AS and ADHD: A bold hypothesis

Post Reply New Topic

I was Dx'ed with ADHD inattentive subtype [original DX was ADD], then later AS. maybe there is more of a direct link between inattentive ADD and AS?

ADHD is often misdiagnosed instead of ASD. The psychologist who diagnosed me said that ASD includes symptoms of ADHD, and so usually people are not diagnosed with both.

Those with ADHD have executive functioning issues, but not problems with understanding socialization. They may have trouble socializing because of impulsivity, but not lack of social instinct.

I know of someone with pretty severe ADHD, who does not have problems with socializing, or of needing to follow rituals or routines, has no sensory issues, and no special interests/obsessions. But the executive functioning is terrible.

The only things that ASD and ADHD necessarily have in common are problems with executive functioning, and repetitive movements. In ADHD, it's more like fidgeting rather than stimming, though. And those with ASD can also be hyperactive. I was as a child and still often am at times.

I don't think it's true that all Autistics have an intellectual disability, apart from having specific deficits in the areas of social understanding and communication. I have a diagnosis of Autism Spectrum Disorder, not Aspergers, but I have a high IQ. I don't have any ADHD.

On the whole I don't think ADHD and Aspergers/Autism are the same thing. I think they are frequently found together but they are also frequently present seperately and they are different even though they share some common threads.

Thanks for sharing your story. I was never diagnosed during childhood, but my mother was very worried because, like you described, I seemed to be propelled by a motor. She bought several books about ADHD and was almost certain that I had it, but in the end she decided not to treat me because giving stimulants to child kind of scared her.

Later I settled down and through my late childhood and adolescence, I was certainly one of a kind in my classroom (and school, maybe). I was laughed at, mocked and severely bullied (though verbally for the most part), but even then, even if I acted a bit weird and was constantly distracted and daydreaming, I was kind of respected and liked by most who got to know me, because I managed to act like the bullying did not matter at all to me, I kept the friendly attitude towards my bullies, as if I was "mature" and "over it". But in all honesty, it did generate a trauma in me which later developed into depression and anxiety, among other things.

At first I thought I had inattentive ADHD too, since I had low energy and a difficulty to think. I thought that what I later discovered to be the restless feeling of hyperactive ADHD (in adults/teens), was anxiety. Now, I also had real anxiety, but not 100% of the time like I had the restlessness. At the current time I believe I might have combined ADHD plus AS. But then again, I fail to see when one ends and the other one starts.

And since you mention arithmetic, that was one of the areas where I noticed a severe regression. I was in the top 3 of my grade in mental calculation (not sure if it's the right term in english) during primary. During secondary it got increasingly hard for me to keep track of what I was thinking.

My parents didn't think there was something too wrong with me because in spite of this regression, I would still have an advantage over my peers until the last 2-3 years of high school (from age 15 to 18) and it wasn't until then that I had trouble, academically speaking.

Then I asked to be taken to a psychologist, and somehow I ended being "treated" by a spiritual practitioner instead who did Reiki, flower therapy and "regression to past lives". I have to say flower therapy did seem to work to some extent... or maybe it was placebo, I'll never know.



I strongly agree with that second paragraph, at least in my case hyperactivity evolved into restlessness and impulsivity. The whole description sounds a bit like myself, actually. I am naturally very affectionate, but had to learn to inhibit that behavior since I would display this affection in somewhat weird (non-neurotypical) ways. And it was not "normal" for a male like me to behave in such manner, if you know what I mean. My overly manly appearance didn't help either, lol.

However, I have a hard time responding to affection by others, not sure why. Sometimes I don't know how to react to a hug, or a kiss on the cheek (by a family member or friend). And I just stand there paralyzed while being hugged. I've always been very susceptible to physical contact.



And that is a totally valid theory, imo. Then only thing that I am sure of, is that ADHD and Autism are more related one to each other than what it is officially accepted the current day. I agree with the fact that our knowledge on the subject is quite poor.



I partly agree. I agree with the part that all mental illnesses are connected, but not quite with your last sentence.

I think we have grouped symptoms that commonly (but not necessarily) are given together into fake "disorders" which aren't actually the real thing. From my point of view, it can be seen in two ways, either Autism, ADHD, etc all belong to very broad and symptomatically diverse disorder, or they are just a bunch of different small mutisms which are somewhat related between eachother, and not a concrete disorder per se.



Exactly.

I am usually very good at identifying psychological symptoms and tendencies within myself, because I have studied psychology extensively because of my high curiosity, and I have spent many years exploring my inner self trying to understand who I am. My psychologist herself said I was an extremely "emotionally intelligent" person. And now, it seems that I have 2 different disorders but yet I fail to delimit them from one another. This feeling combined with the huge overlap in symptoms, comorbidities, and mechanisms involved... plus the abstract, ambiguous definitions of the DSM... plus the high diversity within both spectrums... (yes, ADHD is a spectrum too) it just does not fit for me. There is definitely something deeper going on here.



I believe people with autistic traits will probably be more prone to internalize hiperactivity/impulsivity instead of externalizing it.

Do you feel like sometimes you are out of control? Like you frequently can't deny yourself some urges instead of doing what you should be doing? Do you feel something like a constant, silent anxiety withing yourself? Like you can never be 100% relaxed? If the answer to these questions is yes, you probably are impulsive/hyperactive.



Well, I did find in the literature about ADHD many references to a lack of abillity in picking social cues, just as autism. Maybe impulsivity is (partly) behind social difficulties within Autism, too.

I have a question for all you Aspies with a special insterest and a deep knowledge about it. When you researched it, did it feel like an addiction? Did you feel good while absorbing all that info? Did you feel the urge for more? Did you desire to be reading about that subject whenever having to do whatever other thing? If so, then probably Autistic hyperfocus might be a byproduct of impulsivity, just as ADHD hyperfocus.

I disagree with the only thing that AS and ADHD share being EF problems and repetitive movements. I been reading the ADHD forums for a long time, and I found that in many cases, there are OCD traits which means non-practical rituals and perfectionism, just as with AS. Executive Funcion Disorder and OCD are probably deeply linked, and the reward system of the brain is most certainly involved too. At least that's what I think.

About fidgeting and stimming, I myself do both.



Sorry, I worded what I wanted to say in a somewhat ambiguous way. When I said "central" I didn't mean it is always present. I meant it is present as a spectrum. There are people unaffected as well as people severely affected.

I apologize if I offended someone with this little mistake.

And, just out of curiosity, what would you say are the key differences between AS and Autism? (I am genuinely interested, not implying that you're wrong).

-------------------------

Lastly, thank you all for your wonderful opinions. Definitely some food for thought.

Where in Spain do you reside?

I know somebody who lives in Olot, Catalonia.

I live in Alicante, which is located in the eastern coast of the peninsula and a tiny bit to the south. Not close to Cataluña, in any case. Though I have visited the region for a vacation. They have a very nice theme park (is this the correct term?).

I had a good friend there, too. But I ended up cutting contact with her as with most of my friends, unfortunately.

I hope you can make many new friends.

Alicante, from what I understand, has the hottest weather in Spain. But the winters are nice.

I'd say it's even hotter further to the south, in Andalucía for example. But yes, summers are hot. I suffer them, as I don't tolerate heat too well. Cold has always been less of a problem for me (I have been to actual cold places, not talking about the spanish winter).

I don't need many friends, I am better off with a small group of good ones, but it's still something I definetly have to work towards.

Maybe I can find some here, in wrong planet. Who knows.

The people I know with ADHD are socially normal.
I don't know if they perceive themselves as socially normal, but they appear normal to others.

Most of the people I know with ASD mention social problems often, but EF problems rarely or never.
It seems that some don't have major EF problems mentioned often by people with ADHD.

Yeah, they are pretty similar. The official symptoms of each are different, but the other qualities are pretty common among people in both groups. Personally, I have ADHD, not ASD, but I hang around the autism forum because I feel like many of the folks here actually have more similarities. Granted, I may be a special case. I do have that BAP personality, I currently have mild social problems, and when I was a kid, I had the kind of social problems people on here talk about. So maybe I just have super mild ASD in addition to ADHD.

To further complicate things, there is a push to split ADHD into two conditions, and potentially more. Theoretically, many of the people with inattentive ADHD should be diagnosed with Sluggish Cognitive Tempo aka Concentration Deficit Disorder instead (or also). Apparently everyone with actual ADHD has at least some hyperactivity while SCT has few executive function problems (but I guess more brain fog or something; I'm not sure). I was a little surprised by this because I have a lot of EF problems, but my only hyperactivity comes from sensory issues.

In the past, a person wasn't supposed to be diagnosed with both. I remember reading about the DSM text of both conditions, and apparently the reason for this is that ADHD is considered an inherent part of autism, so diagnosing both would be redundant. (In other words, autism is a subcategory within ADHD!) This changed in the recent DSM because people with only an ASD diagnosis weren't getting ADHD treatment that would help them.

I have both ADHD (combined type) and ASD (autism spectrum disorder).

Back in November 2014, I was referred to a specialist to discuss ADHD symptoms. The specialist diagnosed me with ADHD and then suggested I also had ASD. I was surprised. He used the word 'comorbid', which I'd never heard before. He referred me for an ASD assessment with his colleague. I was subsequently also diagnosed with ASD.

Once diagnosed with ADHD, I was prescribed Ritalin first and then Concerta. The Concerta does help with focus and attention. My GP has additionally prescribed Zyprexa/Olanzapine, which has really helped with mood swings and some other unwelcome episodes. I've also been having some sessions with a psychologist, which have been helpful. All of these services have been provided here in the UK by the National Health Service (NHS) free universal health care system. I've been pleased with the service.

It's interesting to read what others have said here about the way ADHD and aspergers/ASD conditions overlap. I've done some research and trying learn what's what. This is what I think so far. I've chosen to put key words in bold.

I've always been anxious. Following counselling, I'm realising that my anxiety is often triggered by uncertainty and not being able to predict or control situations. Not knowing what's going to happen can be quite distressing. (eg the dreaded unexpected meeting with a line manager). I wonder if this is related to aspergers/ASD

Subject matter can often extraordinarily interesting (hyperfocus). I can easily immerse myself in railway train timetables or airline or bus schedules. But it takes so much effort trying focus on other stuff which doesn't seem interesting. So I can get bored easily.

I came across this report on ASD/ADHD comorbidity.
http://www.rcpsych.ac.uk/pdf/Whitwell%2 ... pdates.pdf
In this report, I can really relate to the comment "Could symptoms be masked by co-morbidity – eg ADHD symptoms may lead to better ratings on social interaction in children with ASD, partly because of the increased talkativeness seen with ADHD". My ASD diagnosis singled out my good communications skills and I've always seen myself as a chatty person.

Hopeless working memory / executive function. I'm much better at memorising information, rather than juggling different pieces of information. I'm terrible at project management, but will faithfully execute step-by-step linear instructions with clear outcomes.

Anyone who knows me will say I'm impatient, easily distracted, sometimes manic/hyper and prone to panicking. The ADHD pills to seem to help some of these symptoms.

Empathy - In my ASD diagnosis, I was scored poorly on empathy. On their system, 30/80 and below was a trigger for possible autism. I scored just 16/80. Others have said the same: I struggle with empathy and I know it can make me rude, inconsiderate, cold and uncaring.

Special interests - I've been called 'rainman' because of my encyclopedic knowledge of UK train services. I really enjoy my hobbies and prefer them to random social chit chat. I've never be great at small talk.

Looking back, I know that my situation has contributed to my poor employment record. And that does get me down, sometimes. But I'm mainly fine about these dual diagnoses. I've cut back on drink (which was making things worse), the prescription drugs help and greater self-awareness. I know that more counselling/specialist therapy will be helpful.

If ADHD were placed on the autism spectrum, then autism rates would sky rocket and there would be more autistic people in the world. I do not view people with ADHD as autistic.

I do not have ADHD but I was only two symptoms away from fitting it so I only had ADD the inattentive type. My psychologist seemed to think I had ADHD when I was in 6th grade and I think others suspected it too. I was on medicine for my ADD and then taken off it in 6th grade because they were not the right pills. I don't know why I was on them for two years if they were not the right ones.

My son could have ADHD but he could also have very mild ASD (he scored a 32 on the CARS-2 which is barely on the spectrum because 30 is the cutoff) but we don't know yet which is why we are going to get him reevaluated by professionals. My mom thinks it's social anxiety that is manifesting the symptoms because they only appear in certain situations like in large groups and his behavior is different in school than it is at home. But he is hyperactive and impulsive which happens at home and he has difficulty with transitions and throws tantrums and he likes to chew on his fingers. He also likes to run around and he will do the same thing all the time which is watching youtube on his 3DS and we have to limit it because it's not good for his brain to have a lot of screen time which are the only things I see at home and also boredom is hell for him because he gets into a lot of trouble and can't be good when he is bored so long lines are not for him. But in school more symptoms appear which is what they picked up on so they wanted to test him for it but it's not a diagnoses. He did have a late start too and I can't recall him using any gestures except pointing. He is using them now according to my mother. He will shrug his shoulders and do something with his hands. I don't know if this was a normal thing for a five year old or something with TOM deficits but he can't seem to understand that his sister doesn't want to play and he will point to things and expect me to know what he is talking about. I know kids develop TOM by age four and he is five now but I also read online that some don't have it fully developed until age six so some NT kids might not pass the Sally Ann test until that age. I have never tried the test yet with my son to see what he answers. But I still don't view him as autistic.

But I do see a lot of overlaps between the two so they are like sister conditions and people with ADHD can also have dyspraxia and SPD plus ODD and other co morbids like anxiety and OCD.

Funny thing when I was a kid I was impulsive and I can remember being very hyper but it wasn't on a daily basis but yet I don't have ADHD so I wonder what does this mean? These are traits of ADHD and I seem to fit the label but I don't have it so it makes me wonder if it's just my ASD traits? I also had a hard time controlling my impulse as a child. I don't know if this was ADD or ASD. I also fidget too which might just be my ASD symptoms of me stimming. I also interrupted and I also talked a lot and would go on and on and I have blurted out answers without raising my hand. I also had behavior issues. But yeah they could just be my ASD traits that are mimicking ADHD and only a psychiatrist can know. But I don't know, this is all very confusing.

I recently underwent evaluation, and am awaiting my results.

However, from the short time he observed me, he said he saw signs of ADHD. Which I get, but the thing is, I wasn't distracted, I wasn't making eye contact. Also, I wasn't fidgeting, but used my hands to figure things out in my head like I've always done (for example, I was signing a sequence of numbers with my left hand and picking out the correct re-order with my right).

So while ADHD DOES explain some things, it doesn't address the eye contact issues, nor does it address the sensory issues or the inability to recognize subtext (small talk, boredom in conversations, rhetorical questions, etc). Among others.

I have no intellectual impairment, in fact, he found me astoundingly bright with a large capacity for retaining information, as well as an ability to combine multiple sources of separate information to come to a unified conclusion. (I'm a freakshow, trust me, I know). For someone having supposedly having attention issues, I think it suspect that he would say I am able to accomplish much when focused. While I get that 'hyperfocus' is a part of ADHD, does that hyperfocus occur over a span of days? From what I've read, the hyperfocus ends frequently without completing projects, whereas I have a tendency to complete what I've set out to do.

So I wonder if ADHD isn't actually a comorbidity but maybe it is a misconception about what Autism looks like in some ways? So therefore ADHD isn't Autism, but some ADHD is misdiagnosed Autism.