What’s the difference between ADHD and autism?

Research keeps finding more similarities.

“How do you know if you’re ADHD or autistic?”

I get questions like this in my DM’s a lot. They are also questions I am trying to not worry about so much anymore, because I think the premise of these questions is flawed.

They are based on the assumption that these are concrete, biological conditions with a rigid set of symptoms that can be accurately differentiated, but they’re not.

Diagnosis is still completely based on observable behavior, which makes it more of a narrative process than a biological one. You don’t get diagnosed with a brain scan or a blood test — it depends what you tell the doctor about yourself or your child, and what they see in the stories you share. It also depends heavily on their implicit biases regarding race, gender, and class.

Colloquially, I’ve come to see these words — ADHD, autistic — as rhetorical, narrative tools, short-hand for a common human experience.

Like telling someone you’re “such a Gemini”, referring to yourself as ADHD calls up a list of traits and a reference for a certain experience. You don’t have to explain it all because you have this one word carrying a loaded pack of meaning for you.

This is convenient! And it allows us to relate more efficiently, to talk about our personalities and our lives in less words, and to find community. But it’s also vague, stereotypical, and generalizing, which is perhaps a double-edged sword for neurotypes that contain such massive variability (what science-types call “heterogeneous”).

My ADHD is likely not your ADHD. The category contains so many different kinds of people, even doctors have admitted that “the diagnosis is a mess” — in his book ADHD Nation, Alan Schwarz details a massive public hearing held by the National Institute of Health that made headlines in 1998.

After three days of presentations in hopes of reaching an official consensus on what ADHD is, a journalist asked a panel of doctors to describe the typical person with ADHD, and they couldn’t. Because there isn’t one!

I sometimes wonder if I was misdiagnosed as ADHD, when really I am just autistic. When I hear people talk about how…