Subclinical AuDHD
I was kind of excited to learn that AuDHD was a thing, because I've failed both the autism test and the ADHD test, but the reality is that it is not a thing. The only thing that changed was you can be both fully autistic spectrum and fully ADHD. There's no official hybrid category to straddle the two.
It's a bummer for me because I think AuDHD perfectly explains everything that is horribly wrong in my life, mostly around work: I don't get along with coworkers, so I never get promoted and often I get fired. I see a problem, I point it out. I'm honest even during job interviews, which are very stressful.
On the attention side, I don't really do well with repetitive tasks. If I can listen to podcasts all day, I'm OK, but if it's just staring at a counter waiting for customers to come in, that's pretty hellish. I also don't have much in the way of special interests. Every once in a while, the fever will take me and I'll learn programming or kayak-building or instrument-making or instrument-playing or languages, but the drive to really crank that is more typical of autism is lacking, so when I'm faced with long periods of time, I do very little (averaging 30 comments/day for the last 5 months!). And during that long period, I sometimes pick up career books about "finding your passion," but I mostly put them down pretty quickly.
I've been unemployed for 3 months. I'm afraid to apply for jobs, not just because of the rejection, but because I'll be getting back on this treadmill of unbearable jobs where I will eventually fail, will make no friends, will garner no references.
I hate going to the mental healthcare system, which has done absolutely nothing to resolve or even acknowledge the root cause or even the root problem. I've been called very intelligent and promising and capable. I've also been saddled with harmful diagnoses like bipolar and put on meds which make me lose what little contact I have with my emotional world.
Just to put this into context: I'm over 50 years old and this is the same exact problem I had in high school and college and ever since, just a real inability to figure out what I want to do, even in my own spare time. And it's the source of everything else. I need to work to live, and if working is difficult, it is obviously hard to live, and that will obviously have an impact on my mood. "Great," says the useless mental health system, "mood is something we can easily diagnose and medicate!"
Yet, if that is the core problem, there really isn't any treatment for it, but at least a diagnosis would open up some benefits (and maybe a free train ride to a Kennedy-run camp in the future), but that is probably beyond my reach.
15 replies
One nasty thing about overlapping ASD and ADHD is that one masks the other, to an extent. ASD puts you in a rut, with repetitive behaviors, but ADHD moves you out of it to seek new shiny things. ADHD makes it hard for you to focus, but every now and then ASD kicks in and you compensate that lack of focus by being hyper productive and doing in a 18 h binge (or 38 h once for me) what would have taken most people 2 weeks.
The usual questionnaires sometimes fail to identify either, especially in adults with regular masking going on plus the masking the two disorders give each other.
I think the science is catching up to it, I don't know whether there is an established differential diagnosis protocol yet. And after one is made, there is the hurdle of establishing it as praxis in the medical profession and health programs / insurance.
I’m 42, diagnosed recently with ASD, not yet tried for an ADHD diagnosis (but I suspect I am). I can really relate to what you’re going through.
Getting diagnosed has this extra hurdle of needing to be honest about your natural state but not honest about how you are presently. In my case, that meant answering the survey questions by evaluating how I was, thought and felt as a youth and not as the adult I am now with the years of life experience and the adaptations that came with that (which naturally exhaust the fuck out of me).
Just because you don’t cleanly fit the DSM V criteria (which is very outdated now), that doesn’t mean you don’t have ASD, ADHD or both.
Doctors were so unhelpful for me that you’d swear they serve Satan himself. I had to identify my own problems and seek the diagnosis on my own. I’m fortunate that my mother was able to also answer questions about my childhood behaviors because her observations lined up with my own.
I’m sorry you’re where you’re at right now, but try not to lose hope. Maybe consider the context of your honesty when answering those vague and ambiguous survey questions. AND don’t be afraid to unmask and stim during your in-person evaluation.
What's weird to me is the DSM consciously makes decisions to keep diagnostic groups small when it comes to autism, but basically everyone is eligible for anxiety and depression.
The DEFINING trait of what is a "problem" is interference in functioning. If I can't keep a job because of a combination of my social skills and attention profile, why does it matter that the tags on my shirt don't bother me?
Imagine if you couldn't get out of bed because you felt so hopeless, but you couldn't get a dx of depression because you're also not suicidal. I know you can but the point is, there is something interfering with your life and it's allowed to have a name when it's something like depression, but when it's a neurodevelopmental problem, people get all squirrely and start demanding a lot of abstract things that don't make sense because the main thing is and always should be if it interferes with functioning, not if it satisfies an arbitrary profile.
I think I'm a long shot for autism, honestly. I don't stim. And I understand people, but like the way an entomologist understands bugs. "Like, oh, are we establishing ourselves in the social hieararchy by talking about our jobs? Ok. I can do that."
It sounds like you interacted with some doctors who aren't updated on autism presentations. There used to be a question about trains, apparently, and if you didn't like trains you would be disqualified, they dropped that. They're only just in the middle of shaking up the definition of autism and noticing women do have autism but present differently, and that it's not solely a paediatric condition (they used to think autism was entirely contained in childhood, pfff idiots!!) I mean these people have to be ignoring obvious signs to be thinking like this.
Not all doctors are going to be up to date, and not all of them are going to be capable of diagnosis, correctly, your feelings are absolutely a million percent valid. It absolutely sucks balls. These dickheads are professionals, they bloody should be on top of all the current findings. Fuck them.
You deserve acknowledgement, and as much as it sucks, it might take engaging with multiple professionals (hopefully just one more) to get the acknowledgement you deserve.
I absolutely get it, I'm 49, I think I'm asd and adhd, although I'm woman and gifted, so I was able to ace school without really trying, (but couldn't finish anything, kept dropping out and going back to try again) and I'm able to mask really well. Although I started to stop masking and holy bananas, when you put the mask down, you can't pick it back up. I just wonder how much easier my life would have been if I had had a diagnosis earlier in life.
It's worth pursuing. Keep going. I'm sorry you found a dickhead doctor.
I wonder how much of my "not being autistic" is masking and how much is me building a life around it to the point that I don't notice. For instance, I could never work in a place with loud sounds and only use power tools because hand tools are so excruciatingly slow--ie my ADHD hatred of boredome beats out my autistic hatred of loudness... part of the problem with diagnsosing adults is that they've been living with workarounds and avoidances for years and they might forget why they're there.
How do you know the difference between doctor shopping and getting an informed opinion? My thing i'm honestly open to not having anything, but I can tell you very definitely what my core problems in life have been.
Now that you have a diagnosis, what has it changed for you? One of my first posts here was asking how diagnoses are releveant. I know that I don't like chit-chat, I know that I like speaking the truth, I know I have trouble moitvating myself to do things, I know I have a kaelidoscopic array of interests.... I can know that and feel like that's just part of who I am without the blessing of a white coat.
There's a comedian who said something like, "So that's the difference between being rude and autistic. If you're autistic, then the tags on the back of your shirt bother you. But if they don't, then you're just rude."
Nobody neurotypical wonders if they're neurodivergent. If you feel like things are a struggle, they are!
Doctor shopping is when you purposefully skirt the laws around prescription drugs to get more than you should be safely consuming. It's not when you need a second opinion, or even a twentieth opinion.
I get you, from what you have described to me, I would highly recommend seeking a diagnosis from someone who is trained up to current standards. I feel like you have expressed enough sensory struggles and life hurdles that qualify for a diagnosis.
There's a lot of propaganda going around and it's hard not to fall for some of it. A diagnosis helps you understand all the factors that might effect you, assess how much they're effecting you and adjust your life accordingly to be able to live a better life. Imaging if this same argument and gatekeeping and invalidation propaganda went on for people with amputations or obvious physical disabilities, it would look ridiculous, it should look ridiculous for the people who try and minimise what it's like living with an invisible disability.
It's incredibly hard to step back and see the forest for the trees, it's hard to see what's effecting your life, when it's always been like this, you can't step outside your life and have a look at it from afar, and you acclimatise to what you're living with so things might even be impacting you more than you realise! And that's where you need a good currently, and up to date trained professional to help you sort through it all. Doctors are just people, they're just as fallible as people can be. You have to find a person who fits your needs.
Neurotypicals don't struggle with the things you have described. They just don't. Not just tags in shirts, (they don't bother me, they don't bother my grandson who's diagnosed asd level 3) it's if your senses are turned up too high. Do your socks bother you, are you picky about fabric you can stand or not stand, do you struggle with certain waist bands, or shirt cuffs or length of sleeve, you could probably fill in some more. How are you with towels, they get to me, I can't stand them! I still use them, but it's hell.
There's so many things that aren't on the diagnostic standards that will be in 10 years, even.
The reason there's a flood of people getting late stage diagnosis now, is because they've finally acknowledged you don't "grow out of" autism and adhd, and they're recognising parts of the conditions, that have always been there, that excluded all the people in levels 2 and 1, who are now currently recognised. It's worth it at any stage.
Thanks for the detailed reply!
To me it sounds like you're mixing up diagnoses and treatment, and diagnosis is the pathway to treatment. But I can also just find therapists who work with this population and self-declare and ask to be treated as-if (oh, and put me down for depression and anxiety, I guess). And I can also do my own reading/reflection. Someone mentioned PDA/RSD yesterday and that was tremendously helpful.
I'm just bringing it up in case I can't find someone to diagnose me; I don't want to be waiting around on that before I start making changes/doing research.
Yes, everyone can go from healthy to mentally unwell which most times looks like depression and/or anxiety. Theoretically these conditions can be cured as well. No one can get autism/adhd: this condition is present from birth and it cannot be cured (it feels offensive even to say this).
If a person's brain is wired such that it warrants a positive diagnosis for a neuro developmental condition then it follows that this person's perception of their entire life has been drastically different and because our society is not really accomodating for such folks, this potentially causes a whole range of secondary health issues (mentally as well as physically). So this is a question of support and how society can facilitate it but not how you should feel about yourself.
Have you been introduced to the levels of autism? It kinda does meet your understanding of a bit in between both. ASD comes with a number that aligns with the levels it effects your life, from 1 to 3. Level 2 and 3 are quite significant, and have huger impacts on your life, level 1 is what used to be named after a nazi guy, who's name I won't say, and it was changed for that same reason. Being level 1 is still full autism.
Also adhd tends to compensate or mask asd, so if you got an adhd diagnosis and then find medication that helps compensate for the executive dysfunction that is a part of adhd, that sometimes clears the way for noticing the asd more clearly. A lot of people get adhd diagnosis and didn't notice the asd till after they have found medication that works for them. And then go back. Your adhd might be compensating for your asd and also messing with the test results. Maybe try to eliminate the adhd first? But it sounds like you need to find better doctors first, wishing you well in your journey, friend.
I remember being convinced I had ADHD and I was so frustrated because the therapist I landed in the clinic insisted I didn't have it. SO I went and spent $500 to see a psychologist at a hospital and he did an interview and concluded I had it. Wrote it down on a piece of paper. I showed it to my non-believing therapist and he just dismissed it: "He's seen you for an hour. What does he know?" Meanwhile, I think I'd only been seeing him for a month at that point...
Then one psychiatrist told me flat out, "ADHD does not exist."
So the field is absolutely a mess and I know that what I get as a result says as much about the psychologisit as it does about me.
I have taken ADHD meds and it really doesn't help my motivation much. I still do the things I was going to do anyway, but I do them for a lot longer. That's all I noticed.
But subconscious masking is something I need to think about.
Oh, I went on a job interview today and found myself taking off my glasses so the people across the table were a fuzzy little blue that I could comfortable look at; usually I'm avoiding eye contact desperately.
Wow, this describes me and my work history. Only just realised a few months ago that I’m autistic, and the effects that I’ve felt throughout my life match yours almost exactly.
But what kept you from considering autism for so long? Are there things you think wouldn't pass muster with the psychologist if you did get an assessment?
Honestly, I'm thinking of calling disability lawyers to see if they can recommend people, because I think most psychologists would be happy to by-the-book it and say I'm not.
It just never occurred to me. My entire life, I knew that everyone else thought I was the weirdo, and I thought everyone else was square/strict/narrow-minded/ignorant.
Only a few months ago, I was reading about autism, trying to learn how to get along with my stepson who had come to live with us, and discovered that I matched every single behaviour described. Suddenly all the difficulties in my life, at school, at work, with friends, made sense, and I realised that I’m obviously autistic, and everyone else had always known, but no one told me.
Now trying to cope with this new understanding. If only I could have had help and guidance when I was young at school, when I started my career, maybe my life wouldn’t have been so difficult and messed up.
Does PDA/RSD profile feel like a fit?
Sure does! BUt it looks like it's more targetted around kids and is reactive more than foundational.