AuDHD — co-occurring ADHD and Autism — is one of the most commonly missed neurodivergent profiles, especially in adults who learned to mask early and mask well. Standard ADHD treatment often feels off. Standard Autism support often feels irrelevant. You've probably been told you're "a lot" by people who simply didn't have the right framework for you.
ADHDers often crave novelty, stimulation, and spontaneity. Autistic folks often need predictability, routine, and time to process. When both are present in the same brain — which is more common than most clinicians realize — they create an internal experience that's genuinely hard to describe and harder still to treat with cookie-cutter approaches.
The result is an internal tug-of-war that often looks like anxiety, mood instability, or just "being a contradiction." It isn't. It's your nervous system navigating two competing operating systems — without anyone ever handing you the manual.
You appear warm and socially capable. Behind that is enormous, invisible effort — and post-social exhaustion that needs days to recover from, not hours.
Autistic burnout is real and clinically distinct. It's triggered by prolonged masking, sensory overload, or major life transitions — and misread by providers who aren't looking for it.
You've been told you're too sensitive your whole life. What you were experiencing was a neurological reality — and it genuinely costs you more energy than it costs allistic people.
You hold a job, maintain relationships, appear capable. The internal cost of that appearance is invisible — and gets dismissed because you look fine. Functioning labels erase this completely.
Autistic? ADHDer? AuDHDer? You're not sure which community you belong to — and neither fits perfectly. That uncertainty deserves real space, not a diagnostic shortcut.
For many AuDHDers, queer and neurodivergent identities were discovered around the same time — often in adulthood. Masking across multiple axes simultaneously is its own specific weight.
I'm an ADHDer, and I engage seriously with the AuDHD community — both clinically and personally. I understand diagnostic uncertainty, the experience of feeling like you're too much and not enough simultaneously, and what it's like to find a framework that finally fits after decades of wondering why you were so different.
I don't require a formal diagnosis to begin meaningful work with you. The experience is real before the label is official. What I bring is clinical training, lived neurodivergent experience, genuine community fluency, and 9 years working with people who were told their whole lives that the problem was them.
"The experience is real before the label is official — and the work doesn't have to wait for a piece of paper."
— George Goldston, LMFT · ADHDer · he/himQueer AuDHDers make up a significant part of my practice. Research consistently shows higher rates of LGBTQ+ identity among neurodivergent people — and the late discovery of both queer and neurodivergent identities often happen together, creating a specific kind of identity reckoning that mainstream therapy isn't equipped for. This intersection is where I work.
The goal is not to make your brain behave neurotypically. It's to help you understand how it actually works — and build a life that doesn't require you to constantly override it to be acceptable to people who never had to work this hard just to exist.
Understanding what dysregulates your specific nervous system and building sustainable responses — not willpower-based suppression or toxic positivity about shutdowns and sensory spirals.
Moving from "what is wrong with me" to a coherent, integrated understanding of how your specific brain operates — including the parts of you that are neurodivergent, queer, and everything else.
Reducing the performance without collapsing the life you've built. This includes examining where masking protects you and where it costs you — because it's genuinely not always simple.
Hiking sessions at Umstead are particularly well-suited for AuDHDers — reduced sensory demand, no forced eye contact, movement supporting regulation. The forest doesn't require you to perform.
No insurance. Neurodivergent-affirming, unhurried work — no diagnosis-driven treatment constraints.
Superbills available for out-of-network reimbursement.
Ready to work with someone who actually understands? Let's find out if we're a good fit.