Leanne Maskell is a former model who was diagnosed with ADHD and autism as an adult. She explains how the conditions affect her life.
Experts are learning that ADHD and autism – known as AuDHD – often go hand-in-hand, leading to a brain in a constant tug-of-war.
Leanne Maskell is the founder and director of ADHD coaching company ADHD Works, and the author of ADHD Works at Work and ADHD an A-Z
OPINION
Imagine having a brain that is at constant war with itself. Desperate to fit in, yet determined to escape social situations. Obsessively creating complex structures for stability, but just as predictably smashing them all up. Chronically overwhelmed, yet unable to say no.
That’s the reality of living with both ADHD and autism. The two conditions might seem at odds with each other but can, as experts are increasingly realising, coexist and lead to non-stop internal conflict.
While ADHD brings hyperactivity, impulsivity and inattention, autism is associated with social challenges, sensory sensitivity and repetitive behaviours.
Until 2013, autism and ADHD couldn’t be diagnosed in the same person. Today, researchers have found that there is a 50% to 70% crossover between these neurodevelopmental conditions, which is increasingly being referred to as AuDHD.
I was diagnosed with ADHD at the age of 25 after spending a year ruminating daily over the best way to end my life, moving to a different country every month and quitting any job that I started. The diagnosis helped me make sense of my life, but it didn’t seem to fully fit with my experience.
Now, six years later, I finally have the missing piece of the puzzle: an autism diagnosis.
It might sound like a diagnosis too far for most people, but I was relieved. It explained an awful lot about my life to date and why I’ve always struggled with social situations.
As a child, I questioned why we had to visit family at Christmas just because we share DNA. The answer of “because they’ll always be there for you” felt transactional and has shaped how I have approached every relationship since.
I’ve spent my life figuring out how to be useful to people in a relentlessly exhausting trade for companionship. I constantly regulate everything – from forcing myself to make the “right” amount of eye contact, to saying the “right” things – but I never stick to my own pre-planned script. ADHD impulsivity sees me veering off course, often saying the wrong thing and then beating myself up over it for hours afterwards.
I’ve lost count of how many people have stopped talking to me for reasons I’ll never know. Group settings are even worse, as competing demands overwhelm me to the point where I often hide in the bathroom, my brain ready to explode.
After moving abroad at the age of 13, I discovered a way to turn off the constant AuDHD radio of thoughts blasting in my head. Getting paralytically drunk seemed to turn my brain off, at least temporarily. This coping strategy lasted until I was diagnosed with ADHD; I would kick social interactions off with a tequila shot wherever possible.
The lack of inhibition associated with ADHD saw my teenage self drinking cocktails abandoned by strangers and picked up off the tables in bars. The loud, crowded clubs left me chronically overstimulated because of my autism. The sensory overload was so intense that I’d often fall asleep right in the middle of the noise – a shutdown response when my brain simply couldn’t cope. It wasn’t unusual for my friends to find me curled up next to a thumping speaker.
However, this didn’t just happen in clubs. One time my friends spent an entire night looking for me in a pub before eventually finding me passed out under a pile of coats. It doesn’t matter whether it’s noise, lights or simply the intensity of being around people; any of this can lead to overstimulation – then shutdown. I often fell asleep in class, in the cinema and even whilst out for dinner.
I couldn’t understand why I kept putting myself into situations that caused me so much stress. Now I do: it was easier to blend into the noise than to be stuck with my own thoughts. However, living like this felt like being prisoner to a sadistic scriptwriter on season six of a terrible TV show.
Unable to trust myself, I took cues from those who seemed to know better – but not everyone has your best interests at heart.
As a teenage fashion model, I was confused about the “right” way to behave and was, therefore, easily manipulated. When I tried to cover up in front of the male stylists who were dressing me, they laughed and explained that they were gay. The guilt that I felt led to a pattern in which I would immediately undress upon request from strangers in public – whether it was casting directors in offices, photographers on set or agents who had invited me to meet with them. For years, I was terrified of offending anybody, constantly conforming to the expectations set by those around me.
I hated modelling, but I was unable to quit. My autism thrived on the predictability of receiving a daily email at 6pm that outlined my schedule for the next day. The routine provided both the structure that my mind craved and kept my ADHD brain engaged with dopamine, novelty and adrenaline.
Outsourcing my personal agency could be relaxing because it meant someone else was in control of my life and, therefore, the “small” decisions that caused me so much stress because of my ADHD, such as what to eat for lunch. On jobs, I usually just had to do or mimic whatever the people around me said, and I wasn’t expected to talk.
However, it was also extremely stressful because my ADHD struggled with the monotony of being a human coat hanger. I had to hide the hyperactivity of my internal experience and force my face to stay calm as my mind felt like it was on fire, exploding with racing thoughts.
It was only when I was diagnosed with ADHD that everything changed. It felt like I finally had the guide to life that everybody else seemed to have. The diagnosis enabled me to access medication, which, in turn, enabled me to stop self-medicating with alcohol. After completing a law degree, I eventually got a job in law; I was determined to “hack” my ADHD by getting ahead of it.
Getting to the office was a hurdle in itself, so I rented a flat over the road from it to avoid having to travel every day. Although I didn’t know I was autistic at the time, I did know that I couldn’t cope with public transport during rush hour; I regularly had panic attacks if I thought I was going to be late. AuDHD impacts executive functioning skills, such as time management, which meant I was often late, so a flat opposite the office felt like the most sensible option, even if the rent was extortionate.
However, I wasn’t prepared for how stressful I’d find working in an office. The lights, the noise and the open-plan environment made me constantly on edge. On top of that, I was constantly worrying about making a mistake. I would beg my bewildered manager not to fire me and provide her with 15-page reports detailing everything I’d done that week for our catch-ups.
I struggled to say the right thing and had difficulty regulating my behaviour. For example, one colleague used to speak very loudly in the kitchen next to my desk, which I found very distracting. One day, I snapped and impulsively emailed them to ask them to stop talking so loudly because no one cared about their weekend, only realising that this was a mistake once I’d pressed send. The mortification when they responded, cc’ing in both of our managers and the Culture Code, was like nothing I have ever experienced. It’s no excuse, but it’s an example of how undiagnosed AuDHD can contribute to these situations. Eventually, two-and-a-half years later, I quit to become an ADHD coach and write a book.
When I told my therapist I thought I was autistic, she dismissed it because I was nothing like the autistic children she worked with. I accepted this at face value, just as I accepted doctors telling me I was fine (before I was diagnosed with ADHD) because I had a law degree – a symptom of autism is literal thinking.
Autism makes all relationships harder to navigate and also makes you more vulnerable to abuse. Like nine out of 10 autistic women, I have been a victim of sexual violence, including being groomed at the age of 15 by a man 10 years older than me.
When I contacted the police after being harassed by an ex-partner, they asked me a list of mandatory questions that they ask about relationships that could involve coercive and controlling behaviour. I answered “yes” to every single one. I’d been in a relationship where I’d been told what to wear, do and see, whether I could take medication, and even whether I could drink coffee, and yet I hadn’t realised that this was wrong.
Thanks to societal conditioning, women are far less likely to be diagnosed with autism or ADHD than men. Women tend to mask symptoms, so our struggles are less noticeable to others.
This is the truth of living with AuDHD, especially for women like me, who’ve spent their entire lives hiding their symptoms as a way to survive. I felt I had to monitor every part of who I was, terrified of unintentionally doing something wrong because I could never understand the rules that everybody else seemed to know.
Autistic women are twice as likely as autistic men to attempt suicide, with autistic people nine times more likely to die by suicide than the general population. Nearly one in four women with ADHD have attempted suicide, with a five times higher risk of suicide linked to the condition. For me, things came to a head earlier this year when I started considering ways to end my life after a big change in my routine. Eventually, after I had a screaming breakdown in an airport when I got lost, I booked an appointment with a psychiatrist. It was then that I got my autism diagnosis, and the last piece of the puzzle fell into place.
Our society is increasingly stigmatising neurodivergence, associating it with people seeking disability benefits and using it as a justification for poor behaviour. However, the reality is that these labels enable people to take responsibility for themselves, reclaim agency over their lives and contribute meaningfully to our society.
It is easy to view AuDHD as a convenient excuse for personal failings. However, if I’d had this diagnosis earlier when I was growing up, I would have been far less vulnerable to the harm inflicted by others. Instead of shaming the individuals seeking help, we should focus on the broken systems that allow so many people to go undiagnosed for so long. AuDHD isn’t an excuse, but it can be a life-changing lens to explain our experiences.
Ultimately, these labels enable people to “name it to tame it” – far from marking themselves as victims, they’re survivors of a world that wasn’t designed for them.
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