> Before these potential suggestions could be translated into practice, there is a need to investigate the mechanisms underlying our results. While the specific neurocognitive processes that underpin our findings are unknown, a possible explanation for this pattern of results may be the differential executive function difficulties that characterise ASD and ADHD. A systematic review by Craig and colleagues53 revealed that, while both neurodevelopmental conditions are associated with executive dysfunction, autistic individuals tend to have more problems with cognitive flexibility and planning, while those with ADHD have more response inhibition difficulties [see also54]. Crucially, such response inhibition problems have also been documented in depression and anxiety. We therefore speculate that response inhibition difficulties, which appear to be a cognitive feature of ADHD, may also potentially underpin the stronger association between ADHD traits and internalising problems.

Totally anecdotal, but what might help with ASD is some sense that you’re different from other people, and other people sensing that you’re different. On one hand that is innately difficult, but it’s somewhat more concrete and tangible than with ADHD. You at least get a sense of what you’re working with. On the other hand, ADHD can trick you into thinking you’re neurotypical.

You end up living decades feeling like a complete fraud. You have to internalise debilitating shame and anxiety for failing to be normal. You’re 25 and still can’t remember to pay your bills on time, or 35 and still drive your car until it runs out of fuel, 45 and can’t hold a job, 55 and can’t remember your family’s birthdays (you know the dates, but it comes and goes), etc. You constantly fail on basic tasks and disappoint everyone around you. People don’t think you’re forgetful or distractible; they think you’re cold or aloof, irresponsible or careless, and so on.

Everyone assumes you’re just a regular person who opts to perform poorly. You begin to think it must be true.

I’m not saying ASD is easier. I think ADHD simply has an insidious nature that causes one to try to hide themselves even more so, sabotaging themselves in ways that make the condition even worse.

My experience with ASD is that you can be a target, people are unfair and unkind to you, but unless you’re exceptional at masking or you’re closer to the neurotypical side of the spectrum, people seem to stop expecting you to be “normal”. They won’t necessarily penalize you for being atypical. People recognize that you need assistance. They might not like it, but you’re less likely to be scolded for going off script. With ADHD, your life is spent doing that dance, and everyone expects you to stay on script. If they stop expecting you to, then you’ve really fucked up — at least if you were on the spectrum you’d have an excuse, though.

Again, not saying ASD is easy. My sister is fairly debilitated by it and I’m not so much, and while my ADHD has caused significant struggles it has still allowed me a more comfortable life and career than she has. It just seems that you’re more likely to be overtly discriminated for having ADHD, I guess.

Feel free to tell me how wrong I am, how this doesn’t reflect your experience, and so on! I don’t think I’m right, I think I’ve just had this impression over time. I’m curious what others think and what this study brings to mind.