In this short video, I explain why an AuDHD crisis often combines collapse with a sudden urge to change everything, and how we steady both by video.
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Acute online AuDHD psychotherapy helps adults who are autistic and ADHD, or suspect they are, when life has just tipped into crisis: a crash after weeks of hyperfocus, overload so heavy you cannot function, or an impulsive decision you are now afraid of. Sessions take place by video and in English, each a 1-hour appointment with 50 minutes of therapy, and can usually start within days.
I help you take pressure off your system, hold big decisions for a while and agree a short, workable plan. This is the acute branch of online AuDHD psychotherapy, within online neurodiverse psychotherapy and my wider online psychotherapy. Related acute help exists for ADHD and autism on their own.
You can book a free 30-minute call, grab the first open session, read my client policy or send a short message if a call feels like too much.
Acute online AuDHD psychotherapy is for English-speaking adults, wherever they live, whose autistic and ADHD sides have both been pushed past their limit at once. You need help this week to calm the storm, avoid choices made in panic and find your footing again.
Acute AuDHD sessions are meant for the first days and weeks after things give way. Should a line below fit you more closely, its page is the place to go.
You can also send me an email
These reviews describe clients’ experiences of working with me. They come from my wider practice and do not all relate to online sessions. Each person’s experience is their own, and a review does not promise a particular outcome.
“Across the 9 countries I have lived and worked in, I learned what a sudden change of setting does to a nervous system, and I see an extreme version of it in AuDHD crises. One side of you wants everything to stop. The other wants to change everything tonight. Under that I hear ‘Will you give up on me as well?’ and a cooler voice: ‘I need to get away from all of this, by myself.’ My firm view is that the impulsive exit is the real danger in these weeks, more than the collapse. So my first rule is simple. Nothing irreversible happens until your system has had time to settle.”
Mark Colclough, MA, psychotherapist and EFT couples therapist
I am Mark Colclough, MA. I have practised since 2004 and offer online psychotherapy and couples therapy in English.
My training brings together your emotions, your thoughts and your relationships. My deep passion is the moment when what happens between you finally makes sense, to each of you and to each other. I have lived and worked in nine countries, so I know something of life across languages, cultures and borders.
Read about my background, or explore online psychotherapy and online couples therapy.
I meet regularly with experienced psychotherapists to reflect on my work, question my understanding and develop my skills. Supervision is part of the professional care I bring to individual and couples work, including online sessions.
My focus is thoughtful practice, integrity and responsibility.
You are welcome to ask about the kind of support you need.
Tell me where you are based and your time zone. We can then consider whether online sessions together are suitable.
Wei is 33, grew up in Kuala Lumpur and works as a game designer in Stockholm. For 6 weeks he worked late every night to finish a release, absorbed and almost happy. He crashed 2 days after it shipped. Light hurts, voices grate, and he cannot shower without planning it. At 3 one morning he booked a one-way flight home for next week and drafted his resignation. His girlfriend found out over breakfast and cried.
I would start by agreeing with Wei that the flight and the letter wait until we have met at least twice more, and that his only tasks this week are rest and food. In a first video session he would probably see that the urge to leave is the crash speaking, not a considered decision.
I have presented this clinical example as a compound of 22 years of clinical practice.
Your usual way of recovering has stopped working, and part of you is ready to tear everything up.
There is no threshold you must cross before asking for prompt help. A sense that you are running on empty while your mind demands drastic action is reason enough. You do not need a dual diagnosis, a coherent account or a calm head. In 22 years of practice I have met many people in the days after an AuDHD crash, and I know how quickly that state can lead to decisions that are hard to undo.
I usually start by protecting you from those decisions and lowering the load, then we look at what built the crisis. Use the 6 questions below to check whether this describes your week.
If so, the crash makes sense, even though it feels like it came from nowhere. For weeks you may have slept little, eaten at odd hours and ignored every signal from your body because the work was absorbing. Now there is nothing left, and even small tasks seem enormous.
I would look at how long the sprint lasted, what it cost and what is still being asked of you now. That helps us see how deep the depletion goes and what to lift first. If this is you, book a session with me and we can start with what must happen this week.
Both are happening at once, and both make sense. Your ADHD side looks for relief in action, novelty and escape. Your autistic side is overloaded and wants stillness, darkness and sameness. The result can be a strange paralysis full of urgent plans.
I do not treat either pull as wrong. The urge to escape is trying to end the pain, and the freeze is trying to protect you from more input. I help you hear both and choose a few small, safe steps that answer each of them a little.
In an overload you may have said something sharp, cancelled at the last minute or disappeared. Now you are checking whether they have replied, rereading the last message and imagining the worst. The fear of having ruined things can be as loud as the overload itself.
Your need to know where you stand is entirely reasonable. I help you calm the alarm that expects rejection, look at what you actually know, and find a short, honest way to repair contact when you are ready.
Yes, this is very common in crisis. You want someone near you, because the loneliness is frightening. Then their questions or their touch feel unbearable, and you need them gone immediately. They may feel rejected, and you may feel guilty and misunderstood.
In our sessions I help you put words to this pattern so it is less confusing for everyone. We create simple signals for company without conversation, or space without explanation. I have compassion for both needs, and I will help you protect the people close to you from the sharpest edges.
When everything is too much, withdrawal can feel like the only option. Your phone stays face down, curtains stay shut, and you answer nobody. The silence brings relief, but each day it lasts makes reconnecting harder.
My view is that withdrawal in this state is protective, and I will not shame it. I help you understand what it shields you from and find the smallest contact that keeps the important people informed, often a single message written together in session.
After a crash, you may doubt everything: the person who worked so brilliantly last month, the person who booked the flight, the person who cannot get up now. It can feel as if none of them is really you. That confusion comes from extreme strain, not from a broken identity.
When the pressure lifts, I help you look at what each of these states was telling you and what genuinely needs to change in your life. I will challenge sweeping conclusions drawn in crisis, and I will not impose a new direction. Clarity returns once your system has room to think.
If this is where you are, request a call, book the first open session or write to me, and I will be clear about how soon we can meet.
You can also send me an email
Tell me briefly what kind of support you are looking for.
Include your country and time zone so we can discuss whether online work together is possible and find a suitable time.
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In an AuDHD crisis the order matters: protect yourself from rash choices, lower the load, then understand.
Acute work with me will help you get through the next days safely, see how the crisis built up and make changes that make a repeat less likely. Understanding the crash is useful, but right now you also need relief and a plan.
In 22 years of practice I have learned that crisis work needs a therapist who is willing to lead when you cannot. I will set a structure, say clearly what I think matters and challenge drastic plans. The 6 questions below describe what we work towards.
Related reading: Why does ADHD keep pulling us into the same fight?.
I help you separate the visible event from what fed it. The crash, the outburst or the sudden decision may look like the problem, yet underneath there are usually weeks of overstimulation, lost routine, too little sleep and needs that went unmet.
I give you my professional view of what to address first and challenge the belief that you simply cannot cope with life. When you can manage it, book a session with me and we start with the most pressing thing.
By learning the early signs of the rush. Often there is a pattern: a sudden thought that everything must change, a surge of energy, then rapid action such as booking, sending or quitting. Seeing the first step gives you a chance to pause.
I help you agree simple rules for the crisis weeks, such as waiting 2 nights before any big purchase or message. Noticing the pattern is only the start. We practise the pause until you can use it without me.
Settling does not mean forcing yourself to be calm. It means finding the conditions in which both sides of you can rest. That might be low light with a familiar series playing, or a slow walk on a quiet street.
I help you notice what keeps you wired and what helps you come down, and we build a short daily routine for the crisis weeks. I will ask you to follow it between sessions, even when it feels too simple to matter.
Before you can say anything clearly, you need to know what you are asking of whom. In crisis, you may write a long, emotional message, apologise for everything or say nothing for days. None of these gets you the support you need.
Together we find brief, honest messages for the people who matter: what happened, what you need and what you cannot do this week. I challenge self-blame and the expectation that others will understand without being told.
Decisions become clearer once panic, exhaustion and the craving for relief are separated from what you actually value. In an AuDHD crisis, leaving a job, a city or a partner can feel like the obvious answer at 3 in the morning.
I help you sort what must be decided now from what can wait a few weeks. You will hear my honest view, and I will say so when a choice looks driven by the crash, but the decision is yours.
Change has to go further than surviving this month. You may need limits on hyperfocus sprints, more predictable recovery time, different work arrangements or clearer agreements at home.
I help you decide what to change so the cycle is less likely to repeat. Some people continue with online AuDHD psychotherapy, some pause and some stop. I help you choose deliberately rather than by default.
You can also send me an email
Arriving confused is fine. Making sense of it is my job as much as yours.
When you begin, I ask what has happened, check you are safe and help you agree what will and will not happen in the next few days. I also tell you honestly whether acute sessions fit your situation.
Once the crisis has passed, many people continue within my online psychotherapy, which is structured individual work at a steadier rhythm. If the crisis is mainly between you and a partner who wants to join, online couples therapy offers long-term relational development and healing. When you expect several sessions close together, a therapy bundle saves money and spares you repeated booking.
In the first session I ask what has happened, what you are tempted to do, what is still being demanded of you and what helps even a little. I keep things simple and give you room to answer in your own way.
Towards the end I share how I see the situation and propose a plan for the coming days, and you decide whether it feels workable. A free 30-minute call is available if you would like to test the fit before booking.
Individual work is right when the crisis sits mainly in your own life: your energy, your work, your choices or your sense of self. We can think about the people involved without them joining the call.
While things are fragile I offer direction, continuity and challenge. When the worst has passed, online psychotherapy describes the structured individual work that can follow.
Couples therapy helps more when the crisis lives mainly in the relationship: your partner is frightened by your sudden plans, you feel smothered by their worry, and trust has been shaken. When both of you are willing, joint work usually goes further.
In couples sessions I help you both understand the cycle and agree how to handle future crises together. Online couples therapy is long-term relational development and healing, and online neurodiverse couples therapy is designed for relationships where autism, ADHD or both play a part.
In the first week or two we usually meet more often than in ongoing therapy, so that impulses and overload do not run away between sessions. If you are very depleted, we keep sessions shorter in content and allow more rest between them.
I recommend a rhythm based on your energy and on how the first session goes. As things settle, we space sessions out, and I will say honestly when that is safe.
A bundle makes sense when you already expect several sessions over the next weeks. It takes away the repeated question of whether to book again, which helps when decisions feel either impossible or dangerously easy.
A bundle lowers the price per session and gives you a fixed structure for the crisis weeks. I will tell you whether I think it fits. The sizes are explained on therapy discounts and bundles, and the cards follow below.
The acute phase is over when you are sleeping and eating more regularly, the urge to make drastic changes has faded and you can think about next month with some calm. You will also understand better how the crash built up.
I review this openly at each session. You may stop, move to regular sessions or come back if a new crisis arrives. Returning later does not mean the first work failed.
Not sure acute sessions are the right step? Here is how they compare with the closest alternatives.
| Option | Choose it when | Pace |
|---|---|---|
| Acute online AuDHD psychotherapy (this page) | Overload and impulse have hit together, and you need help this week. | Video sessions within days, close together |
| Online AuDHD psychotherapy | There is no crisis, but your two sides keep pulling against each other. | Weekly 1-hour video sessions |
| Acute online autism psychotherapy | You are in burnout or shutdown, without the impulsive side. | Short, frequent video sessions at first |
| Acute online neurodiverse psychotherapy | You are neurodivergent and in crisis, without one clear label. | Video sessions soon, then spaced out |
Acute online AuDHD psychotherapy with me is short-term, structured individual psychotherapy by video, in English, for adults who are autistic and ADHD and are in crisis now. It focuses first on lowering the load and holding back irreversible decisions, then on understanding what happened.
I work at a pace your system can manage, with the whole person in view. If there is no immediate crisis, online AuDHD psychotherapy is the broader place to start.
You need acute help when daily life has stopped working, when you are making or considering big decisions in a hurry, or when rest no longer brings you back. If you are wondering, take it seriously.
I look at how quickly things have changed, what you are tempted to do and what support you have. If the crisis is not easing on its own, prompt help is sensible.
I can help you think it through calmly, work out what can still be reversed and decide what you actually want. I cannot undo it for you, and some choices may already have consequences.
In my clinical experience, decisions made at the bottom of an AuDHD crash often look very different a week later. I would focus with you on pausing anything that can be paused, and on understanding what the decision was trying to solve.
Yes. Many people only recognise the second side of themselves during a crisis. Labels are not a condition for working with me.
I do not assess or diagnose. I work with what you are going through. If a formal assessment would help later, I will tell you, and you can arrange it with a qualified assessor in your own country.
Both are attempts to end unbearable pressure. Acting fast gives a burst of relief. Shutting down protects you from more input. In AuDHD crisis you may move between them several times a day.
I help you notice which one is taking over and what it costs. Then we build a middle route: small, reversible steps, and rest that does not cut you off from everyone.
That is expected. I will ask short questions, help you put events in order and pick out what matters most. You will leave with a simple plan for the next few days.
Nothing needs preparing. A few notes sent beforehand can help if writing is easier. Take the earliest available session, or begin with a free 30-minute call.
Most AuDHD crises ease within a handful of sessions spread over 2 to 4 weeks. If the crisis grew out of long-term burnout, the work often continues at a steadier pace afterwards.
In 22 years of practice I have found that close support early on, reviewed after every session, works much better than waiting to see. We agree together when to step back.
For many AuDHD people it does. You can stay somewhere familiar, adjust light and sound, move around and avoid travel when you are depleted. You can look away from the screen as often as you need.
Practically, you need privacy, headphones, a device with a camera and a steady connection. Times appear in your local time zone. These sessions are not an emergency service, so if you are in immediate danger, contact the emergency services where you live. Anything else you can ask by message.
Acute sessions use the same format as my other individual work: 1-hour online psychotherapy sessions with 50 minutes of therapy. My prices page shows what one session costs today, in US dollars.
Because crisis work often means several sessions in a few weeks, a therapy bundle can help: it saves 10 per cent and gives you a set plan. The options are on therapy discounts and bundles.
Book the first session that is open, or request a free 30-minute call if you want to talk first. Every time appears in your own time zone.
If nothing is soon enough, or speaking feels impossible, write to me with a few lines about what has happened. Because I keep some space free for acute work, a time within days is usually possible. Write that message before you make any other decision.
You can also send me an email
I want therapy to help you understand your experience and make choices you can use in everyday life. We pay attention to feelings, needs and the responses that happen before you have time to think.
Our online room should offer enough trust and honesty to explore what is difficult. I bring attention and professional judgement. You bring your experience, questions and the right to say when something does not fit.
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P.S. I’ll call you in a bit!
