Why Polyvagal Theory Makes So Much Sense for ADHD, Autism, and AuDHD

By Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS | Clinical Director of Myndset Therapeutics

If you’ve ever felt like your nervous system was living its own life—stuck in hyperdrive, frozen in shutdown, or constantly scanning for danger—you’re not alone. For adults like me who are both Autistic and have ADHD (AuDHD), life often feels like a chronic negotiation between energy and overwhelm. That’s exactly why Polyvagal Theory doesn’t just make sense—it feels like the missing puzzle piece. It gives language and structure to something many neurodivergent folks have always intuitively known: our nervous systems operate differently, and that difference matters.

Let’s break down how and why.

What Is Polyvagal Theory?

Polyvagal Theory (PVT), developed by Dr. Stephen Porges, reframes our understanding of the autonomic nervous system. Instead of seeing it as a binary system—either fight-or-flight or rest-and-digest—PVT offers a hierarchy of three neural states:

1. Ventral Vagal (Safe & Social): Where we feel regulated, open, and connected.

2. Sympathetic (Mobilized): Fight-or-flight energy. Hypervigilant. Fast-paced.

3. Dorsal Vagal (Shutdown): Collapse, numbness, dissociation, freeze.

What’s groundbreaking about PVT is how it centers safety—specifically, neuroception, or the subconscious detection of safety or threat—as the driver of these states (Porges, 2007). For neurodivergent individuals, this neuroception is often biased toward detecting threat even in neutral environments.

ADHD Through a Polyvagal Lens

ADHD is not just about dopamine or executive dysfunction. It’s also deeply tied to dysregulation of the nervous system. People with ADHD often swing between hypoarousal (brain fog, fatigue, boredom) and hyperarousal (impulsivity, restlessness, anxiety). Polyvagal Theory helps us understand this fluctuation as a dance between sympathetic overdrive and dorsal shutdown, often skipping over the ventral “safe and social” zone (Arnsten et al., 2015).

That’s why tasks that are “boring” can feel threatening to someone with ADHD. Boredom doesn’t just mean disinterest—it triggers a stress response because our nervous system doesn’t know how to find safety in stillness. We need stimulation to avoid slipping into dorsal collapse. That’s not bad behavior—it’s a survival mechanism.

Autism and Chronic Nervous System Activation

Autistic individuals often describe feeling like they are “always on,” constantly monitoring their environment, facial expressions, tone of voice, and their own behaviors. That vigilance? It’s classic sympathetic overactivation. And when it becomes too much, we shut down—dorsal vagal style. That’s what many of us refer to as Autistic burnout (Raymaker et al., 2020).

Polyvagal Theory explains why this happens. For many Autistic individuals, the world doesn’t feel predictably safe. Bright lights, loud sounds, social demands—these all register as cues of potential danger, not because we’re broken, but because our neuroception is more finely tuned. We are wired for pattern detection and detail, which means we can also be wired for persistent stress. The nervous system becomes overburdened trying to regulate constant threat input.

AuDHD: The Polyvagal Balancing Act

Now imagine living with both ADHD and Autism. That’s me. That’s many of my patients. That’s AuDHD.

We don’t just bounce between sympathetic and dorsal—sometimes we live there. The world is either too much or not enough. Our nervous system is either burning rubber or stalling in place. Polyvagal Theory helps us see that these are not moral failings or personality traits. They are survival strategies of a nervous system that rarely gets to hang out in Ventral Vagal safety.

This is why things like transitions, task initiation, emotional regulation, and interpersonal connection can feel exhausting. It’s not that we don’t want to do them—it’s that our body doesn’t feel safe enough to try. We need more than behavior strategies. We need co-regulation, body-based interventions, and environments that honor our wiring.

Why Polyvagal Theory Works for Neurodivergent Care

I integrate Polyvagal Theory into my work because it gives people a map back to themselves. It validates why traditional “top-down” strategies (like executive functioning coaching or CBT alone) often fall flat. You can’t think your way out of a dysregulated nervous system. You have to feel your way back into regulation—and that begins with safety.

Here’s what that looks like in practice:

• Co-regulation before self-regulation: Neurodivergent folks often thrive when someone else helps “anchor” them first.

• Sensory diets grounded in neuroception: We build strategies based on what helps someone’s nervous system feel safe, not just what’s stimulating or calming.

• Tracking nervous system states: Using tools like my Nervous System Tracker helps clients build awareness of their physiological state and shift it consciously over time.

• Bottom-up therapy modalities: Incorporating breathwork, somatics, and sensory grounding before asking clients to intellectualize their feelings.

Final Thoughts

Polyvagal Theory doesn’t pathologize neurodivergence. It invites us to understand it. It shows us that our reactions aren’t random or “too much”—they’re responses to a nervous system that is often overwhelmed by a world not built for us. When we bring this lens into therapy, parenting, education, or just self-understanding, we stop trying to “fix” ADHD or Autism. Instead, we start listening to the language of the body—and honoring its wisdom.

If you’ve ever felt like no one understood why you get so overwhelmed or shut down without warning—welcome. You’re not broken. Your nervous system has just been trying to protect you. And that’s where the healing starts.

References

• Arnsten, A. F. T., Rubia, K. (2012). Neurobiological circuits regulating attention, cognitive control, motivation, and emotion: Disruptions in neurodevelopmental psychiatric disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 51(4), 356–367. https://doi.org/10.1016/j.jaac.2012.01.008

• Porges, S. W. (2007). The Polyvagal Perspective. Biological Psychology, 74(2), 116–143. https://doi.org/10.1016/j.biopsycho.2006.06.009

• Raymaker, D. M., Teo, A. R., Steckler, N. A., et al. (2020). “Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout. Autism in Adulthood, 2(2), 132–143. https://doi.org/10.1089/aut.2019.0079

• Dana, D. (2018). The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. W. W. Norton & Company.

• Williamson, V. J., & Creswell, C. (2021). Understanding and supporting co-occurring ADHD and autism: A qualitative study of parent and clinician experiences. Research in Developmental Disabilities, 114, 103976. https://doi.org/10.1016/j.ridd.2021.103976