AuADHD Diagnosis: Divergence from the Typical Neurodivergence

It's so hard to diagnose ADHD and depression or Autism because the nature of ADHD is an inconsistent state… an inconsistent state of mood, motivation, focus, interest - even the concept of time and space… basically, any state of being. Which I think is amazing.

But also, if you don't see a psychiatrist on a regular basis over many years, the chance of that appointment coinciding with a depressive episode or a hyperfocused mode is incredibly slim.

This is not good. It's especially not good if people don't have the resources or insurance to see a psychiatrist... which is a hallmark of undiagnosed neurodivergence.

It means real diagnoses can take tens of thousands of dollars. In my experience, most independent psychiatrists either don't take health insurance or incredibly difficult to book (or both).

One of my acquaintances is struggling with the fact that diagnosing any of these things is imprecise and difficult, if not impossible. He’s *really angry*. He’s blaming the system and his doctors and everything… but it’s not like you can just take a blood test and say, “yep, here’s the drug that fixes it,” especially if there’s ADHD in play.

I think a person would basically have to be hooked up to electrodes for 3-8 *weeks* just to get any idea what’s going on in a person’s brain. Because people are awful at self-reporting.

The witness is too compromised.

Is AuADHD Real? Why is it new?

Two Words: THE. PANDEMIC.

So much of life is designed for neurotypical people, and until everything broke and we had to remake everything, we didn’t realize how much we (effectively masking Autistic people) had contorted to the shape of the world.

The pandemic made it possible to see where we were all masking… while we were all literally masking, many of us were figuratively unmaking. So that’s why all of a sudden, doctors are seeing how many of us *super effective* maskers actually would be if we didn’t have to pretend to be normal.

And now it’s hard to put that genie back in the bottle. It turns out, there are A LOT of weirdos - cough - neurodivergent folks. I think they’re just now finding out about how masked many people were… during the pandemic, all these neurodivergent people finally got to stop pretending to be normal 24/7, and got to be normal-weird for most of the day.

We got used to being weird, so all of a sudden all these weird people who used to be normal are wandering the streets and acting weird social encounters and everything. Going to social encounters and talking about AI and sometimes having to draw and talk just so we can think… it’s a new world!

It’s kind of sweet. People finally meeting themselves after spending 10% of their energy trying to figure out what their face was doing, and what the other person’s face was doing, and why the tv in the background isn’t driving anyone else totally bonkers.

And all these psychiatrists going, “Hey! Wait, you just thought everyone thought either really fast or really slow, depending on the weather or sunspots or whatever?”

I personally never realized how stressful grocery stores were until I didn’t have to go into them for a couple years. So now, I almost never go. Because I can just build things around not having to go to the grocery store… it’s not a handicap if it’s not a handicap.

The Early Diagnosis

In 2011, my psychiatrist diagnosed me as having ADD (now called ADHD) and Asperger's (now called "being on the Autism spectrum").

He was ahead of his time! I’ve seen a lot of mental health professionals and he is the only psychiatrist I trust. I had been diagnosed as bipolar because of my periodic surges of hyperfocus and enthusiasm. The correct diagnosis changed everything. I told him he can’t retire.

For me, getting a diagnosis gave me some kind of meaning around why I always felt so weird and alone, and why I couldn’t understand things that seemed obvious to other people.

The Side Effects both Visible and Invisible

I was depressed over the past two days, and now I feel a little better, and tomorrow I probably wouldn’t even remember I was depressed if I didn’t have a journal.

I believe that alcohol is the main/default way that we Autistics can “mask.”

Here are my theories:
1. Our Autistic side is likely dampened when we drink, making us feel and act more “normal”
2. Other people’s standards are lower when others are drinking, so we experience “weirdness”/“otherness” less acutely

This means from both our own feelings and other people’s experiences of us, alcohol really does help “treat” the condition. But the side effects are not good (the whole “death” and “addition” thing). I think this is also why it’s so difficult to regulate… we keep feeling less autistic, which is a good feeling.

Until it isn't. But we won't remember all the bad stuff the next time we are faced with a choice around our drinking.

The ADHD, in my observation, also means that we struggle with “error-finding and correction” - this means that we won’t remember the hangover as acutely, and we may selectively remember the experiences we have when we drink or take other substances.

ADHD & Dementia: When does our struggle to grasp reality turn into a terminal illness?

The inability to recognize your own cognitive decline - specifically with dementia - is called anosognosia. It has to do with self-reflecting on errors and the ability to correct those errors.

I think this is part of the connection between untreated ADHD and dementia - people with ADHD are 70%+ more likely to develop dementia.

I also think there’s a link between ADHD and the inability to process thoughts/feelings, leading to repetitive negative thoughts (rumination) - there have been studies that show people with cognitive decline also ruminate…. And people with Autism also get stuck in thought loops (that part is well-documented, but the ADHD and dementia rumination link is pretty recent - I only know of it because I put it on Instagram and people sent me links to studies).

In my opinion, within the next 10 years, all these data points will lead to a big, obvious, “how could we not have seen it?” connection.

I have other thoughts on the whole psychiatry & neurology land masses (and how it seems like people rarely traverse from one continent to another), but that will have to be another post for another day. For now, I just wanted to get these thoughts into some semblance of an organized form... and now I have!