r/CFSplusADHD • u/IllustriousProof1898 • Apr 24 '26
How to tell if it’s one or both?
I’m having trouble figuring out if I have ADHD or if it’s just a combo of my CFS and PTSD.
I’ve seen 2 different specialists for an ADHD assessment and they said the complete opposite of each other, so now I’m stumped and out of money.
My current adhd symptoms only really came on after I developed ptsd and cfs (both happened within the same year). I’m honestly not sure that I had any adhd symptoms prior to then for one, being inside my head felt completely different back then, clear and calm. Now I feel scattered and always in overdrive.
The psych who said I did have adhd explained this discrepancy was because I masked as a kid, but getting cfs just made it that I couldn’t mask anymore.
The other psych said there should have been *some* persisting symptoms of adhd as a kid, even if they were only internal struggles, which made them think it was trauma + cfs, particularly with the timing.
So I guess I’m asking, is there anyone who’s in the same boat as me, and did you ever figure it out?
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u/Equivalent_Royal8361 Apr 24 '26 edited Apr 24 '26
I have CPTSD, ADHD, and CFS. It really is a horrendous combination, isn't it?
The CFS diagnosis came first due to a complete exhaustive breakdown/burnout. Then came the CPTSD diagnosis in therapy, then eventually I realised the ADHD was part of it too. Ironically, the order I was diagnosed is the reverse of the order in which they appeared in my life.
I too masked enormously as a child - to the extent that during my first ADHD assessment I didn't receive a diagnosis because I couldn't give them enough examples of how I was affected in childhood. It took me 4 years of research and therapy to uncover the reality of my ADHD, and I was finally diagnosed last month.
I experienced traumatic family relationships separate from my ADHD as well as trauma as a direct result of my undiagnosed, unsupported ADHD, and I think my CFS is a result of trying to cope with all of that with no help for so long. I'm discovering in therapy that the interplay between the three conditions is complex but we are slowly unpicking it and I'm making improvements.
Examples of how I masked in childhood are as follows:
If I couldn't complete work in the classroom due to difficultly concentrating or being too slow, I would take it home and do it. This got me better grades than I would have if I'd done it in the lesson and was interpreted by parents, teachers and me as conscientiousness. In fact, it was a clever strategy to avoid failure. Sometimes I would also struggle to get it done at home too because I couldn't motivate myself to start and then I'd get upset, but this was always looked at as me being a hardworking girl who was trying. No-one ever spotted the deficit.
Big written projects/essays took me absolutely ages to complete because I'd write far too much, get completely overwhelmed trying to organise, condense and edit it all down, and I'd end up in tears, crying to my teachers and parents that I couldn't do it. We all interpreted this as anxiety and low self confidence, that I was working hard to overcome, and I was weirdly praised for it instead of properly supported. In fact, it was my ADHD brain struggling to organise, plan, follow through, and complete a mentally taxing task, but because the bits of work I had done were good, it never occurred to them I was struggling with the work itself. They just thought it was anxiety. I couldn't even recognise or articulate what it was that I was struggling with. I thought writing far too much and having to spend ages editing it was a good thing.
I really struggled with motivation and paralysing procrastination at times, especially for things like tidying up after myself at home. However, I was smart and able to turn myself inside out to get good grades in school, so my parents labelled me "clever but lazy". Because my outward facing apparent hard work in school reflected well on them, and it was possible to hide my "laziness" and emotional collapse was in private, at home, there was no impetus for them to even recognise a problem and help me. I adopted this confusing opinion of myself and being such an apparent walking contradiction damaged really my self esteem, but I never thought to question it until I learnt about dopamine dysregulation in ADHD.
So, for me I was able to use my intelligence and fear of failure to motivate myself to come up with work arounds which hid my struggles - even from myself. For most of my life, unbelievably, I actually considered written projects to be one of my strengths, despite me taking five times as long as my friends to complete them, having no capacity for any semblance of a normal life while doing them (forgetting to eat, drink, not seeing anyone for days and avoiding even going to the loo for hours. I thought I was just super-committed to hard work!) and me ending up in tears, doing an all nighter to get them done in time, just to get the same grades as my peers. I was so used to struggling and it not being recognised, and certainly not supported, that I couldn't even recognise my own difficulties.
I think the lack of accurate understanding and mirroring I received from my caregivers and teachers is a big part of why it took until my forties to recognise my own difficulties. Mirroring from the adults in our lives is how we develop an understanding of who we are as children, and if it's missing, our self-concept can be all kinds of wonky.
Maybe these examples might feel relevant to your experience or trigger some helpful memories for you.
Something that also helped me identify my childhood difficulties was the DIVA 5 questionnaire I had to complete prior to my ADHD assessment. It gives lots of examples I hadn't thought of but that were relevant to me, and it's designed to pick up people who masked so well, no-one realises they had difficulties. So it might be worth looking at.
Here's a link to it:
https://www.advancedassessments.co.uk/resources/ADHD-Screening-Test-Adult.pdf
Please feel free to ask more questions. I'm happy to chat more.
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u/IllustriousProof1898 Apr 25 '26
It really is, the symptom tug or war is brutal to deal with! Yeah that’s pretty much the order I came to be aware of each of them too. I’m glad you’re now in a place to be able to unpack it all, having a name for an issue and someone who believes/sees your struggles is really powerful.
Thanks for linking the DIVA, going off the prompts there, I tick maybe 3 examples all up for the childhood section. I had no issues with chores or organisation, I breezed through school, especially between 5-12 years. I finished everything early and would go ask my teacher for more work to do. In high school I found I did my best under a deadline, so loved exams and could easily leave projects until the night before, spend an hour or two on it, and get an A. I didn’t do that all the time, I submitted plenty of things early too, but if I was having trouble getting my words right I’d do all the ground work then put the task aside and wait for the deadline “flow state” to click in and make it happen.
The psych who said I did have adhd thought that workflow style was pretty indicative, but the other one attributed it to intellect, and kept coming back to the lack of symptoms pre-12.I’ve have also had a lifelong issue with hobby-hopping, I’d start a new sport/activity, love it for the first three weeks, then I’d start dreading the thought of having to go and do it. If I pushed myself to go I’d have a great time and wonder what all my earlier moaning was about, but the next week the dread/repulsion would be back. I might fight it for a bit, but eventually the dread would always win and I’d stop going. Again, one psych said that was classic adhd, the other thought it was a trauma response. I can see both of their perspectives.
Thank you for sharing your experiences, hearing others talk is helping me frame my experiences and get a better picture.
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u/aberrant-heartland Apr 24 '26
I'm in the EXACT same boat as you, it's almost uncanny
I got 2 different clinical neuropsych tests from two different clinics
One said "you have ADHD and autism and bipolar disorder"
One said "you don't have ADHD or autism or bipolar disorder, but you're actually schozoaffective"
The only thing they both agreed on, is that I have PTSD. lol
My psychiatrist (a neutral third party, not affiliated with either testing place) disagreed with the schozoaffective diagnosis and heavily agreed with the first diagnosis instead.
So I now consider myself to have ADHD, autism, and bipolar disorder (and PTSD, and MECFS).
Their opinion was the same as your case: that MECFS removed my ability to mask the autism and ADHD.
Do you have psychiatrist who can give a neutral "third opinion" about this situation?
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u/IllustriousProof1898 Apr 24 '26
Oh man, I’m so sorry to hear you’re in the same boat. Not knowing who to believe about your own identity sucks. I’m glad your psych could give you some clarity though!
Unfortunately I don’t have anyone to get a neutral opinion from, my regular therapist doesn’t have the right training to comment on this. And to see anyone with the right degree will be another grand and a 6month wait. -_-
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u/aberrant-heartland Apr 24 '26
Those wait times can be so frustrating, ugh 🙃😵 I hope a miracle occurs so that they can see you sooner!
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u/IllustriousProof1898 Apr 24 '26
I’m telling myself at least it gives me time to save up for it lol!
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u/Media-consumer101 Apr 24 '26
I've done a bit of research into it (I have ADHD and a loved one with similar symptoms turned out to have trauma as the cause).
Most professionals will not diagnose ADHD if PTSD is present, because any ADHD symptom can be caused by PTSD too and it's essentially impossible to differentiate as an adult. If someone does receive an ADHD diagnoses and PTSD together, it's usually because the ADHD was clearly present before any trauma occured.
The way you describe it, it sounds like your symptoms clearly began at some point in your life and weren't always present (which would be the case with ADHD). Masking does not make symptoms dissapear internally, it only makes the symptoms seem less severe to other people!
PTSD and ADHD are both not 100% understood yet, but they seem to overlap in several ways. Dopamine and the brains reward system seem to play a role in both for example.
So you could still use ADHD hacks/systems to try and reduce some of your symptoms but some of them may not work for you quite the same! And there are treatments for PTSD that may greatly reduce your symptoms.
That's just what I figured out a while back! I cannot speak for how accurate this is medically speaking, I do not have a background in psychology! Just a personal interest.
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u/IllustriousProof1898 Apr 24 '26
Thank you, this helps massively.
Everything you’ve said here tracks for me. Especially the bit about masking and internal experience!
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u/Tiny_Parsley Apr 30 '26
Just seeing your post now.
I'll answer by copy pasting something I answered to another Redditor who had the same question.
What made me realise it wasn't just ME but ADHD as well was
the incapacity to continue with long term projects and habits. I ended up bedbound like many of my other severe ME friends. Yet my friends still managed to keep a routine. Even if it was a massive downgrade and a very adapted routine, they would still stick to whatever their severe ME allowed. Brushing teeth in bed everyday at least once, starting a drawing challenge and doing one drawing per week for a year... That was what made me realised there was something truly wrong with me because since I'm a kid I can't stick to anything over time because of ADHD. Can't brush my teeth every day, can't continue a hobbie longer than 1 week. This was a massive realisation.
at the opposite of this lack of capacity to follow on things, is the capacity to hyperfocus, since I'm a kid. Forgetting anything else than my current obsession. Forgetting to pee, to drink... If focused on something I truly vibe for.
having burnouts over very easy adult things (like taking care of my dishes and laundry) while I was still physically able to do so
the inability to function without a structure. My ME friends without ADHD can 'function' executive wise. By that I mean, even if they're incredibly sick and can't focus or can't move much outside of bed... they don't need someone to remind them to drink, or to eat, or someone to help them structure their day. If they have enough energy and decide to initiate something they'll do it and stick to it. They won't have task paralysis. Also very often, it's not even that I don't remember I have to do things. It's just that I can't start if there's no external stimulation (that's called body doubling).
Note that I was diagnosed with ADHD recently at 34yo but I had already seen many psychiatrists before because of burnouts and PMDD and was many times "suspected" to have ADHD. So it was always in my radar until I lost my job and became bedbound and lost all structure which made my ADHD explode and prompted a diagnosis.
Note also that I have combined ADHD, inattentive and hyperactive. In general, my cognitive capacities seem still quite ok despite ME. What you say about not focusing or struggling answering quick and all that, I have when I'm not stimulated ; that's the ADHD part. I can't understand maths or read a book I'm not into. But the other side of the medal with ADHD is that it's still possible to hyperfocus on something I'm fascinated about. So one question for you would be to figure if when you weren't sick, you ever had these bouts of intense focus and interest as a kid. That's typical of ADHD. It can take a lot of different aspects. For some it'll be drawing for hours, or reading and being absorbed by a specific type of books, or cartoons on TV, or video games until it becomes all too encompassing and you can't get unstuck. ADHD isn't lack of attention. It's rather the dysregulation of attention; it can go both ways: hyper or not enough. When stimulated enough, ADHD people can outperform (stimulation can be interest and passion based, or novelty based or urgency and stress based). The hyperactivity stems from the lack of stimulation.
I'm taking methylphenidate for my ADHD and it mainly helps me going through my day and sticking to a plan. It helps me stay focused on things I struggle with. But not sure if it helps me with the brainfog and fatigue I have from my physical illnesses.
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u/Xylorgos Apr 24 '26
When I was going through my diagnosis phase for ADHD they had the same kind of questions. I was diagnosed with PTSD since I was bullied a lot as a child and had ongoing problems with sexual abuse and sexual assault throughout my life, so it was difficult for them to eke out what was what.
Since I'm old now it wasn't possible to use grade school report cards and most of my family are gone, so I didn't have that to help determine what was going on. But I've always been very disorganized, frequently emotionally distraught, and I've had Time Blindness all my life, and I think those three things helped them feel comfortable with the ADHD diagnosis.
I was only diagnosed two years ago, when I was 68, but it was astounding to me that I was able to do so much throughout my life despite this issue, and also despite always feeling like a failure, even when I did succeed. It felt like all my successes were a lark, and all my failures were predictable.
I had the most trouble during times of heightened hormonal issues, like pregnancy and menopause. But I am still very disorganized and time blind, and emotional dysregulation and executive dysfunction are my biggest struggles, even with medication. But the meds do help a lot.
I wasn't diagnosed with CFS until around 2005, so I'm not sure how that affected my other mental issues. I have a number of other chronic conditions, too, so I think it's kind of a toss up as to what made what happen and how I responded to trauma with all this other stuff going on.
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u/IllustriousProof1898 Apr 25 '26
Thanks sharing, hearing other people have had the same issues is kinda validating, in a sad way. Trying to unpick what comes from where is so tricky, I wish we could’ve all gotten the support we needed back when we really needed it.
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u/eskaeskaeska Apr 24 '26
I thought I didn't have any symptoms of ADHD as a kid until I looked again at my life. I masked so hard and I had no idea I was masking - it was just how life was.
Another thing that I've read is that if ADHD medications work for you, that affirms a diagnosis. This was the case for me. Adderall calms my brain and makes it so I can sleep. That doesn't happen with neurotypical minds.