Navigating life with both ADHD and Autism often feels like a tug-of-war between two distinct forces. ADHD brings chaos, energy, and spontaneity, while Autism thrives on routine, predictability, and structure. This interplay can be both fascinating and deeply challenging, especially when it comes to diagnosing and medicating our children.
The Push and Pull of ADHD and Autism
ADHD can act as a shield, bringing spontaneity and resilience. It’s the drive that helps us shoulder stress, multitask, and move forward with energy. But when ADHD is medicated Autism can emerge unshielded, leaving individuals exposed to paralysing anxiety, overwhelming sensory sensitivity, and analysis paralysis.
For children, ADHD often gets the most attention – schools and parents focus on its immediate challenges. However, research shows that 50-70% of people with ADHD are also Autistic. Despite this overlap, Autism often goes undiagnosed, especially when its traits are masked or camouflaged.
Risks of Overlooking Autism
When we fail to see the full picture of ADHD and Autism, the consequences can be devastating. For instance, many children showing withdrawal or sadness on ADHD medication are prescribed antidepressants, such as SSRIs, which have no proven efficacy for Autistic people. In fact, SSRIs are linked to increased risks of self-harm and suicidal ideation in children, with concerns about their impact on brain development.
One mother I know watched her 12-year-old son, medicated with a stimulant and a non stimulant for ADHD but undiagnosed as Autistic, withdraw and escalate to self-harm within a week. The school continued to tell her how well her son was doing, but behind the scenes he was falling apart. This scenario highlights the urgent need for comprehensive assessments and tailored care.
The Frightening Statistics
The stakes are high. In Australia, suicide is a leading cause of death for young people:
- 304 young people aged 18–24 took their own lives in 2022.
- 77 deaths by suicide occurred among children and adolescents under 17, with most in the 15 – 17 age group.
These numbers only represent reported cases; the true scale is likely far greater.
Are we inadvertently contributing to this crisis by relying on medications like SSRIs or medicating ADHD without addressing Autism? Are we mistaking hormonal changes or mental health struggles for issues that could be better managed with a deeper understanding of neurodivergence?
A Call for Comprehensive Care
We need to drop the stigma around Autism. It’s not a flaw; it’s a difference – a unique way of interacting with the world. Recognising this difference is crucial to creating better mental health outcomes for children and teens.
If your child is showing signs of withdrawal, sadness, or anxiety, don’t accept “it’s just hormones” as an answer. Advocate for thorough assessments that consider both ADHD and Autism, especially in teens.
Rethinking Medications
While ADHD medication has proven benefits, it’s essential to approach it with caution when you have not ruled out Autism. SSRIs are often prescribed as a quick fix for mood-related issues, but studies reveal they are ineffective for Autism and may even exacerbate the problem.
If medication isn’t working or is making things worse, don’t be afraid to ask questions, seek second opinions, and explore alternative therapies. Combining medication with environmental adjustments and sensory accommodations can often have better results.
What Can We Do?
- Advocate for comprehensive neurodivergent training for paediatricians and psychiatrists.
- Push for education around masking, camouflaging, and how Autism can present completely differently to what we think.
- Monitor changes in your child’s behaviour, and don’t hesitate to speak up if something feels off.
- Seek support from clinical psychologists with lived neurodivergent experience.
The Path Forward
Our children deserve a system that sees them fully. Let’s work together to drop the stigma, advocate for better care, and ensure our kids have the tools and support they need to thrive. We’re in this together.
References:
Hours, C., Recasens, C., & Baleyte, J. M. (2022). ASD and ADHD Comorbidity: What Are We Talking About?. Frontiers in psychiatry, 13, 837424. https://doi.org/10.3389/fpsyt.2022.837424
Reiersen, A. M., & Handen, B. (2011). Commentary on ‘Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD)’. Evidence-based child health : a Cochrane review journal, 6(4), 1082–1085. https://doi.org/10.1002/ebch.786
Murdoch Children’s Research Institute
Australian Institute of Health and Welfare
