Adult ADHD and Autism Level 1 in Men: Why So Many Are Being Diagnosed Later in Life?

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. Recognition for these conditions in adults only began in North America in 2013 with the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). 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.  

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  
• semotional numbnes 
• 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 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. 

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 counsellor  

 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 that 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. 

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 offer neurodiversity-informed counselling and executive functioning support for men wanting clarity, confidence, and a better way forward.  

Learn more or book a consultation at Centre of Gravity Counselling: https://cofgcounselling.ca/.

You don’t need to keep pushing through alone. The right support can change the trajectory of your life. 

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.