Brain health · Sanctum

Executive function, doubly hit

Worse than ADHD on its own. You cannot start, you cannot switch, and you cannot stop, and the harder you try to be organised the more it seems to cost you. The systems meant to run the day are stretched from two directions at once.

When ADHD and autism sit together, executive function takes a double hit: the ADHD difficulty getting going and holding attention, plus the autistic difficulty shifting set, changing task, and moving off something once locked in. So you are both unable to begin and unable to let go, sometimes about the very same thing.

Because it gets assessed as one condition or the other, the combined weight is underestimated, and people are judged to be coping better than they are. The sheer effort of holding a day together when both systems are stretched goes unseen.

We look at executive function with both conditions in mind, because the combined load is the part most often missed. None of this is a diagnosis. It is what we explore with you.

Written by Dr Asad RaffiConsultant Psychiatrist · Founder & Medical Director