Autism in Women: When ASD and ADHD Walk Together

Autism isn’t always what people think it is, especially when it comes to how it shows up in women. For decades, the traits of autism were defined by how it typically appeared in boys. But that left many autistic women, especially those with ADHD, feeling confused, missed, or misunderstood.

If you’re a woman wondering whether you might be autistic and have ADHD, you’re not alone, and you’re not imagining things.

🧠 Autism and ADHD: What’s the Difference?

Autism (ASD) and ADHD are both neurodevelopmental conditions, which means they affect how your brain processes the world — how you think, feel, interact, and organise. Though they’re often treated as separate, they actually share a lot of overlap.

Autism (ASD) often involves:

• Sensory sensitivities (to noise, light, clothing, etc.)

• A need for routine and predictability

• Deep focus on interests (sometimes called “special interests”)

• Difficulty reading social cues or understanding the ‘hidden rules’ of interaction

• Struggles with identity, masking, and social exhaustion

ADHD often involves:

• Difficulty with focus, attention, and memory

• Impulsivity or emotional reactivity

• Restlessness (physical or mental)

• Difficulty with planning and completing tasks

• Mood swings or burnout cycles

When the two appear together — which is more common than once thought — it can create a unique and often confusing mix of traits.

💡 How Autism Can Present Differently in Women

Women and AFAB (assigned female at birth) individuals are often socialised to “fit in,” “be nice,” or “not make a fuss.” This can lead many autistic women to mask their traits from an early age. That might look like:

• Studying people like a script to figure out how to behave

• People-pleasing or fawning to avoid conflict or rejection

• Feeling “too sensitive” or emotionally overwhelmed, especially in relationships

• Burning out after social situations, even if they seemed “fine” on the outside

• Struggling to know who you really are, because you’ve spent so long adapting to others

Many autistic women don’t realise they’re autistic because they’ve become so skilled at hiding it. But the cost of masking is high: anxiety, depression, exhaustion, identity confusion, and often, late diagnosis.

⚡ What It Looks Like When Autism and ADHD Coexist

When ADHD is also in the mix, things get even more complex. Here’s how the two might interact:

Autistic Traits	ADHD Traits	When They Collide
Needs routine	Forgets routines	Feels constantly dysregulated
Deep focus (monotropism)	Distractibility	Struggles to balance hyperfocus + chaos
Social confusion	Impulsive speech	May overshare, then mask in shame
Rigid thinking	Emotionally reactive	Meltdowns, shutdowns, or freeze responses
Sensory sensitivity	Sensory seeking	Constant inner conflict or overstimulation

You might feel like you’re too much and not enough at the same time. You may deeply crave structure but struggle to maintain it. You may long for connection, yet find socialising exhausting. You may constantly switch between overthinking everything (autistic) and acting before thinking (ADHD).

And that’s not a failure, that’s the unique tension of living with a dual neurodivergent brain.

🧩 Common Misdiagnoses and Missed Diagnoses

Many autistic women with ADHD are misdiagnosed or only diagnosed with one part of the picture.

Common mislabels include:

• Anxiety disorders

• Borderline Personality Disorder (BPD)

• Depression

• OCD

• “Too sensitive,” “too dramatic,” or “just hormonal”

It’s not uncommon for women to be diagnosed in their 30s, 40s, or even later, often after a child is diagnosed or during a major life change (burnout, career shift, menopause).

🌱 What Can Help?

1. Self-understanding – Learning how your brain works is not selfish; it’s essential. Whether or not you have a formal diagnosis, if the traits resonate, you deserve support.

   
   

2. Unmasking gently – You don’t have to unmask all at once. Start by noticing where you feel safe to be yourself, and where you’re shrinking to fit.

   
   

3. Routine, with flexibility – Build a structure that’s ADHD-friendly and autism-affirming. Use visual tools, timers, and reminders — but leave room to adapt.

   
   

4. Community support – Find others who get it. Whether online or in person, being around neurodivergent women can feel like finally exhaling.

   
   

5. Therapy or coaching with neurodivergent understanding – Work with someone who recognises the overlap and complexity, not just the labels.

🧡 Final Thoughts

If you've always felt "different," "too much," or as if you're pretending to be an adult, know that you're not alone and you're not flawed.

Autism and ADHD in women often go unseen, but that doesn’t mean your experiences are invalid. You deserve to understand yourself, to feel safe in your own skin, and to live in a way that honours how your brain works.

You’re not behind. You’re just discovering the truth, and that’s a powerful place to begin.