hard as I can.
So in my case I feel a dual diagnosis makes sense.
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u/lovelydani20 53m ago
I definitely think it's possible to have both autism and ADHD. But I think the diagnosis process for AuDHD will change and become more specified so that clinicians can more easily tell the difference between ADHD-like symptoms in autistics and actual ADHD in autistics.
Most likely, there's people who are diagnosed with both (not saying you, specifically) who actually only have autism. But they're prescribed meds that they won't get the full benefit from like an actual ADHDer might.
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u/stifstyle51 5h ago
I feel that probably the complex nature of human brain is oversimplified with those finite buckets - it's good that now at least it's not the only "bucket" (NT) but multiple that are considered normal. But I wonder whether in the future we would have a more complex understanding of that spectrum and its dimensions.
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u/Ok-Tour7131 2h ago
Agreed! Not to mention that the way in which we conceptualise disabilities is socially constructed. I'm not saying that f.e. autism and ADHD are not real and that they don't have causes that lay in the material brain. But society shapes the way in which these brain structures present themselves. Children with ADHD that spend a lot of time playing outside show significantly less ADHD 'negative' symptoms than those who play more inside, because they are more regulated (exercising and being in nature is good for you), which makes their neurotype less of an 'outlier', if you know what I mean.
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u/hanitizer216 1d ago
I think everyone has both and it is one neurotype, often misdiagnosed. If autism is failure to prune and having extra neural connections and storage in the brain (resulting in getting overstimulated) then ADHD is the executive dysfunction that we experience as a result of being overstimulated.
If your iPad has triple the storage, itās going to glitch more. You canāt experience one without the other.
I think the AuDHD neurotype is extremely prevalent in society (40-70%?) and is misdiagnosed as anxiety, depression, OCD, bipolar disorder, hysteria, operational defiant disorder, etc.
I think this neurotype is genetic and related to the MTHFR gene mutation and RCCX gene theory.
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u/Ok-Tour7131 1d ago
Thank you for your elaborate reply! Do you have a link to this theory? I would love to look into it more
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u/hanitizer216 1d ago
Nah I dont have a singular link to one paper that is going to unify and confirm everything I believe š¤£If that paper existed, then my theory would not be a theory.
I came to this conclusion after reading hundreds of peer reviewed studies, thousands of comments, listening to every podcast I could find about autism and adhd, connecting with other people like me, observations from being hospitalized several times while masking, discourse with healthcare professionalsā¦. my enhanced pattern recognition kinda just figured it out.
Instead of asking for a paper that will tell you what to think, I encourage you to think for yourself. And I know that can be perceived as a spicy statement, but I mean it genuinely and with love. Donāt ask someone to tell you what the truth is. Figure it out yourself!
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u/DenM0ther 1d ago
I agree with a lot of what you said. But I've also a questions: if medication fixes (temporarily) a lot of what are defined as adhd symptoms, why wouldn't it affect any of the ASD symptoms?
*When I say adhd / Asd symptoms, for this question I'm hoping we can go with the ones that are normally agreed to fall into the 2 different 'disorders'.
Also, ASD can be so severe that it CAN mean the individual is unable to function in any normal way or enjoy life (headbanging, non-verbal/non-communicative, read/wtite, play music etc.) ADHD can certainly be in different severity but not in the same way right? Or do you think they're to do with a different part of the brain/disorder?
Genuine question.
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u/hanitizer216 1d ago
Thanks! Hope I remember to reply to all points!
I donāt think medication fixes ADHD symptoms. I think stimulants cover the problem and provide a temporary solution like you said, but all while harming the cardiovascular system and creating a profitable dependency on amphetamines to function. Iāve noticed a huge overlap between neurodivergent people and chronically ill people with mineral deficiencies. Most of my ADHD and ASD symptoms can be attributed to chronic illness and misdiagnosed conditions.
I donāt think autism is a disorder that needs medicating or fixing. I think we only have a disability because society is run by Neurotypical people. If you are experiencing depression or mood swings along with being autistic, medication can certainly help that. But I donāt believe that being autistic itself inherently calls for the use of any medication. We just medicate the symptoms that we experienced as a result of NT people being in charge.
Regarding individuals with severe intellectual disabilities who require assistance to functionā¦ Iām not sure. I would need to see an MRI and be more knowledgeable about neurology and parts of the brain in general? I would assume that just like any syndrome or mutation, severity can vary. I think the location of said hyperconnectivity in the brain matters. Is it widespread? Concentrated to one lobe? What part of the brain is most affected?
I look forward to your reply. I enjoy polite discourse and I love learning.
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u/DenM0ther 22h ago
Idk why you got downvoted, I think it was an excellent, extremely well thought out reply! I ll do my best to do the same a bit later.
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u/hanitizer216 11h ago
I canāt even see any down votes haha. Sounds great! I look forward to hearing what you think.
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u/NapalmRDT 10h ago
40-70%? I would find that very hard to believe, that is a magnitude more than the numbers I've read, and that would put neurotypicals in the minority or weak majority, which is just not the case?
Also understimulation is as least as much worth a mention. Often we experience both simultaneously
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u/hanitizer216 10h ago
That figure is based off the estimated prevalence of the MTHFR gene mutation, which is highly comorbid with neurodivergence. I do indeed believe neurotypicals are the minority and a huge portion of the AuDHD population is undiagnosed or misdiagnosed. I see a lot of evidence in this in older generations like Baby Boomers, who grew up in a time where ASD and ADHD were not common diagnoses at all. Boomers can tend to appear very narcissistic, and autism can look like narcissism when undiagnosed.
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u/NapalmRDT 10h ago
I think the prevailing theory is that ADHD is a group of genes, and ASD is a group of genes, which have some overlap?
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u/hanitizer216 10h ago
Iām not aware of any prevailing theories at this time. Itās like calling customer service 10 times, youāll get 10 different answers depending on who you ask.
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u/Illustrious_Rice_933 19h ago
There's some interesting work on co-occurrence of OCD, ASD, and ADHD. The results of one I'm thinking about in particular showed how two people with two different diagnoses could have more in common with one another than two people with the same diagnosis. I think about it a lot.
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u/hanitizer216 11h ago
A lot of autistic people are misdiagnosed with OCD. Dr. Teresa Reagan says that any symptoms that get someone diagnosed with OCD are better attributed to autism. She has a free Spotify podcast and does a four episode miniseries explaining how every mainstream psychiatric diagnosis can actually be autism in disguise. Changed my life. Highly recommend it.
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u/Illustrious_Rice_933 1h ago
Thank you so much for the recommendation! I will be sure to check that out, especially since my official diagnosis is OCD plus ADHD with GAD and depression. I went through the DSM-5 with my psych who thinks I align with some autism markers, but not enough to be ASD. My goal is to ultimately understand myself better, so I think that pod could give some interesting perspective!
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u/zerooocontrol 16h ago
What about people who present with one but not the other? I kinda get that some autism symptoms can be a presentation of ADHD, but not necessarily the other way around. I donāt have any prior knowledge on this topic, so this is just based on intuition. I think it would make things really complicated to classify everyone under the same diagnosis. There are already so many individual differences across both diagnoses in terms of types/presentations, and support needs. I canāt imagine how it would work in terms of therapy, interventions, or support if all of us were placed into the same category.
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u/hanitizer216 11h ago
I donāt think anyone displays only one set of symptoms. People are just uneducated/ignorant about their behavior and donāt realize theyāre exhibiting both ASD and ADHD symptoms or behaviors.
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u/zerooocontrol 31m ago
Could you say more? Especially about how people with ADHD might fit into Autism criteria A? Iām genuinely curious and want to learn more. I struggle with alexithymia which really impairs my ability to socialize, and Iāve seen ADHDers who are very people oriented and seem to have great intuition for social cues which I really admireā¦. Sorry if I have misunderstandings on this topic but I genuinely wanna learn more
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u/MechanicCosmetic 3h ago
ASD and ADHD are different things with some overlap and many differences, but brain development does not take place in an isolated manner, therefore people who have neurodevelopmental conditions frequently have multiple. It can be viewed as a spectrum in that regard -- a spectrum of neurodevelopmental differences.
And the presentations are therefore unique. AuDHD is not simply autism and ADHD, but kind of a third thing. Nevertheless, ADHD is most likely not part of the autism spectrum. And it's good that things are diagnosed separately because then it's easier to understand what someone is dealing with.
I am autistic with no intellectual impairment and no functional language impairment, and I also have ADHD and non-verbal learning disorder (NVLD).
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u/lydocia š§ brain goes brr 1d ago
It feels to me like autism and ADHD are on the same spectrum, and I think it will be categorised as such in the futuure, just like how Asperger's used to be a separate thing and now it's considered autism.