Brain health · Sanctum

Impulsive, then paralysed

You act on a whim without a second thought, and then freeze for an hour over a small choice. All or nothing, with no middle gear. The same person who leaps before looking cannot, an hour later, decide what to have for lunch.

When ADHD and autism sit together, both extremes can run at once: the impulse that fires before the pause, and the need for certainty that stalls when the path is not clear. So you swing between acting too fast and not acting at all, and neither feels like a choice.

Because the two look contradictory, each gets explained away on its own, the impulsivity as recklessness, the freezing as anxiety, and the pattern that connects them is missed. Living between the two is exhausting, and easy to mistake for being unreliable.

We look at the swing itself, not just one end of it, because the contradiction is the clue. None of this is a diagnosis. It is what we explore with you.

Written by Dr Asad RaffiConsultant Psychiatrist · Founder & Medical Director