Biomarker Workshop 2025: Save the Date – December 11, 2025, Thursday, 1:30 PM–5:30 PM, possibly a full-day event.
Disclaimer: This text was translated from German to English using AI. While efforts were made to ensure accuracy and clarity, some nuances may differ from the original.
The diagnosis and understanding of neurodivergence have evolved significantly over the past decades. Yet, the distinctions and overlaps between ADHD, autism spectrum disorders, anxiety disorders, and hypersensitivity remain a challenge for professionals, individuals affected, and their families.
Differential Diagnosis: More Than Superficial Similarities
As Aleksander Knauerhase insightfully outlines in his analysis, the issue of differential diagnosis in neurodivergent conditions is complex. Autism, ADHD, and hypersensitivity may present with superficially similar behaviors, yet they have different neurological foundations and processing patterns.
In autism, the main challenge lies in the sheer quantity of stimuli reaching consciousness. As illustrated by the parcel center metaphor: while neurotypical people process about 300 “parcels” a day, autistic individuals face around 1,000—an overwhelming sensory load due to volume.
ADHD, on the other hand, is more about the way information is processed. The problem lies not primarily in sensory filtering but in attention regulation and impulse control after stimulus reception. In ADHD, the organized processing system breaks down more frequently—all the “parcels” land in a chaotic heap, leaving the individual unsure where to begin.
Comorbidities and Interactions
In reality, things are even more complex, as these conditions often co-occur. Studies show that 20–70% of autistic individuals also meet criteria for ADHD, with the wide range in statistics due to diagnostic inconsistencies and varying research methodologies.
Anxiety disorders play a particularly significant role in this context. As Miriam Thunser describes from personal experience, many autistic individuals develop comorbid anxiety disorders over time. These often arise as a direct result of:
- Chronic stress from sensory overload
- Social misunderstandings and bullying
- Constant masking and compensating
- Unpredictable environments and changes
The Cycle of Overload and Anxiety
A central issue often overlooked in therapeutic practice is the interaction between autistic traits and anxiety disorders. Anxiety leads to heightened sensory sensitivity and reduced tolerance, which in turn increases the likelihood of overloads and meltdowns. These, in turn, reinforce fear of future situations—creating a vicious cycle.
Heidrun Overberg emphasizes, based on her many years of clinical experience, that the foundations are often laid as early as kindergarten or primary school. Autistic children who have early negative experiences often develop defensive strategies that later manifest as full-blown anxiety disorders.
Hypersensitivity: More Than Just “Being Sensitive”
Die HypersensitivitHypersensitivity deserves special attention as it plays a central role in both autism and anxiety disorders. It can manifest in various forms:
- Sensory hypersensitivity: Overreaction to sounds, lights, textures, or smells
- Emotional hypersensitivity: Intense perception of and response to emotional stimuli
- Social hypersensitivity: Heightened sensitivity to social cues and atmospheres
These different forms of hypersensitivity may occur independently or in combination and can be present in both autistic and non-autistic individuals.
Therapeutic Challenges and Approaches
Current therapeutic offerings often fall short of meeting the complex needs of neurodivergent individuals. As Thunser critically notes, many therapists lack sufficient knowledge about the interplay between autism and anxiety disorders.
Effective therapeutic approaches should consider:
- Individual sensory profiles
- The limited “energy battery” of autistic individuals
- The necessity of structured and predictable environments
- The importance of self-regulation strategies
- The validation of autistic experiences without pathologizing them
Societal Implications
Growing awareness of neurodiversity calls for a paradigm shift in education, the workplace, and healthcare systems. Overberg’s observation that the quality of care has actually declined in recent years is alarming and underscores the urgent need for action.
Conclusion: A Holistic View of Neurodiversity
The future of neurodiversity research and care lies in a holistic understanding of the complex interactions among various neurological variations. Only by acknowledging this complexity can we develop appropriate support and therapies that reflect individual lived experiences.
The goal should not be the “normalization” or “cure” of neurodivergence, but the creation of environments and strategies that empower neurodivergent individuals to realize their full potential and lead self-determined lives.
