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The Hidden Cost of Completion in AuDHD Women

By Michelle Labine, PhD

May 16, 2025

For a long time, I thought something was wrong with me.

Not because I didn’t follow through—but because I always did.
Even when I was exhausted.
Even when I was drowning.
Even when something inside me screamed to stop.

I was the girl who got things done. The woman who held it all together. I didn’t quit, I didn’t flake, and I didn’t leave things half-finished—at least not where anyone could see.

But behind the scenes? It was different.

I’d hyper-focus until I burned out.
I’d commit myself to impossible standards and then white-knuckle my way through them.
I’d plan everything to perfection—only to feel trapped once those plans became reality.
I needed structure. But I also needed out.

This wasn’t inconsistency. This was AuDHD—the co-occurrence of Autism and ADHD—and it shaped every part of how I moved through the world.

When “Follow-Through” Becomes a Mask

For women with AuDHD, follow-through often becomes a coping strategy. A way to be taken seriously. A shield against being labeled “lazy” or “scattered” or “too much.”

Many of us weren’t allowed to unravel, so we over-delivered. We outperformed. We earned praise for being organized, focused, or high-achieving—never revealing the chaos it took to get there.

We weren’t praised for our creativity or divergence. We were praised for being “put together.”
And so we learned: finish at all costs. Even when it hurts.

But here’s what most people don’t see:

  • We stay late. We rewrite things that were already fine. We obsess over tiny details not because we want to, but because our Autistic brains crave completion and correctness—and our ADHD brains can’t stop spinning until it’s done.
  • We lose sleep. We forget meals. We fall apart behind closed doors.
  • We live in cycles of extreme effort and total shutdown, never knowing how to stop the loop.

What Looks Like Discipline Might Be Dysregulation

Here’s the truth: compulsion isn’t commitment.
Exhaustion isn’t integrity.
And constantly following through, while abandoning ourselves, isn’t a virtue.

In AuDHD women, what looks like strong work ethic may actually be driven by:

  • Rejection Sensitivity (fear of disappointing or being judged)
  • Masking (performing competence while hiding overwhelm)
  • Perfectionism (a trauma response to chronic misattunement)
  • Hyperfocus (feeling unable to stop until it’s “right”)

We don’t struggle to finish things.
We struggle to stop.

The Healing Comes When We Pause

Getting diagnosed late in life means unlearning decades of internalized pressure.
It means asking: What if I don’t finish this right now? What if I rest first? What if following through means honoring myself—not just the outcome?

Healing, for many of us, isn’t about learning how to do more.
It’s about giving ourselves permission to do differently.

  • To take breaks without guilt.
  • To circle back to projects without shame.
  • To let some things be good enough.
  • To stop proving our worth through productivity.

Because the truth is: we were never broken. We were just wired in a world that didn’t understand our rhythm.

You always followed through.
And maybe now, you don’t have to.
Not like that. Not anymore.