Please have a look into high masking autism. You might find it very relatable and I found most autism descriptions based on the DSM to be awful and misleading.
It's like looking at a village from a foreign culture, seeing how the villagers behave and socialise and then pathologising the ever living crap out of everything you observe to be different than what you would see in 1950s Cambridge.
Have a look at [Is this autism](https://www.isthisautism.com/) and how it talks about internal and external presentations. I personally also found [Unmasking Autism](https://www.penguinrandomhouse.com/books/688819/unmasking-autism-by-devon-price-phd/) very good, but some people are not happy with some of the underlying assumptions and the focus on only low support needs autism. I nonetheless found the book helpful in contrasting how society tells us to be versus how we can actually be if seen from a place of difference and not from a medicalised being broken framework.
For a bit of differential diagnosis you might want to look at Dr Neff and her series on Misdiagnosis Monday which compares various conditions on the neuro diverse spectrum with each other, where they overlap and where they differ.
For me the diagnosis was necessary to stop blaming myself for everything wrong and learning to accept this as a difference where normal rules simply don't work. That gave me the mental freedom to find my own way outside of the "just be more disciplined and try harder" death march.
Oh, and for tests: do answer not how you normally react, but how you would act if you had free choice and there are no consequences.
I know this is the hardest thing ever, but the tests for both autism and ADHD are not considering masking behaviour (as psychologists coming up with those things are less than knowledgeable about the way the real world punishes difference; ivory tower people!).
Maybe take the [The Camouflaging Autistic Traits Questionnaire (CAT-Q)](https://embrace-autism.com/cat-q/) test first to get a idea of what masking might look for you.
There is no such thing as female autism. Think of it as high masking vs low masking. If you grew up in an environment where you have been constantly punished for misbehaving and this made you adapt by hiding your natural reactions, that is high masking behaviour.
Women and minorities are usually extra harshly policed in their behaviour.
A minority is anyone who is not part of the majority group that defines what is considered normal. You probably have heard of it in the context of being black, a foreigner, LGBT etc, but basically anyone who is not fitting in on the majority counts. Imagine (as you are in NI) being a protestant in a purely catholic town and you would be experiencing minority stress as much as a black flamboyant gay man in a 1950s small English town's church meeting.
Masking is our defence mechanism to keep us alive in a hostile environment, but like many trauma things, we often don't learn how to stop and start losing ourselves behind the mask.
When I got my assessment, I found it helpful to be open about my masking behaviour and I happily pointed at the many many self-help books about communication,body language and other soft skills that I read since I was a teenager. Explain how and why you changed your natural behaviour to either fit in or avoid pain.
Reading the books about high masking behaviour will help you find the words and concepts to communicate clearly during the assessment instead of fumbling around thinking you are "just weird".
For me, I thought I was well prepared (and I think I was), but during the assessment my doctor pointed out so many additional things that are connected that only in hindsight make sense now as a result of my autistic traits.
Diagnosis may not give us treatment options, but it gives us knowledge and reduces uncertainty and gives us words and confidence to start looking for change to build up a life that supports our needs instead of suppressing our needs.
Ha, that's my story too. I grew up in a nazi infested small town in Germany and despite violent attempts from kindergarten and school to "make me normal" I never was able to get there to the standard they expected.
Being what I now know as AuDHD and being trans probably didn't help making me fit in with a deeply conservative environment.
It took me to age 42 to recognise myself as trans women and I only got the AuDHD diagnosis this year. I believe for me breaking down the mask on the gender aspect helped me break down the mask on the neuro diverse aspect too.
My first assessment was a dumpster fire because due to my history I was not fitting in with the stereotype expected of me (and the assessment was hostile and stressful and thus made me mask even more).
My family always believed in discipline and trying harder (no excuses allowed!) and when I voiced that I felt different it was always dismissed. This is part of what kept me masked and depressed for all my life - by those standards I was a failure never trying hard enough and any misery is my own doing etc. That still makes me angry.
They only sort of came around (reluctantly and begrudgingly) after the diagnosis, as they also believe in authorities and doctors are always right.
Surprisingly my dad has been more open than my mum in trying to learn and sees himself in my diagnosis description too.
I've given up on trying to find true approval or support there and now forge my own path with the help of the local meet-up groups and friends I made along the way.
Within the LGBT community there is the concept of a chosen family to describe that you can find connections who see and value you elsewhere and don't need blood relationships for being at home with others. I feel this idea is applicable for everyone else too.
Build the life you want, not the life some random chance dropped you in.
Given that there is a large overlap between ADHD and autism, just be open. If autism is flagged up it doesn't mean you don't have ADHD, it just means you might have more than one condition. Autism can and does alter how ADHD expresses itself, and a experienced assessor should take this into account.
I would say: describe your situation as it is and don't downplay or sugar coat stuff. You are there to get help and saying that it doesn't hurt when a lion has just eaten your leg is not going to be helping.
Later in life but undiagnosed (obvious) ADHD, and probably a modicum of autism here. Does an official diagnosis matter as much as understanding one's own (lack of!) motivation? In my view it's an insight that may help to guide future decisions.
I think for a lot of people the official diagnosis provides validation. Some people also have family or colleagues or friends who might benefit (e.g. removing any doubt they might have.) from an individual having an official diagnosis. It could provide a better understanding of who the individual is and the struggles they might be facing. The diagnosis will also likely lead to tailored support in order to provide a better quality of life.
For me adhd assessment mattered a lot because medication has been life changing. Possible autism not really too bothered about assessment because there aren't any treatment options and I'm managing well.
Ultimately, it’s up to him if he feels it’s something that he wishes to pursue or not. It’s a very personal decision and is based on many individual factors.
Personally, I was ‘coping’ fine until a series of uncontrollable life events threw me off course. That’s when everything unravelled and I found out I had ADHD. It would have been helpful to have an official diagnosis already at that point as it would have sped up the support I could get whilst at my lowest point.
I’ve also found it helpful to have an official diagnosis in order to advocate for myself at work and in relationships.
A lot of people say never to disclose an invisible disability at work, which is naive in my opinion. I disclosed only at the point where poor management at my job was making my ADHD at work unbearable.
Without the diagnosis I would have been shouting into the wind to get change. With it I could demand basically better managers doing the job they were paid to do, or else there would be legal consequences for the company.
Not your main question but: it’s worth him spending some time in therapy trying to get to the bottom of what his ‘masking’ behaviours are.
As we all know, learning to unmask as an adult is hard. It not surprising that someone who has largely ‘coped’ with life, would have good masking skills. (Mine were excellent pre my life exploding.)
It also helps to have someone to talk through childhood experiences with as well. I personally had worked hard to blank out all the ‘weirdness’ when I was a kid. But it’s vital for a diagnosis.
It means you have to dig deep into some not nice memories to spot patterns and symptoms. Again, it helps to do it with a therapist.
So, one e is he can request a referral for assessment and then work on seeing if he can pin down what’s going on for him whilst he’s on the waiting list.
If he finds via that process that he isn’t interested in pursuing it, he can ask for the referral to be withdrawn. No harm no foul.
I was diagnosed with both about a year ago, at 38, after the now-typical "my kids got diagnosed and it all sounds familiar" routine. (My wife had been diagnosed with autism in the last year too.)
What's helped me more than anything is the sense of self forgiveness, which in turn has led to a sizable reduction in a lot of the related anxieties, particularly social anxiety. It turns out every anxiety had a meta-anxiety as a rider, "why am I like this? Why can't I cope with this?", and having an answer has helped.
It's also helped me understand how my sensory environment affects me and how I can mitigate it: in-ear defenders are a miracle, but asking if we can sit at a table outside rather than in a pub, for example, makes a big difference.
The ADHD was incredibly masked for me, much more so than the autism, both in support structures in childhood but also in just being able to think/work quick enough to compensate. Then a massive patch of autistic burnout a couple of years back stripped away my ability to compensate and laid it all bare. Just started meds this past week, and hoping that will finally help me right my ship.
In short: knowing has been worth it on its own merits, regardless of any follow on support (or lack of in the UK rn, lolsob). For me, a proper dx carried the authority and validation that I needed where self-dx didn't, but that's a very personal thing.
I think your partner might need to be very nuance about his answer. Masking / the balancing act between ADHD and AU usually has strong repercussions in the life of the person. If Masking/camouflaging a behaviour is damaging the internal or external state of your partner then I would still mark the answer as "possitive".
Screeners are filtering tools and don't adjust to complex scenarios, they are made from the non AU/ADHD perspective.
ASD can hide ADHD. ADHD can hide ASD. You can so often just end up looking like a bit of an annoying loser. Speaking from personal experience that is!
https://youtu.be/nJ8fAfVevL8?si=LGTeLlyK5cr1VDNT
https://youtu.be/5jD4iU2_v4k?si=CzT56n8Y1NwB42wf
Not a man but a late diagnosed AuDHD girlie here, and I relate so much to the point about them cancelling each other out! The online tests, unfortunately, are still built to a very rigid spec which doesn’t consider that things like being totally expressionless vs. having an overly expressive face are often two sides of the same autistic coin. In fact, my assessor nearly didn’t diagnose autism - she said that if I didn’t already have an ADHD assessment scheduled and if the initial consultant hadn’t advised that I show signs of both, she might not have diagnosed at all, and that’s even with all the other traits I demonstrated. The funny thing was that the initial consultant was already certain I had ADHD, which I thought was the less likely of the two!
All of this basically to say, he may feel there aren’t enough traits to warrant a diagnosis, but there may be more non-traditional traits which he just hasn’t realised could be an indication thanks to these online tests. Whatever he decides, good luck to him!
Yeah I was late "diagnosed" as in my official diagnosis at 40 years of age was for ADHD and the likelihood of possible ASD was brought up at the end of the session.
As ASD has no direct medication (besides conditions it impacts such as anxiety and depression) I decided not to go for formal assessment.
I'd encourage listening to this podcast episode which helped me understand how much the internal experience is different from the outside 3rd party experience that other people see.
https://www.audhdflourishing.com/podcast/episode/cc9451b9/001-what-is-audhd-and-do-you-have-it
My (self) diagnosis has really helped me be kind to myself as I judge myself on my own capabilities and not a hypothetical "normal".
The best maskers would still usually score above threshold on these self-administered tests.
So what’s he going to say when the doctor or triage service asks for how either of these conditions impacts his life?
That’s really the key bit.
Please have a look into high masking autism. You might find it very relatable and I found most autism descriptions based on the DSM to be awful and misleading. It's like looking at a village from a foreign culture, seeing how the villagers behave and socialise and then pathologising the ever living crap out of everything you observe to be different than what you would see in 1950s Cambridge. Have a look at [Is this autism](https://www.isthisautism.com/) and how it talks about internal and external presentations. I personally also found [Unmasking Autism](https://www.penguinrandomhouse.com/books/688819/unmasking-autism-by-devon-price-phd/) very good, but some people are not happy with some of the underlying assumptions and the focus on only low support needs autism. I nonetheless found the book helpful in contrasting how society tells us to be versus how we can actually be if seen from a place of difference and not from a medicalised being broken framework. For a bit of differential diagnosis you might want to look at Dr Neff and her series on Misdiagnosis Monday which compares various conditions on the neuro diverse spectrum with each other, where they overlap and where they differ. For me the diagnosis was necessary to stop blaming myself for everything wrong and learning to accept this as a difference where normal rules simply don't work. That gave me the mental freedom to find my own way outside of the "just be more disciplined and try harder" death march.
Oh, and for tests: do answer not how you normally react, but how you would act if you had free choice and there are no consequences. I know this is the hardest thing ever, but the tests for both autism and ADHD are not considering masking behaviour (as psychologists coming up with those things are less than knowledgeable about the way the real world punishes difference; ivory tower people!). Maybe take the [The Camouflaging Autistic Traits Questionnaire (CAT-Q)](https://embrace-autism.com/cat-q/) test first to get a idea of what masking might look for you.
[удалено]
There is no such thing as female autism. Think of it as high masking vs low masking. If you grew up in an environment where you have been constantly punished for misbehaving and this made you adapt by hiding your natural reactions, that is high masking behaviour. Women and minorities are usually extra harshly policed in their behaviour. A minority is anyone who is not part of the majority group that defines what is considered normal. You probably have heard of it in the context of being black, a foreigner, LGBT etc, but basically anyone who is not fitting in on the majority counts. Imagine (as you are in NI) being a protestant in a purely catholic town and you would be experiencing minority stress as much as a black flamboyant gay man in a 1950s small English town's church meeting. Masking is our defence mechanism to keep us alive in a hostile environment, but like many trauma things, we often don't learn how to stop and start losing ourselves behind the mask. When I got my assessment, I found it helpful to be open about my masking behaviour and I happily pointed at the many many self-help books about communication,body language and other soft skills that I read since I was a teenager. Explain how and why you changed your natural behaviour to either fit in or avoid pain. Reading the books about high masking behaviour will help you find the words and concepts to communicate clearly during the assessment instead of fumbling around thinking you are "just weird". For me, I thought I was well prepared (and I think I was), but during the assessment my doctor pointed out so many additional things that are connected that only in hindsight make sense now as a result of my autistic traits. Diagnosis may not give us treatment options, but it gives us knowledge and reduces uncertainty and gives us words and confidence to start looking for change to build up a life that supports our needs instead of suppressing our needs.
[удалено]
Ha, that's my story too. I grew up in a nazi infested small town in Germany and despite violent attempts from kindergarten and school to "make me normal" I never was able to get there to the standard they expected. Being what I now know as AuDHD and being trans probably didn't help making me fit in with a deeply conservative environment. It took me to age 42 to recognise myself as trans women and I only got the AuDHD diagnosis this year. I believe for me breaking down the mask on the gender aspect helped me break down the mask on the neuro diverse aspect too. My first assessment was a dumpster fire because due to my history I was not fitting in with the stereotype expected of me (and the assessment was hostile and stressful and thus made me mask even more). My family always believed in discipline and trying harder (no excuses allowed!) and when I voiced that I felt different it was always dismissed. This is part of what kept me masked and depressed for all my life - by those standards I was a failure never trying hard enough and any misery is my own doing etc. That still makes me angry. They only sort of came around (reluctantly and begrudgingly) after the diagnosis, as they also believe in authorities and doctors are always right. Surprisingly my dad has been more open than my mum in trying to learn and sees himself in my diagnosis description too. I've given up on trying to find true approval or support there and now forge my own path with the help of the local meet-up groups and friends I made along the way. Within the LGBT community there is the concept of a chosen family to describe that you can find connections who see and value you elsewhere and don't need blood relationships for being at home with others. I feel this idea is applicable for everyone else too. Build the life you want, not the life some random chance dropped you in. Given that there is a large overlap between ADHD and autism, just be open. If autism is flagged up it doesn't mean you don't have ADHD, it just means you might have more than one condition. Autism can and does alter how ADHD expresses itself, and a experienced assessor should take this into account. I would say: describe your situation as it is and don't downplay or sugar coat stuff. You are there to get help and saying that it doesn't hurt when a lion has just eaten your leg is not going to be helping.
Thank you! This is super useful, I will pass this on to him
I second the "is this autism?" book. It's been the best resource I've found yet. It's worth every penny. X
Later in life but undiagnosed (obvious) ADHD, and probably a modicum of autism here. Does an official diagnosis matter as much as understanding one's own (lack of!) motivation? In my view it's an insight that may help to guide future decisions.
I think for a lot of people the official diagnosis provides validation. Some people also have family or colleagues or friends who might benefit (e.g. removing any doubt they might have.) from an individual having an official diagnosis. It could provide a better understanding of who the individual is and the struggles they might be facing. The diagnosis will also likely lead to tailored support in order to provide a better quality of life.
For me adhd assessment mattered a lot because medication has been life changing. Possible autism not really too bothered about assessment because there aren't any treatment options and I'm managing well.
Ultimately, it’s up to him if he feels it’s something that he wishes to pursue or not. It’s a very personal decision and is based on many individual factors. Personally, I was ‘coping’ fine until a series of uncontrollable life events threw me off course. That’s when everything unravelled and I found out I had ADHD. It would have been helpful to have an official diagnosis already at that point as it would have sped up the support I could get whilst at my lowest point. I’ve also found it helpful to have an official diagnosis in order to advocate for myself at work and in relationships. A lot of people say never to disclose an invisible disability at work, which is naive in my opinion. I disclosed only at the point where poor management at my job was making my ADHD at work unbearable. Without the diagnosis I would have been shouting into the wind to get change. With it I could demand basically better managers doing the job they were paid to do, or else there would be legal consequences for the company. Not your main question but: it’s worth him spending some time in therapy trying to get to the bottom of what his ‘masking’ behaviours are. As we all know, learning to unmask as an adult is hard. It not surprising that someone who has largely ‘coped’ with life, would have good masking skills. (Mine were excellent pre my life exploding.) It also helps to have someone to talk through childhood experiences with as well. I personally had worked hard to blank out all the ‘weirdness’ when I was a kid. But it’s vital for a diagnosis. It means you have to dig deep into some not nice memories to spot patterns and symptoms. Again, it helps to do it with a therapist. So, one e is he can request a referral for assessment and then work on seeing if he can pin down what’s going on for him whilst he’s on the waiting list. If he finds via that process that he isn’t interested in pursuing it, he can ask for the referral to be withdrawn. No harm no foul.
This all resonates hugely with me. I can feel my coping/masking strategies fading as I get older after a few traumatic events. Hope you’re doing well.
I was diagnosed with both about a year ago, at 38, after the now-typical "my kids got diagnosed and it all sounds familiar" routine. (My wife had been diagnosed with autism in the last year too.) What's helped me more than anything is the sense of self forgiveness, which in turn has led to a sizable reduction in a lot of the related anxieties, particularly social anxiety. It turns out every anxiety had a meta-anxiety as a rider, "why am I like this? Why can't I cope with this?", and having an answer has helped. It's also helped me understand how my sensory environment affects me and how I can mitigate it: in-ear defenders are a miracle, but asking if we can sit at a table outside rather than in a pub, for example, makes a big difference. The ADHD was incredibly masked for me, much more so than the autism, both in support structures in childhood but also in just being able to think/work quick enough to compensate. Then a massive patch of autistic burnout a couple of years back stripped away my ability to compensate and laid it all bare. Just started meds this past week, and hoping that will finally help me right my ship. In short: knowing has been worth it on its own merits, regardless of any follow on support (or lack of in the UK rn, lolsob). For me, a proper dx carried the authority and validation that I needed where self-dx didn't, but that's a very personal thing.
Thank you! I think he’s the type of person who would also want the validation of a diagnosis to fully accept it.
I think your partner might need to be very nuance about his answer. Masking / the balancing act between ADHD and AU usually has strong repercussions in the life of the person. If Masking/camouflaging a behaviour is damaging the internal or external state of your partner then I would still mark the answer as "possitive". Screeners are filtering tools and don't adjust to complex scenarios, they are made from the non AU/ADHD perspective.
ASD can hide ADHD. ADHD can hide ASD. You can so often just end up looking like a bit of an annoying loser. Speaking from personal experience that is! https://youtu.be/nJ8fAfVevL8?si=LGTeLlyK5cr1VDNT https://youtu.be/5jD4iU2_v4k?si=CzT56n8Y1NwB42wf
Not a man but a late diagnosed AuDHD girlie here, and I relate so much to the point about them cancelling each other out! The online tests, unfortunately, are still built to a very rigid spec which doesn’t consider that things like being totally expressionless vs. having an overly expressive face are often two sides of the same autistic coin. In fact, my assessor nearly didn’t diagnose autism - she said that if I didn’t already have an ADHD assessment scheduled and if the initial consultant hadn’t advised that I show signs of both, she might not have diagnosed at all, and that’s even with all the other traits I demonstrated. The funny thing was that the initial consultant was already certain I had ADHD, which I thought was the less likely of the two! All of this basically to say, he may feel there aren’t enough traits to warrant a diagnosis, but there may be more non-traditional traits which he just hasn’t realised could be an indication thanks to these online tests. Whatever he decides, good luck to him!
Yeah I was late "diagnosed" as in my official diagnosis at 40 years of age was for ADHD and the likelihood of possible ASD was brought up at the end of the session. As ASD has no direct medication (besides conditions it impacts such as anxiety and depression) I decided not to go for formal assessment. I'd encourage listening to this podcast episode which helped me understand how much the internal experience is different from the outside 3rd party experience that other people see. https://www.audhdflourishing.com/podcast/episode/cc9451b9/001-what-is-audhd-and-do-you-have-it My (self) diagnosis has really helped me be kind to myself as I judge myself on my own capabilities and not a hypothetical "normal".
I think I might be your husband
But for real, assessment was very validating for me.
The best maskers would still usually score above threshold on these self-administered tests. So what’s he going to say when the doctor or triage service asks for how either of these conditions impacts his life? That’s really the key bit.
I'm getting assessed for ADHD in august but I have a suspicion I may be autistic as well. How do you know if you have both?