My Dual Diagnosis: Autism and ADHD
I was in the waiting room of my therapist. I was very nervous. An outside opinion is needed when researching health topics.
I stumbled upon “autism” all by myself by typing in “I need help with social skills all the time” into Google. I decided I was in over my head and needed to talk with a professional.
In my opinion at the time, I wasn’t anything like what I thought autistic people were like. I sought a therapist with expertise in autism because I figured they would recognize the condition when they saw it.
I paid for a few sessions to see if I could trust her. My chest was pounding. I decided to discuss my elephant in the room, which I believed was partially happening because I needed help with my social skills.
I was asked if I had heard of the disorder.
I lied and said, “No.”
I was told by my therapist that I should check out some websites. I felt connected to other people with the same issues. I started a binder to collect what I learned after diving in.
For the next couple of months, I shared many aspects of my life with my therapist, inviting her to help me understand and address them. She started leaning toward me potentially having a dual diagnosis of autism and ADHD. After working together for 6 months, she suggested I meet with a psychiatrist.
Everything was starting to cost a lot. Each appointment was a copay of $100 and the copay was calculated on a sliding scale.
“I talked to two different physician’s assistants who said nothing was wrong with me. My therapist called the psychiatrist because she was upset by that. She told me to show him my binder of notes and resources.”
The psychiatrist almost immediately diagnosed me with autism spectrum disorder (ASD). He also set up an appointment the week after for me to get evaluated through use of the Conner’s Continuous Performance Test, a computer test used to diagnose ADHD.
The whole thing took only 15 minutes once I got past the PAs and into the office.
I completed the Conner’s test, which cost me $160 coinsurance. After I got the results, the doctor started me on Adderall.
I hated being on Adderall. I had a breakdown after taking each dose. This happened a lot. It was hard to function this way.
This reaction to the medication often occurred during my work shifts, surprising both me and my coworkers. I found I had to explain myself and my behavior a lot, which was awkward and burdensome. My autism masking skills disappeared, and I lost other skills too.
“I couldn’t smell a seasoning or a Spice to tell if it was in a dish I was making, and my seasoning hand was no longer as steady. I lost a lot of confidence in my cooking and other areas of my life after it suffered immensely.”
I started to have real problems where I acted on things that were not real. I pushed my husband because I was arguing and not because of the urge in my brain. It was very frightening and completely different to me.
My doctor and I decided to change my medication from Adderall to Vyvanse. This was more manageable, but I developed tics as a side effect.
“My doctors didn’t accept the new insurance policy that I had. After a few months without care, I found a provider who took my insurance. My treatment resumed.”
I was given a variety of drugs to see what worked. I had to try a different medication every 4 weeks because the side effects of the previous one were too much to bear.
One medication I was on, an antipsychotic, overcorrected my aggressive urges. I felt hollow inside. Nothing touched me, not even movies that always make me cry, like The Notebook. I couldn’t even get excited about going to the zoo. I just didn’t feel like myself.
Another medication, Zoloft, caused my vision to become wonky to the point where I couldn’t drive.
There were more drugs.
“My reputation at my job deteriorated as a result of my perceived flakiness. The fact that my productivity wasn’t affected didn’t matter. After a meeting about my performance ended, I decided to look for a new job.”
I was upset by the suggestion to change locations. I had been there for 4 years and was good at my job. I didn\’t understand why I was sent away. I had a tense atmosphere and awkwardness with the management team in my final weeks at the office. The representative nodded and said, “It\’s probably for the best.”
I found a new job in 2 weeks.
“My doctor advised me to go part time after 1 month at the new position because of my mental health difficulties. I didn’t take her advice because I didn’t feel comfortable doing this since I had just started the job. I worked full time until my next appointment.”
My doctor wrote me a note saying that I needed to go part time and that I should give it to HR. I began a part-time schedule.
The new schedule allowed me to establish consistency in my work, which was a big help in my finances. This consistency gave me time and space to analyze what was not working in my medication regimen. I kept a journal and organized my feelings.
“I concluded that I couldn’t focus on work tasks and deal with my emotions at the same time without crashing and having a physical meltdown.”
“I had no control over what would set me off. I would end up crying after regular conversations that wouldn’t have bothered me at all. I was trying to figure out my feelings. I felt like I couldn’t keep up with everything outside my job because of my brain chemistry changing.”
I knew that I had spent too long trying to cope with things that hurt my well-being. I put others first when I needed to prioritize myself, and overworking myself, ignoring my boundaries, and putting others first. My therapy sessions were meant to teach me to keep boundaries even when dealing with the ups and downs of my medication.
After taking over 25 different medications, I finally found a combination that worked for me.
- The global mean age of autism diagnosis between 1990 and 2012 was between 38 to 120 months (between around ages 3 to 10 years old), according to research from 2020.
- Research shows the average age of ADHD diagnosis is
7 years old.
“I never imagined that life would change so much when I was in my therapist’s waiting room. It took a team of mental health professionals a long time to figure out how to help me. My diagnosis was expensive and I had to manage my attention deficit and anxiety.”
The decision to get a professional opinion was one of the most important decisions I have ever made. I thought I was like what the person on the other side of the spectrum looked like. There are many forms of the condition, which is called autism.
Society is learning how to accept, support, and reach out to the full spectrum of people with a diagnosis of Autistic Spectrum Disorders.
I would like to pass along any wisdom I can to those on a diagnosis journey, but I would like to stay strong of will and not lose myself. People have ideas about how things work and are not interested in having those ideas challenged. My existence challenges the norm regarding timelines for diagnoses of both disorders.
Not everyone receives a timely diagnosis, or gets the care they need at a young age. But that doesn’t mean it’s too late.
Arianne Garcia is an autistic Chicana writer based in San Antonio, Texas. She was diagnosed at 25 with ADHD and Autism Spectrum Disorder. She writes about autism and other things on her website www.arianneswork.com, and you can follow her on Twitter @arianneswork.