Why Are so Many Men Being Diagnosed Later in Life with Adult ADHD and Autism Level 1 ?
Why Are so Many Men Being Diagnosed Later in Life with Adult ADHD and Autism Level 1 ?
For many men, life has always felt a little harder than it should. You may have been capable, smart, or even high-performing — yet still struggled with overwhelm, frustration, or a sense that you were constantly “behind.”
Only recently have many men begun to understand that these challenges can be the result of ADHD, Autism Level 1, or both, especially when these patterns were missed in childhood.
This article explores how these neurotypes show up, why so many men are diagnosed later in life, how they interact with anxiety and depression, and what you can do if you’re wondering whether this applies to you.
How Common Are ADHD and Autism Level 1 in Adults?
ADHD Prevalence
Affects 3–5% of adults
Only 10% of adults with ADHD are diagnosed
Many men were missed because they weren't disruptive or because their
intelligence masked their challenges
Autism Level 1 Prevalence
Affects 1–2% of adults
Many were mislabeled as introverted, intense, or “different but bright” in childhood
ADHD + Autism Overlap
20–40% of autistic adults also meet criteria for ADHD
20–30% of adults with ADHD show significant autistic traits
The combination is more common than most people realize — especially in men.
Why Men Are Only Realizing This in Their 30s, 40s, and 50s ?
Childhood diagnostics were narrow
Older diagnostic models assumed:
ADHD = hyperactive little boys
Autism = severe social or communication difficulty
Anyone who was bright, verbal, quiet, or compliant was often missed.Many men learned to mask
Masking looks like:
Becoming extremely logical or rigid
Overworking to compensate
Mimicking social behaviour instead of intuitively understanding it
Picking careers with structure and rules
Masking works — until life stress increases (career changes, parenting, relationship strain). Then symptoms become harder to ignore.
Boys were told they were “lazy,” “not applying themselves,” or “immature”
Instead of being assessed, many were blamed for symptoms outside their control.
Adult diagnostic tools are new
Meaningful adult assessment for autism and ADHD only emerged in the last decade.
It was only in 2013 with the release of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), or the DSM-V, that made several key changes over earlier editions:
It expanded ADHD criteria to better capture how symptoms present across the lifespan — including in adults — such as changing the age-of-onset criterion from 7 to 12 years, and reducing symptom thresholds for older adolescents and adults
It allowed concurrent diagnosis of ADHD and Autism Spectrum Disorder (ASD), which previously couldn’t be diagnosed together under older DSM versions.
These changes significantly improved diagnostic validity and accessibility for adults, and many clinicians regard this shift as foundational for diagnosing ADHD and ASD in middle-age and later life.
Society now places heavier demands on executive functioning
Digital communication, multitasking, email overload, and constant stimulation highlight neurodivergent challenges that were easier to hide in the past.
How ADHD Shows Up in Adult Men:
Cognitive
Trouble following multi-step instructions
Losing track of tasks
Difficulty switching attention
Chronic procrastination
Time blindness
Emotional
Irritability
Quick frustration
Feeling overwhelmed by demands
Shame about inconsistency
Behavioural
Starting many projects but finishing few
Relying on deadlines or pressure
Difficulty maintaining routines
How Autism Level 1 Shows Up in Adult Men :
Social-Cognitive
Difficulty reading social cues
Literal communication
Confusion in unstructured conversations
Sensory
Noise, clothing, or texture sensitivities
Fatigue in overstimulating environments
Emotional
Shutdowns when overwhelmed
Difficulty identifying emotions (“alexithymia”)
Behavioural
Deep, narrow interests
Strong preference for predictability
What Happens When ADHD and Autism Occur Together ?
The combination creates a unique internal clash.
ADHD seeks novelty. Autism seeks predictability.
Men describe this mix as:
“I want to start new things but also don’t want anything to change.”
“I get bored easily but overwhelmed quickly.”
Shifting attention becomes harder
ADHD → difficulty sustaining
Autism → difficulty shifting
Together → feeling stuck, scattered, or mentally frozen
Emotional overload becomes more intense
This mix often leads to:
shutdowns
irritability
internal pressure
difficulty recovering from stress
How ADHD and Autism Increase Anxiety, Depression, and Burnout in Men
Neurodivergence doesn’t cause mental illness, but the mismatch between a man’s neurotype and the demands placed on him can create significant distress.
Chronic Anxiety
Anxiety appears when:
tasks feel unclear
expectations are unpredictable
sensory overload is constant
social rules feel like a moving target
responsibilities exceed executive capacity
Many men describe living in a “permanent state of tension.”
Depression
Depression often develops from:
years of masking
repeated failures that don’t match intelligence
social difficulty despite effort
burnout
internalized shame (“Why can’t I get it together?”)
Depression in neurodivergent men often presents as:
low motivation
irritability
emotional numbness
a sense of futility
Emotional Dysregulation
ADHD affects impulse control, while autism affects processing speed under stress. Together, this may look like:
shutting down
withdrawing
snapping unexpectedly
difficulty calming the nervous system
Burnout
Autistic burnout and ADHD burnout share features:
exhaustion
loss of capacity
decreased tolerance for stress
declining performance despite effort
This is common in mid-life when responsibilities increase at the same time coping resources begin to decrease.
Are ADHD and Autism Becoming More Common?
Prevalence is rising — not because these neurotypes are new, but because we're finally recognizing them.
Reasons for the increase
Better diagnostic tools
Reduced stigma
More men seeking help
Workplaces demanding more executive functioning
Increased public awareness
Shifts in parenting practices
What looks like a “surge” is actually a correction of decades of underdiagnosis.
What Helps Men With ADHD and Autism Level 1
1. Medication (for ADHD)
Benefits:
improved attention
better emotional regulation
reduced overwhelm
Limitations:
does not teach skills
does not address autistic needs directly
2. Executive Function Coaching
Helps men:
organize tasks
create routines
break down projects
manage time
develop accountability
3. Neurodiversity-Informed Counselling
Supports men with:
emotional regulation
identity development
reducing shame
understanding patterns
navigating relationships
developing tools that match their wiring
Approaches that work well:
CBT adapted for ADHD
Autism-informed counselling
ACT (Acceptance and Commitment Therapy)
Trauma-informed approaches (many undiagnosed men carry relational wounds
from childhood)
How to Explore a Possible Diagnosis Without Spending Thousands
1. Talk to a physician or nurse practitioner
They can diagnose ADHD and sometimes ASD. Cost is usually covered in Canada. Depending on your country and health care system, this may vary.
2. Use validated screening tools as a starting point
(Not diagnostic on their own, but extremely useful.)
ASRS v1.1 — ADHD
CAT-Q — masking
RAADS-R — autism traits
AQ-10 — autism screener
3. Medication trial for ADHD
A supervised stimulant trial may clarify whether ADHD is likely.
4. A few sessions with a neurodiversity-informed psychologist, counsellor, or psychotherapist
Often enough to differentiate ADHD, autism, trauma, anxiety, or burnout.
5. Low-cost “focused assessments”
Many psychologists offer targeted assessments rather than full batteries.
Final Thoughts
If you’ve spent your life feeling like you’re capable but constantly overwhelmed, or that you’re missing a manual everyone else received, you’re not alone. Many men discover in adulthood that the issue was never motivation or discipline — it was wiring.
Understanding your neurotype is not about labels. It’s about clarity, compassion, and learning how to work with your brain rather than against it.
If you’re starting to recognize yourself in these patterns, you’re not alone — and there’s nothing wrong with you. Many men reach mid-life before understanding how their brain was wired and how much easier life can feel with the right tools. I’m one of those men, and still on that journey. Realizing that there is a path to improve my functioning was hopeful and inspiring, once I could see beyond the shame as well as the grief and anger over opportunities lost.
If you’d like support making sense of your symptoms, exploring the possibility of ADHD or Autism Level 1, or building practical systems that work with your brain instead of against it, I’m here to help.
I don’t consider myself an expert in this area…yet. The understanding of my own neurodiversity is new. What I can offer is neurodiversity-informed counselling and executive functioning support for men wanting clarity, confidence, and a better way forward. I strongly recommend for any man who believes that they may have adult ADHD or ASD to consider the executive functioning (EF) coaching as well, either prior to or concurrent with counselling. My own experience is one of having had considerable therapy with many practitioners over the years for personal and other issues, and yet not experiencing the results that many people normally do. Now that I understand my own neurodiversity, my experience in therapy makes sense. Neither the practitioners or I recognized the underlying neurodiversity. That was due to my own ignorance of my condition and my capability at masking. It’s my belief and hope that undergoing a comprehensive regime of EF coaching may increase the capacity of a client to have success in counselling. I would recommend seeking practitioners for such work who are informed and comfortable working with neurodiversity.
You don’t need to keep pushing through alone. The right support can change the trajectory of your life.
Learn more or book a consultation at Centre of Gravity Counselling, www.cofgcounselling.com.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Antshel, K. M., Zhang-James, Y., & Faraone, S. V. (2013). The comorbidity of ADHD and autism spectrum disorder. Expert Review of Neurotherapeutics, 13(10), 1117–1128.
Cooper, M., Martin, J., Langley, K., & Thapar, A. (2014). Autistic traits in children with ADHD symptoms. Journal of Autism and Developmental Disorders, 44, 2584–2598.
Kooij, J. S. et al. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56, 14–34.
Lai, M. C., Lombardo, M. V., & Baron-Cohen, S. (2014). Autism. Lancet, 383(9920), 896– 910.
Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. Lancet, 392, 508–520.
Matson, J. L., & Williams, L. W. (2013). The stability of ASD. Research in Autism Spectrum Disorders, 7(1), 1–7.
Sibley, M. H. (2021). ADHD in adults: updates on diagnosis, impairments, and interventions. Current Psychiatry Reports, 23, 70.
World Health Organization. (2023). Autism spectrum disorders: Fact sheet.
