After my son was born instead of newborn cuddles and bonding time we had constant screaming. My baby had to be held against an adult human body at all times. Nothing soothed him except full-body contact, and nursing. No swings, seats, swaddles…and definitely no pacifiers. Intuitively, I knew there was something sensory going on. At that point I started considering that perhaps it was me and my ADHD that was the problem. I was after all, the troubled one. I was diagnosed in 1991, long before anyone cared about screening girls.

Fifteen years later, AuDHD, as we now call it, is everywhere. And when I look back at my collection of memories and stories, my own family history paints a vivid picture of the overlap between ADHD and Autism.

If you asked me what I remember most about my Grandma, I’d tell you her picky eating. Elsie had a fairly short list of foods she would tolerate. No butter, no oil, no pepper or spiciness, and no garlic ever. I had to order her a dry chicken breast and steamed broccoli with no butter or seasoning of any kind for my wedding.

In our family Grandma was the North Star —she anchored all of us, but she also felt somehow unreachable. She was warm and loving, but also her own person.

Grandma never sat down. She was always doing something. At the same time, she disliked too much talking or noise. Grandma had five children, which doesn’t make for a quiet home. I’d heard stories about her wearing earplugs at swim meets. And according to my grandfather she read books at football games. My grandfather, who was an extrovert, and obviously “neurotypical”, attended all the school activities for both while she worked nights as an RN.

My grandmother worked full time throughout the 1950-60s. She told me once she worked nights on the surgical floor because it was quieter, “less noise after the doctors go home”. We used to joke that she preferred her patients unconscious. Even with me, her oldest grandchild, she was shockingly direct. “Stand up straight, Elizabeth, or you’ll get a hump in your back.” I knew she loved me, but toward the end of her life the years of unsupported masking took its toll. She grew irritable and anxious.

Grandma has been gone since 2020. Knowing what I know now, and taking her life story into consideration, I believe my grandmother was autistic and ADHD.

She fits the profile: overachiever, highly intelligent, driven, sensitive, but secretive about it, and always masking. I also think within our family the women all have a smattering of both ADHD and Autistic traits. My son though, that was a surprise. His diagnosis was a shock at first. But now, every so often I see a glimmer of Grandma in him. And if I’m being honest, in myself. We all have a little ambivalence about the world, a distaste for forced interaction, that feels familiar.

It is now widely understood that up to 70% of those with autism also have co-occurring ADHD. Current research indicates that it is more common to identify ADHD without autism than it is to identify autism without ADHD. There are many similarities in both executive function and social challenges. All of which showed up in my grandmother, me, and now my son.

When I was diagnosed young with ADHD I always felt intuitively that she understood me in some unspoken way not even my parents could. She never attributed it to my character. Her quiet confidence in me, my goodness and potential, got me through everything that came after. Including the misunderstandings around girls and women, mental health, and brain-based challenges that persist to this day.

If there’s one thing I want girls and families to understand it is this: earlier identification is better. Whether it’s ADHD or Autism or both, knowing is better than not. My grandmother over functioned and masked and lived her life without support up until she had dementia and couldn’t do it anymore. I wish she didn’t have to. But I know, as a woman of science, and an ardent feminist, she would have been thrilled to know that young women now will be understood and supported.

If you know a girl or a young woman who needs support, offer to talk to her about her experience. When you meet teachers and clinicians, ask if they are aware of what brain-based challenges look like in girls. As I write in my book we must get loud. To change the world, we need to have uncomfortable conversations, we need to ask the awkward questions others shy away from. And we need to do it together. The collective power of women is bigger than the forces trying to stifle us. My Grandma used to say “women should run the world”.

I think neurodivergent women are capable of so much – I mean look at what we’ve already done! Keep showing up, keep advocating, and never stop thinking about the next generation of girls. We’re in this together, and together we can do anything.

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

Bio

Liz Lewis is a writer, science geek, and conversation starter dedicated to supporting women and mothers with brain-based challenges. Through her Substack, coaching, and (very occasional) speaking, she offers practical support for ADHD women navigating midlife transitions, mental health, and questioning all their life choices.