This essay is a follow-up to Reflecting on My Adult ASD Diagnosis. In the three and a half years since, I’ve learned quite a lot through post-diagnosis therapy, continued research, and, more recently, psychiatry. I now have a more complete picture of how my brain works - why some “easy” things feel harder than they should, and why some “hard” things feel easier to me than others.

I was diagnosed with Autism Spectrum Disorder Level 1 four years ago at age 34, and ADHD last July. I started taking Duloxetine in July 2024 for help with anxiety and burnout, added Lamotrigine in January 2025 which complements the SNRI with mood stabilization, and just recently added Adderall for help with the executive function challenges that come from both conditions.

The autism realization and diagnosis came after a difficult burnout and realizing my job at the time — the first one I’d ever had that involved more meetings than deep work — triggered a pattern I’ve struggled with every 3-4 months until this year. They weren’t always long-lasting, but even when I recovered, it still felt like I was hovering just above the next burnout.

My neurodivergence is on the milder side. To me it feels like more of a difference than a disability in that I don’t require support to live alone (I actually prefer it), and it’s also what gives me a number of strengths.

That makes my autism harder to see because it doesn’t affect others in a way that at times could feel burdensome and expensive for them.

It also means the kind of support I need is easily overlooked, and my social challenges have always prevented me from even asking for help most of the time.

Because my challenges are offset by what are considered valuable strengths in a capitalist society, my lived experience aligns more with the social model of disability.

I believe that many people who want a cure for autism, at least partially, want that because of how it impacts their own lives and the expense that higher levels of support needs require.

However, for myself and many people with milder presentations of autism, a broader understanding and validation of our differences is more desirable.

So I have mixed feelings about the DSM-5’s reclassification of Asperger’s, classic autism, and a few other similar conditions into a single spectrum disorder.

The intent behind that decision makes sense, but on the other hand it only makes it harder for most people to understand what it means to be “on the spectrum,” and what kind of support is needed when someone like me says they are autistic compared to other autistic people who may require a full-time caregiver, may be non-speaking or need assisted communication devices, have autism with intellectual disability, or have severe sensory sensitivities that can make everyday activities overwhelming.

“Mild” autism can come with strengths like strong attention to detail, pattern detection, analytical thinking, and ability to solve complex problems. (Although it’s important to remember that strengths are not limited to those with lower support needs!)

These are great traits to have in a work environment and it’s really easy to assume someone with those abilities would not struggle with much at all, especially when paired with above-average intelligence that can mask challenges.

What can’t be seen is the internal experience — the rapid thinking, the questioning of everything, the stress and anxiety from basic social interactions, need for things to be logical, struggle with and lost time when switching tasks, processing immense amounts of information, desire for a routine and predictable schedule, pervasive drive for autonomy, and need for an atypical amount of alone time.

Our modern, hyper-connected world is designed in a way that is inconsiderate of the needs of neurodivergent people and especially within corporate environments.

What I need to do and feel my best is at odds with the way business prizes and expects a high degree of collaboration, communication, deference to hierarchy, and on-demand availability.

So while it doesn’t feel quite right to consider myself “disabled” when compared to those needing far more support with daily life, I do feel disabled when considering the social model of disability.

Accommodations at work are hard to ask for and harder to get. Some are easier for management to provide than others.

And even though I would argue less and more focused meetings, more individual autonomy and accountability, and quiet days for deep work would benefit most people (at least those outside of customer-facing and management roles), that requires systemic change.

I don’t think the workplace needs to be redesigned just to accommodate neurodivergent people, but rather that it needs to be more flexible for all people. In the long run, that would lead to happier, healthier employees, which is necessary to drive better business outcomes.

It’s very common for late-diagnosed neurodivergent people to feel imposter syndrome.

I struggled with it a lot even long after diagnosis, although it was never a serious consideration — deep down I knew it was imposter syndrome I was feeling, and not that the diagnosis was incorrect.

One of the things that always gave me imposter thoughts is how many people in the neurodiversity communities on Reddit were on a similar combination of medications I’m now on, with diagnoses of co-occurring conditions like GAD, Depression, and ADHD.

Mental health issues like anxiety and depression are not core “features” of ASD or ADHD, but are often side effects for those that are high-masking, which often goes hand-in-hand with late-diagnosis.

Burnout is also very common for autistic adults. It looks and feels a lot like depression, but they occur for different reasons.

It was yet another burnout for the whole month of June 2024 that I decided to see a psychiatrist. I was diagnosed with each of those conditions, and my pharmacological treatment has been in that order. (Plus trazodone for help with sleep.)

Each one has helped in different and complementary ways.

Now that I know I’m AuDHD, and have started taking a stimulant, it feels like a complete course of treatment (along with continuing weekly therapy with the same psychologist who diagnosed my autism) that has removed much of the friction from my daily life.

Through my own research, I’ve long seen myself at the intersection of autism, ADHD, and high intelligence. The diagnoses and understanding they’ve brought feel like a puzzle that’s been completed.

The positive effects of my medications have shown me that when your social environment is what actively disables you, medication can offer crucial support and temper the reality that getting meaningful accommodations in a corporate environment is almost impossible to obtain. (Plus they’ve been a big help in lifting me up and away from burnout!)

I feel no less myself than before starting medication, just less weighed down and more capable of “little things” that neurotypical people find easy.

I still need and enjoy lots of alone time, I still have the same special interests, I’m still shy and quiet, I still dislike smalltalk, I still feel the push and pull between Autism and ADHD when deciding how to spend my time, and I still struggle to keep up with all the external demands that being an adult brings.

Having an AuDHD brain is a 24/7 experience. Medication isn’t a magic wand, nor does it give me any kind of edge — it simply helps balance certain chemicals in my brain, bringing me closer to a more manageable baseline.

Environmental changes, both at home and at work, are still essential for me to thrive, as is the ongoing therapeutic work of designing a life that aligns with how my brain functions best.

I’m glad that I spent 3+ years of post-diagnosis reflection and therapy developing a deep understanding of what my challenges and strengths are, what kind of environments to seek out and others to avoid, what I need to feel and perform at my best, and most of all that it is okay to trust my own instincts about what’s right for me rather than forcing myself to try to follow what society tells us is normal.

And even though I’m sure medication would have been just as helpful earlier on, I’m also glad that I started and added each slowly only over the last year and a half.

I’m still in the early stages of seeing how adding a stimulant into the mix can help, but to my surprise the first and most noticeable effect has not been with improved focus and productivity, rather a remarkable calm and inner peace. And that makes sense to me, as those things are prerequisites to maintaining focus and productivity.

Doing things in that order has taught me how to see medicine as a type of support that is complementary to, and not a replacement for doing the harder work of learning how to navigate life in a way that is sustainable for how my brain works.

With that knowledge, I feel empowered to advocate for my needs even more, to make better decisions, to set better boundaries, and to practice better self-care now and in the long run.

And for now, the key to managing the parts of my daily life I can’t control, my hyperactive brain, and the side effects that come from having an “invisible disability”, is the support that medication has provided.