Neurodivergent Adult's Unnamed Newsletter Issue 2, February 19 2024

Are Autism and ADHD related? Can ADHD Get Worse? What does gut bacteria have to do with Autism?

Author

Neurodivergent Adult
February 19, 2024

Hello and welcome to The Neurodivergent Adult’s Unnamed Newsletter! Thank you all for following, I hope that you enjoy reading this as much as I enjoyed writing it. Just in case you didn’t catch Issue 1 here is a link to where you can read it online.

If you enjoy this issue please consider becoming a Patron on Patreon. There you can support my work for as little as $1/€1 a month. https://www.patreon.com/NeurodivergentAdult 

There are some who mistakenly believe that Autism and ADHD are opposite ends of a straight line spectrum with “normal” somewhere in the middle. But, anyone who has lived experiences with them knows that they’re more like siblings, one of whom likes trains and the other likes Stanley cups. They may not agree on everything, but they can both agree that shiny things are awesome. Autism and ADHD are both neurodiversities, which puts them in the same very big family.

For those who aren’t aware of what neurodiversity is…it quite simply means that your brain works differently in some way to what is considered “normal” by today’s standards. This includes ADHD, Autism, OCD, PTSD, and depression to name a few of the more commonly known ones. It can also include conditions that are acquired like traumatic brain injury, anxiety, and Dementia. 

But, does that mean they are actually related?
Are you more likely to have ADHD if you have Autism?
Are you more likely to have Autism if you have ADHD?

Amazingly 50 to 70% of people who are diagnosed with Autism also get diagnosed with ADHD. On the other hand, only 14% of children diagnosed with ADHD are also diagnosed with Autism. Unfortunately, we can’t assume that these numbers are accurate to the reality of how many people have both. When you go in for diagnosis you aren’t just given both tests on a whim. If you go in to get an ADHD diagnosis the doctor isn’t going to say “hey, let’s see if you have autism too, just for funsies.” The same also applies the other way around.

But, having both is so common that a new term has sprung up for people who have both Autism and ADHD called AuDHD. Personally, I’m not a big fan of the term if only because I find it incredibly awkward to try to say out loud. Awww D H D? This term is one that has been created by the neurodivergent community online, there is no formally getting diagnosed with AuDHD, you have to get two separate diagnoses, which for many is totally out of reach without self-diagnosis.

For a long time now it has always been known that there is a lot of overlap between ADHD and Autism. A lot of shared symptoms like stimming, executive dysfunction, and special interests. For more overlap check out this venn diagram made by Dr. Neff from Neurodivergent Insights.

What you will notice is that AuDHD isn’t included. If it were, it would be a giant circle that includes everything from both sides of the diagram and the part that overlaps in the middle. This diagram isn’t to say that you have to have all of these things to be one or the other or both. For instance you can have ADHD and not be impulsive or get bored with the same routine every day while still being autistic. 

It wasn’t until 2013 that the American Psychiatric Association allowed both Autism and ADHD to be diagnosed! There have been very few studies conducted that look at both of them together. So right now there simply isn’t enough information to say if the two are related. 

What is clear though is that there can be some comorbidities, and it is possible to have both. Who knows, in time it may turn out that we’ve all been AuDHD all along.

ADHD Meme Explored

“I should have…” in my 39 years of life those three words have haunted me. I don’t think there is any other phrase I have cried over more than “I should have.” I’ve missed out on amazing opportunities, failed to do the simplest of tasks, and done the wrong thing in the wrong moment…all of which have ended with me crying with the phrase “I should have…” repeating over and over in my head. There are so many things I should have done differently.

A lot of shame comes with having ADHD. “I should have done the laundry.” “I should have paid that bill.” “I should have done the dishes.” “I should have eaten the leftovers in the fridge.” It’s a type of shame that you never really get over. Sure, the tears only last for so long but each moment of shame leaves an emotional scar and that scar reopens whenever another “I should have” comes up. If it’s the exact same scenario that repeats itself the scar opens even deeper, and it hurts even more.

Along with the shame comes a helping of catastrophizing. “I should have taken the chicken out of the freezer and now we’re ordering pizza because I didn’t and now we’re never going to save up enough to buy a house.” “I should have answered the phone when it rang, but I didn’t and now I’ve lost that job offer in Spain, I’ll never get to live my dream life in Europe.” When you keep failing over and over it starts to seem like nothing is ever going to go your way, like you’re a massive fuckup…unlovable…and certainly not worthy of being loved.

ADHD and the micromoments of shame that come with it eat away at your brain. They kill your confidence and your self-esteem. They make you feel worthless, because no matter what you do to try to stop them from happening they are still going to happen anyway.

It’s even worse when you aren’t diagnosed. You have no idea why you can’t do things right. Things that are so perfectly normal for other people. Things they can do without even having to put any effort in. Getting a diagnosis makes it a little bit easier to face those microshames. Yes, that applies to self-diagnosis too. At least then you know why these things are happening. It’s not using your brain as an excuse though, it’s giving clarity and while it doesn’t make you feel totally better about things…it helps a little. With time, it can even sometimes lead to acceptance and those moments of shame don’t hit quite so hard.

But, there are always more micromoments of shame to come. You can’t control them all. Those scars build up and they hurt so, so much. I wish I could offer words of advice for my fellow ADHDers but the best I can say is advice I struggle to follow myself.

Be kind to yourself.

Last week’s new video on Neurodivergent Adult’s youtube channel was a generic meme video, which I will include the link to here. But, if you’re looking for something related to neurodiversity may I suggest this video on Autism.

Can ADHD Get Worse?

It’s fairly common to hear from your loved ones that you seem more ADHD after getting a diagnosis as an adult. But are you actually more ADHD? Can ADHD get worse? The answer isn’t as straight forward as you might think.

For many when they get an adult ADHD diagnosis those around them will say things like “you’re more forgetful than you were before you got ADHD,” or “you’re more scatterbrained these days, what’s wrong with you?” While we could talk about how wrong and hurtful those comments are, they’re a topic for another time. The real question is, DO you actually get more ADHD after a diagnosis? 

Not really, no…but it might seem like it. It has been observed that after getting an ADHD diagnosis there is actually an increase in the things that ADHD causes, forgetfulness, clumsiness, restlessness, and so on. Why is this? Well, you aren’t actually getting more forgetful, you’re letting down your mask.

Masking is more commonly associated with Autism, but it’s actually something that people with ADHD do as well. When you get diagnosed with ADHD, it’s almost like your brain finally has permission to relax a little bit, and so you end up masking a little bit less, especially around those who you feel most comfortable and safe with. Which results in your closest friends and family seeing your ADHD more, you’re not hiding it as much as you used to. This makes it SEEM like your ADHD got worse. Though the reality is, your ADHD didn’t actually get any worse.

So does this mean that ADHD can’t get worse? Actually, no. Especially if you are someone who experiences periods. If you have ADHD and you get periods have you ever noticed that you seem more easily distracted around your period? Or maybe a bit more clumsy? I can speak from personal experience and say that the majority of my bruises come from the days leading up to my period. (Though how I actually get them is anyone’s guess.) 

There have been studies that show your ADHD does get worse in the days leading up to your period and while you’re on it. What’s causing this? It’s a mix of hormones plus a decline in our old friend dopamine. After your period is finished it takes a couple of days to get back to feeling like your normal, productive self. 

Even if you don’t get periods it is still possible for your ADHD to get worse. Grieving, anxiety, and stress can all cause your ADHD symptoms to become more severe. In fact, being overwhelmed by anything can cause your symptoms to increase. This includes things like overstimulation, which can be caused by too much noise, or the lights being too bright; things you would commonly associate with autism rather than ADHD. Not getting enough good quality sleep will also make your ADHD worse.

There has been some evidence that the foods you eat might also make your ADHD worse, especially particular additives. Most troublesome are the red and yellow food dyes, several of these have been shown to increase the hyperactivity part of your ADHD. There has also been some evidence that sodium benzoate, a preservative in some salad dressings, sodas, and jams may make your symptoms worse as well. However, most of these studies also included red and yellow food dyes in the foods with sodium benzoate, so it’s hard to tell if it’s the preservative causing issues or the food dye. One study has its sodium benzoate combined with those food dyes that causes the symptoms to get worse. Obviously, more studies are needed. Popular sugar substitute Aspartame (Nutrasweet, Equal in the USA) as well as MSG have strong evidence of causing your ADHD symptoms to get worse too.

Some newer studies have looked at gluten, corn, wheat and soy as possible foods that make hyperactivity worse and there is some evidence that they do. So much so that diets that exclude these products have sprung into being and given names like the Autism/ADHD Diet. Though their effectiveness isn’t universal and some may find no decrease in symptoms by adopting these diets. The only way to really know for certain if they will work for you or not is giving them a try. Though do consult your doctor before you start any diet.

So yes, your ADHD can get worse, but it isn’t as straight forward as it might appear at first glance. Plus there are things we can do to decrease our ADHD symptoms. I’ll do an entire article on it in the future but here’s a quick list of what you can do right now to make your ADHD a little bit easier to manage.

  • Get good quality sleep for at least 7-8 hours a night

  • Yoga, meditation, mindfulness

  • Eating a healthy diet

  • Having a therapist you can talk to

  • Spend more time outside in nature

  • Reduce screen time

  • Reduce stress (easier said than done, I know)

These things won’t cure your ADHD, or even replace your ADHD medication if you can’t get it. But, they can help just a little bit.

Autism Personal Story - Why My Brother Went Undiagnosed for Decades

When I was 15 and my youngest brother was 5 I got a hunch. I suspected that my little brother might be autistic. I can’t tell you now 24 years later where I got this hunch from. I must have read about autism somewhere or saw it on TV. Or maybe it was something I saw on the internet, which was my favorite escape in those days. Wherever I got the idea from, I approached my mother with my theory. I laid out all of the evidence as I saw it.

When my brother was REALLY excited he would flap his arms in the air and do this strange gutteral happy scream.

He was extremely restrictive when it came to the foods he would eat, at one point in his life he was down to McDonalds chicken nuggets and microwaved scrambled eggs, in separate meals.

When he played he would line up all of his toys and do a little happy flappy arm dance while doing his gutteral scream. (This scream would eventually end up with the police knocking on our door and inspecting our house to make sure no one was being abused or killed.)

There was one time when I was trying to bring him to an all you can eat buffet that he refused to go inside because he couldn’t see any kids inside (through tinted windows), and for some reason he got it in his head that kids weren’t allowed inside. No amount of me promising him that it was ok would calm him down. He was in full meltdown mode….until a little girl walked out of the restaurant. Then, quicker than you can snap your fingers the meltdown ended and he was eager to go inside.

To make matters more challenging, my brother is deaf. He can’t hear and he doesn’t speak. Communicating with him has always been difficult. But, that’s getting off topic.

My mom agreed with all of the evidence I presented and set out to get an official diagnosis. A couple of months later a woman showed up to interview us and observe my brother. She wasn’t expecting him to be deaf and she couldn’t communicate with him at all. She didn’t even try really except for a few questions which had to be translated through me since my sign language was the best in the family.

She watched him play by himself for the majority of an hour, the whole time pointing out classic signs of autism in children. The previously mentioned lining up his toys, the flappy hands…you know, all the things we had already seen.

But then…one event happened and she totally changed her mind. She asked him to share a toy….and he did without argument. That was all it took for her to decide he can’t possibly be autistic. Nevermind all of the evidence that had come before. None of it mattered because when she asked him for a toy he gave her one. I, a 15 year old, tried to explain that she’s an adult and therefore a figure of authority and you have to obey authority in his mind, but it didn’t matter. I tried to explain there was trauma involved there but again…it didn’t matter. She made up her mind and that was that. No room for discussion or a second opinion…unless we were willing to pay for it ourselves.

So that was that. He went through his entire childhood and into young adulthood without any supports. It took 20 years for him to get his diagnosis. That’s also why I am such a big advocate for self-diagnosis. Doctors can and do VERY frequently get it wrong when it comes to autism and ADHD. No one knows you better than you so if you think you might be neurodivergent but for whatever reason you can’t get an official diagnosis…trust your gut.

You’re probably wondering right off the bat how mice, who can’t be Autistic can offer any insight into Autism, I certainly was. So I’ll lead with that before telling the rest of the story. Mice were given Bacteroidetes (bacteria from the phylum Bacteroidota) at birth then observed. They showed an increase in repetitive behaviors and social behavior dysfunction.

What do Bacteroidetes have to with Autism? I’m glad you asked. A study was done in Israel’s Bar-Ilan University’s Azrieli Faculty of Medicine that looked at the gut microbiomes of 96 diagnosed Autistic people and 42 neurotypical people. They found that in the Autistic people’s gut microbiomes not only had more diversity, they also contained more Bacteroidetes. The scientists propose that exposure to an unusually high amount of Bacteroidetes in early life could possibly lead to Autism.

This is just adding to the mountain of evidence from other studies being done around the world that link Autism and the gut microbiome with one another. These studies have birthed specialty diets built specifically to help the gut microbiome health of those who are Autistic, though they can be quite challenging for those with food aversions.

Obviously more studies need to be conducted before we can truly be certain of anything. A study this small isn’t enough to say anything definitively, but it is a step in the right direction.

A Few More Noteworthy News Stories from Last Week

Last week was a big week for news about ADHD and Autism both and picking just one story to cover was difficult. So, I wanted to share a few more stories that caught my eye. 

That’s all for this week! I hope it resonated with you. Let me know what you thought of it by going over to Patreon. If you did enjoy this, please consider forwarding it to a friend or family member who you think might enjoy it too!

See you next week!

Don’t forget to have some water.