Diagnostic Overlap - Autism, ADHD or Both?

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After receiving my second formal diagnosis of autistic disorder, my doctor has explained that I am not, in fact, ADHD.

According to my shrink, everyone with high functioning autism is ADHD and no one with HFA is ADHD. My p-doc explained that ADHD is merely an umbrella term for a collection of symptoms that we are all familiar with. In my case, these symptoms are caused by autism, therefore an ADHD diagnosis is unnecessary (I will, however, continue stimulant therapy).

So, does ADHD exist as an independent neurochemical imbalance? Or could one have autism induced ADHD or hypothyroidism induced ADHD?

My autistic path of self discovery has been rather interesting.

For many years I just thought I was severely ADHD. I used to say my ADHD was "life threatening."

I can't drive, remember my own address or phone number, and I get lost everywhere I go. I have sensory integration issues and anxiety issues.

Oddly enough, I have an unbelievable capacity to memorize dates, facts and statistics regarding my obsessions.

It seems likely that my ADHD is a natural outgrowth of my autism, as it is not normal for someone to spend hours everyday obsessively studying a special interest, yet forget everything else. Sometimes I forget my own name - eck.

Information just pours out of my mouth every time I open it, but I could get lost in the grocery sore.

Do you guys think ADHD could be related to autism? It seems likely to me, when you consider the similarities of many of the symptoms, especially hyperfocus, anxiety, distractibility, etc... Of course, these issues are far more pronounced in HFA and become quite disabling as you move down the autism spectrum.

Redacted.

Last edited by Willard on 01 Oct 2011, 9:00 pm, edited 1 time in total.

I'm a psych major in college and thinking about going to psychiatry if I go to medical school, so your psychiatrist probably knows more than I do about this.

That's an awfully confusing way to put it.
I have been diagnosed with aspergers several times and diagnosed with ADHD twice, once by a special needs department in elementary that was about as useful as a blind service dog and a psychiatrist. The special needs didn't do any research while my psych said that aspergers was "overdiagnosed" and said I had ADHD.

I shortly left after that because his ADHD medication was not working in the slightest.

I have to halfway agree with your psych though, many of the symptoms overlap into the autism spectrum, but so other disorders such as SDI (sensory integration disorder, something I was also diagnosed with along ADHD.) And I have seen some people who are autistic work well with ADHD medication.

I'm going to say both.

I have read of speculation that ADD could be classified on the autism spectrum, as a less severe disorder than the high functioning autistic disorders. Which I think is highly possible. There are certain behaviors which are similar or basically identical that have different names under ADD. Inability to focus in ADD could be called over-stimulation in Autism, fidgeting in ADD is called self-stimulation is Autism. I also have a similar path to yours though i have not yet arrived at official diagnosis. Im however surprised that you were ever considered ADD, you case of autism sounds rather deeper than mine.

It is important you yourself mentioned hypothyroidism, so we can use it to illustrate why symptomatic similarities may not necessary equate to closely related disorders. Hypothyroidism is an hormone problem, it can cause cognitive abnormalities very much like ADD, but it is a completely different cause. It can easily be tested for in the blood, and then corrected by prescription of synthetic thyroid hormone.

And an analogy can be taken from biology, consider morphological similarities arrived at by convergent evolution. A dolphin is outwardly morphologically far more similar to a shark than it is to a monkey, to which it is much more closely related.

You sound just like me and I am AS + ADHD-NOS and also on stimulants (Adderall XR).

Not being able to focus isn't always about overstimulation. It can be the opposite or because of the lack or too much activation of neurotransmitters. ADHD is separate from autism because it's caused by a specific abnormality in the brain which is why there is medication for it, unlike autism.

Fidgeting and self-stimulation is different too. Fidgeting is often an impatience or boredom thing, stimulation is a calm down method.

ADHD isn't always less severe than autism. Like autism it has a mild to severity spectrum.

Most frontal lobe disorders share similar symptoms but for different reasons.

I don't know why the OP thinks he's less ADHD because from his posts I'm given the impression of someone impulsive and hyperactive, and considerably so.

I was hoping someone would point this out. My dad has ADHD and takes Adderall, as do I. My mom will be starting Vyvanse tomorrow.

My whole family is a hodgepodge of ADHD, autism and general mental weirdness.

Sometimes, I'd swear my dad has Asperger's, but other times it is hardly noticeable.

My mom is just a space-cadet, with classic forgetfulness, fidgeting, mood swings and anxiety.

My sister is certainly ADHD, but also has sensory issues.

I have a classic case of Asperger Syndrome.

To the untrained eye we are just a quirky, interesting, fun and very similiar bunch.

The labels fall short of evoking the real picture, but they have certainly helped us to get properly medicated - life is much better on the right medicine.

I take 40mg of Adderall IR (exclusively Sandoz brand) daily as well as 20mg of Celexa (Citalopram).*

I refused meds for a long time, but I have been far more successful on them.

This combination helps to control my hyperactivity and impulsivity (if you think I'm bad now Penseive, sheesh!), anxiety, sensory issues, obsessiveness and general spaciness.

My stimming is no better, but it was never disabling (just weird finger movements 24/7).

If ADHD is, indeed, a separate disorder, I am grateful that it accompanies my AS, as it makes me considerably more socially ambitious.

I may be weird, but darn it, you're gonna like me and be my friend or else!

*
I do have this to say on the topic of medication...

I have recently been criticized for the medication I take. I'm not ashamed to take medication. My family was very opposed to psych meds for a long time, but when they saw how my life turned around when I began Adderall, they reconsidered.

If anyone reading this is concerned that I am dependent on these medications - don't be. I am dependent on alot of things; these medications not only improved my life, they saved it. Yes, I rely on them. I also rely on my contact lenses to correct what I see as a genuine problem. If you don't need contacts, great, but that doesn't mean I don't. Same with medication. Both are very benign in therapeutic doses.

I was barely managing to remain alive before medication. My family, friends, and everyone who knows me closely would NEVER recommend I discontinue my medication. They like to see me happy and safe.

Oh, hey you! I was wondering what your username on here was!

I do think I'm ADHD, but I really can't tell where the AS ends and the ADHD begins.

Yeep.
There's much similarity in them, as some of the effects appear reciprocal or the inverse, it's too strange to be coincidental.

I'm inattentive with dysgraphia and some other motor issues ( clumsy)--- this latter due to low dopamine.

There can be extra things that accompany this, such as sensory issues, sluggish cognitive tempo, dysgraphia, etc. Imaging suggest that this is pervasive.

One thing though, that would circumscribe ADHD out of the autism spectrum is 'theory of mind'. ToM and the non-verbal are inextricably linked together. To intuit the other mind is reading this non-verbal. Folks with ADHD can be behind in ToM, due to 'attention issues,' but are capable of it, though perhaps delayed.

I believe ADHD is no where near "Autism" when considering "theory of mind." I believe though it should fall under Pervasive Developmental Disorder. A plain "developmental disorder" is way understating of what is happening here--- Dyslexia could be this, not ADHD with all this other.

This thread reminded of another thread in the parents forum: www.wrongplanet.net/postt174106.html. For some people, there appears to be no confusion between ASD and ADHD symptoms. Personally, I don't know where the ASD stops and the ADHD starts. When my daughter's hyperactivity is subdued and her concentration is working well (which happens for no reason I'm aware of as she's not on any medication), the probable Aspergers is more noticeable. But normally her symptoms are all jumbled up and I can't make sense of anything. I've spoken with a mum who was advised to give her child ritalin so that an autism assessment could be carried out, without the interference of ADHD-like symptoms. I expect that if and when my daughter gets a diagnosis, ASD will take precedence over ADHD.

Ignoring effective coping strategies and being used to managing it for a moment for the sake of this post, ADHD basically can do these things to my attention:

ADHD can make me pay shot-lived motivated attention to things I don't care about other than during that moment in which they're new or provide a change from what I've been doing. It can make forget to remember that I don't care for what I spend time on or don't like it.

Rather than always getting upset about a disruption I really don't care for, my ADHD can make me jump at the chance of getting disrupted - because that's a distraction that stimulates me more than what I've been doing before. It might take only half a minute but can take much longer until I become bored and realise that I absolutely don't care for discussing who went where to meet whom or where there was a festival... I just cared for the distraction.

When I am "calm" and feeling well, there're so many things on my mind that I can't even tell them apart. The more relaxed and happy I am, the more things my ADHD can make me start casually but not pursue further.

To me, ADHD is the ability and disability to be interested in everything, to be motivated to spend time on everything and everyone sometimes including things I don't see any reason to waste my time on, to have trouble sticking with one thing because unlike others, I don't lose sight of other possibilities after having made a decision, to welcome and need change to feel calm and happy and to seek out and to try to understand what is "new". And then there's hyperactivity and impulsivity too.

Besides the possible overlap of other symptoms, my ASD feels like the exact opposite.

My son 13yrs when he is over hyper and can't focus or concentrate, he will say sorry mum I can't help it my ADHD is taking over Also dx AS

I was diagnosed (or mis-diagnoses you could say) with ADHD before I was diagnosed with Autism. Many years later, I do believe I have both, and am going to start stimulants for ADHD soon.

I have strong traits of both. I envy folk on the spectrum who do not have ADD symptoms. I was assessed as having Asperger's at a center for autistic adults and children. I had another shrink who refused to believe that I had ADD and was more willing to accept my Asperger's assessment, but jotted me down as PDD-NOS...I am TREATED (for 2 years now) for ADD..only recently did the doc add a low dose of prozac to my med cocktail. Adderall marginally helps me with my executive dysfunction. Prozac helps with the things that I was taking the valium for....but makes me tend to me sleepier than valium...and also assists with the executive dysfunction....which is still a gigantic pain....and I still have the valium for incidents when I am completely overwhelmed...but def. need it less with my low dose of Prozac..am overwhelmed less in general.
I have NOT talked to my ADD doc about my Asperger's assessment. I felt that it was a mistake when I did so with the doc who jotted me down as PDD-NOS.
I had been on ADD meds in the past, and was in the process of trying to get on them again, because I was dealing with much more than I could cope with and was at my Wit's end with not being able to handle multiple tasks that were on my head, partially because I was overwhelmingly distracted by my stupid obsessions...still a problem.

As a child, I was NOT hyperactive, I was inattentive, had above average intelligence and dyspraxia. I def. do have issues with theory of mind. I also have sensory issues. Depth perception issues....All kinds of issues that are connected to the autistic spectrum. I was very different from everyone else in my classes at school blah blah...I don't want to complicate things by bringing up AS issues with my ADD doc after having been treated for ADD for 2 years