Scaffolds and Fire Escapes
On comorbidity, framing, and the need for stability in neurodivergent life.
I’ve stopped using the word comorbidity.
Not because it’s technically inaccurate, but because it smuggles in judgment I no longer accept.
The term comes from medicine—meaning two or more conditions that occur together—and many of us in neurodivergent communities have picked it up along the way. It’s a word you encounter once you start digging into research, comparing notes, or just trying to make sense of the diagnostic language attached to being autistic, ADHD, OCD, or any combination of categorical neurotype or neurological condition.
And in certain contexts, it does its job. It signals legitimacy in spaces where more everyday language might be brushed aside as imprecise. I used it myself for a while, and I understand why so many still do.
But the more I learned, the more I recognized that comorbidity is itself an artifact of the same flattening deficit-based structure it attempts to clarify. It reduces me to a list of deficits instead of recognizing a system of interwoven dynamics. It frames my life as a stack of disorders when what’s actually there is a culmination of traits, a braid of patterns and pressures and strengths that can’t simply be separated without fundamentally distorting them.
And once you see the flaw, you can’t unsee it. The braid is not two ropes tied together. The braid is the weave itself.
My identity is the weave. I am the weave.
And yet I understand how easy it is to fall into language that divides the mind into sides.
I do it myself: the obsessive part versus the focused part, the scattered part versus the steady part. It’s a framing I’ve seen a lot of AuDHD folks use too—sometimes on our own, sometimes nudged along by therapy—as if autism, ADHD, and OCD each sit in their own corner and argue.
In the right context, it’s genuinely helpful. Personifying the “sides” makes the tug-of-war inside visible, often hilariously so. Some of the sharpest, most insightful social media content I’ve seen comes from exactly that kind of playful personification—Chris Gad, aka Generic Art Dad, is particularly brilliant at this.
It’s clever, but also validating, because it gives us a shared language for dynamics that otherwise feel isolating. It’s not just jokes; it’s a tool. It lets us laugh at ourselves while also making sense of what’s happening inside. And sometimes that levity is the difference between shame and self-acceptance.
It’s a useful scaffold, one worth keeping close at hand.
But a scaffold only holds what it’s designed to hold.
The trouble comes when that temporary structure gets mistaken for the building itself. When “these parts keep each other in balance” shifts from metaphor into ontology (the nature of being).
That’s when hierarchy sneaks in: one part quietly cast as the problem, the other as the solution. For me it often looks like my obsessive compulsions being vilified while my autism—my monotropic way of thinking—gets narrated as the more acceptable side. And before I even realize it, what started as a useful perspective tool slips into pathology, into a neat dichotomy of deficit versus clarity—when the reality is something far more nuanced, and far less of a problem.
That slip reflects the bias embedded in the systems around us—the logical inevitability of a deficit-based pathology that defines the status quo. It’s a bias I’m not immune to; the metaphors I reach for are shaped by the same structures that shape diagnosis and public perception. Even when I think I’m speaking just for myself, I’m echoing a framework that has already decided what counts as clarity and what counts as a problem.
This is why so many non-masc presenting autistics—those whose traits don’t line up with the stereotypes of male presentation—spend years, decades, entire lives being dismissed or misdiagnosed: the framing trains people to spotlight whichever trait seems most disruptive to the status quo, so obsessive or compulsive behaviors get pathologized while the underlying monotropic depth is overlooked or misread.
And that isn’t just an academic problem. It’s real people being told their pain is “just anxiety,” real autistic kids being pushed toward eating disorder diagnoses and a life of guilt-riddled struggle to be “normal,” real lives bent around the failure of a system that only sees what looks disruptive and not what’s actually there.
And it’s why society at large gets stuck on classification itself. Once hierarchy feels natural, energy that should go into support and accommodation gets siphoned away into debating categories, into symptom ledgers, into the endless shuffle of naming instead of helping.
And that detour is costly: resources flow to studies that fail to distinguish between correlation and causation and diagnostic categorization arguments while actual basic accessibility in schools, workplaces, and healthcare is left undone. The human reality gets buried under the neatness of classification.
To be clear, if describing your autism and ADHD as counterweights, or seeing your neurodivergent traits in terms of sides that keep each other in check, helps you keep your life manageable, I’m not here to take that away. Even the clinical and connotationally problematic language of comorbidity can be grounding, comforting, stabilizing in the right moment, a way of narrating your inner world as parts that balance each other out.
That kind of framing can provide stability when everything feels chaotic. It can also give you language to explain yourself to others who might not otherwise understand. And sometimes even the humor of it—the way we meme our “sides” into characters—offers relief, validation, connection.
That usefulness is real. It’s why the language sticks.
But usefulness in a moment doesn’t make it the whole truth. And that’s the takeaway, really.
If you’ve got your harness on and it steadies you while you reach what you need to reach, keep using it. What I’m offering here is simply a little more context that I’ve found useful in my own life. Maybe you will too.
If and when you need it, there’s also a fire escape. There are handlebars and rails you can trust. Here’s how securely they’re attached. Here’s how high you are so you can see your own circumstance clearly.
And here’s a hand, if what you need is a little more support. ∞
Yeah, I agree with you across the board. I started using the word co-occurrence a while back. That seems to be the best option.