The Overlap: ADHD, Anxiety, and Autism

One of the most common misconceptions about neurodevelopmental conditions is that they exist in isolation. You either have ADHD or you do not. You are either autistic or neurotypical. Anxiety is a separate issue to be treated independently. But the reality of how these conditions actually work in real people is far more nuanced - and understanding this nuance is essential for getting support that actually helps.

Research consistently shows that neurodevelopmental conditions travel together far more often than they occur alone. Studies suggest that somewhere between 50-70% of autistic individuals also meet criteria for ADHD. Anxiety disorders are present in an estimated 40% or more of people on the autism spectrum. And ADHD itself frequently co-occurs with anxiety, depression, and learning disabilities. If you or your child seems to fit into multiple categories, you are not imagining things - this is actually the norm rather than the exception.

But here is where it gets complicated: these conditions do not just coexist peacefully side by side. They interact with each other in ways that can amplify challenges and make it harder to identify what is really going on. Understanding these interactions is crucial for effective support.

Consider how ADHD and autism might interact in a child. Both conditions can involve difficulty with executive function - the mental skills that help us plan, organize, start tasks, and manage time. An autistic child might struggle with executive function because of rigid thinking patterns and difficulty with transitions. An ADHD child might struggle because of impulsivity and difficulty sustaining attention. A child with both? They face a double challenge, and strategies that work for 'pure' ADHD or 'pure' autism might not be sufficient.

Or think about how autism and anxiety interact. Many autistic individuals experience significant anxiety, but the sources of that anxiety are often different from what we see in neurotypical anxiety disorders. An autistic person might feel anxious because social situations are genuinely unpredictable and confusing - not because of irrational fears, but because they lack the intuitive social understanding that neurotypical people take for granted. They might feel anxious because sensory environments are genuinely overwhelming. Treating this anxiety with standard approaches - like encouraging more social exposure - might actually make things worse if the underlying autistic needs are not addressed first.

The overlap also creates diagnostic confusion. Difficulty paying attention might be ADHD - or it might be an autistic person who is overwhelmed by sensory input and cannot filter out distractions. Social withdrawal might be autism - or it might be anxiety-driven avoidance in someone who desperately wants connection but fears rejection. Meltdowns might reflect emotional dysregulation from ADHD - or sensory overload from autism - or panic responses from anxiety. Without careful evaluation, it is easy to identify one condition and miss the others.

This is why comprehensive assessment matters so much. When we evaluate someone for possible autism, we are also looking at attention, executive function, anxiety, mood, and learning. We want to understand the full picture because the full picture determines what support will actually be helpful. Treating ADHD with medication might help with focus, but it will not address the social communication differences of autism. Treating anxiety with therapy might reduce some distress, but it will not change the sensory sensitivities that are triggering that distress in the first place.

For many people, finally understanding the full picture is transformative. We often hear from adults who were diagnosed with ADHD as children, tried medication, and found it helpful but incomplete. When they later learn they are also autistic, suddenly their whole life makes more sense. The social difficulties they attributed to 'not trying hard enough.' The sensory sensitivities they thought were just 'being picky.' The exhaustion from masking that they assumed was normal. Understanding the complete profile allows for complete support.

If you recognize yourself or your child in these descriptions - if it seems like more than one thing might be going on - trust that instinct. The goal of evaluation is not to collect labels but to understand how your unique brain works. Some people do have 'just' ADHD or 'just' autism. But many have a more complex profile, and that complexity deserves to be understood and addressed.

A thorough evaluation can map out this entire landscape. It can identify which challenges stem from which conditions, how they interact, and what interventions are most likely to help. It can also identify strengths - because these conditions come with genuine strengths, not just challenges. Understanding your full profile means understanding your full self.

If you have been wondering whether there might be more to the story than a single diagnosis captures, we would be honored to help you explore that question. Complexity is not a barrier to understanding - it just requires the right approach.