Neurodiversity

This blog talks about trauma and other sensitive topics. I use humor and, at times, dark humor. Consider this before reading.

You can also read this on my Substack:

https://substack.com/home/post/p-184579579

If this article doesn’t reflect your experience, that doesn’t mean you are broken and can’t find help. This is a summary of neurodivergence, and there isn’t enough time or space to cover everything. And I might have forgotten some important deets! Feel free to message me if there’s anything you think I have forgotten.

Here are my thoughts on neurodivergence, its diagnosis, treatment, and medication. I think for some medication is a huge game-changer, for others it hardly works, and everywhere in between. We are low on dopamine, and the structure of our brain can make it extraordinarily difficult to function in a neurotypical society. Finding the right medication for someone is a process, and one that is becoming increasingly specific through research. Finding the right psychiatrist that you can trust is a huge task in itself, and I know it can be filled with frustration and exhaustion.

If you have a sensitivity to medications, you might want to try gene testing, which your psychiatrist can help you with.

ADHD (inattentive, hyperactive, and combined type) manifests differently for each person. Rather than a disorder, you can view it as a range of traits (as with Autism) that vary in degree of intensity. The DSM (which can be helpful, but it has a ton of biases and incorrect information within it) diagnosis of ADHD research was only tested on boys/men, so other people who have ADHD 99% of the time get misdiagnosed or not diagnosed at all.

I can’t tell you how many clients I have had (usually women or female presenting or other marginalized groups) where their doctor or psychiatrist tells them that they can’t have ADHD due to how they have lived their life so far (they have been successful) or that they have bipolar or anxiety instead (ever heard of comorbidity?!). These folks have learned to overcompensate in order to survive since their problems are dismissed, and how their ADHD presents is overlooked. They are often not diagnosed until they have kids (usually a son is diagnosed with ADHD), and they realize they have it as well. Or they are in such a state of burnout and fatigue that it finally gets diagnosed.

Side note: comorbidity! ADHD/Autism is correlated with Eating Disorders (disordered eating), anxiety disorders, OCD, PMDD, Bipolar Disorder (1 and 2), Borderline Personality Disorder, and trauma.

• You are three times more likely to have OCD and an Eating Disorder (or disordered eating) if you have ADHD/Autism. I like to call it the trifecta (neurodivergence, Eating Disorders, and OCD). They each struggle with moralizing various variables, they each struggle with change/transitions, and they all come with intense feelings and hypersensitiveness.

• It is common to be treated for anxiety disorders like OCD and overcome an eating disorder, only for your ADHD and Autism traits to make themselves known. You don’t have the anxiety or dissociation to mask your neurodivergent traits anymore, so they become apparent.

• If you have AuDHD, you might have to deal with some paradoxes, such as “I like variety because it is stimulating, but change makes me panic.” “I need routine, but I find it boring.” “I need sleep, but fun things happen at night.” “I enjoy meeting new people (it’s fun), but going through the steps of meeting new people overwhelms me.” “I like experiencing life, but I am easily overstimulated.”

• I think in the future, a lot more people than currently are diagnosed will have AuDHD. They heavily overlap! “The force is strong with this one.”

• ADHD/Autism is correlated with a high degree of pain tolerance, migraines, and joint issues like hypermobility and Ehlers-Danlos Syndromes.

• Speaking of pain tolerance, there is a link between those with neurodiversity and finding relief/stemming through kink activities such as impact play. Kink can be an emotionally satisfying experience where another trusted individual takes control, and a neurodivergent person expresses themselves in a safe and grounding space.

  
  

There are quite a few psychiatrists who don’t understand ADHD enough to be diagnosing it, but are, and who believe ADHD is overdiagnosed (when it is still underdiagnosed), who believe people outgrow ADHD when a person reaches adulthood (our brains are actually structured differently, and that is not something you “outgrow”), or refuse to see it any differently than a defeciency. Not to mention how the current administration sees neurodivergence, which is amplifying this issue.

”I’m doing my part (therapist)!”, “I’m doing my part (self-care)!”, “I’m doing my part (friends)!”, I didn’t do sh*! (classic medical field treating anyone who isn’t male)!”*

I have heard other ADHD specialists talk about ADHD (and Autism) as a superpower rather than a deficiency, and that is exactly how I see it, too. The typical diatribe of “you need more discipline and determination” doesn’t work because just “trying harder” (Sound like society... “Everyone can succeed if only they try hard enough.” Ew, no.) leads to using neurotypical tactics for executive functioning and that creates doubt, low self-esteem, low self-worth, comparison trap, self-blame (spiraling), etc.. Working with your neurodivergence and how it manifests for you can be a helpful outlook.

Executive Functioning: Working Memory, Cognitive Flexibility (Flexible Thinking), Inhibitory Control (Self-Control), Task Initiation, Planning and Prioritizing, Organization, Time Management, Self-Monitoring (checking on your own work and behavior), and Emotional Regulation.

Having ADHD can lead to special interests that make us passionate about life. Once we find those special interests, we can become experts and typically go much further than neurotypicals (no shade) who focus on the same area. We think deeply and tend to ponder extensively about topics we find fascinating; we can’t stop talking about them, and we obsess over their research.

Hyperfixations are not your enemies! They show you are able to focus and create joy in life. If you find that these fixations are leading to the neglect of other life responsibilities, mindfulness or time blocking can help (talked about later in this article).

If you have several hobbies going on at once, there is nothing wrong with that (it’s stimulating to have various hobbies), and if money is an issue, there are groups of ADHD people who trade their hobbies so they don’t overspend. Facebook, Reddit, and Discord can be a place to start with finding these communities.

Impulse Control and Dopamine Seeking: There is nothing wrong with seeking dopamine; it helps to regulate our feelings and find joy. Where it can become an issue is with finances, and if it interferes with relationships and general functioning. RAIN meditation, tapping, journaling, and positive self-talk are helpful. If you are beating yourself up about your ADHD, that will lead to shame when you inevitably give in to your impulses. Seeing it as a natural way of being and building boundaries around your behaviors (it will be up and down, cyclical) can take time, but it can help.

• Using an accountability buddy or group (like on Discord) to manage your impulses can also be helpful.

• Sometimes, N.D. folks impulsively buy items meant to help with N.D. executive functioning skills, like organization, or ironiically, impulse buying. My suggestion would be to sit down and write down all the behaviors you have used over the years to support your N.D. ways of being. Do they help? Are you forcing yourself to use them? Are they truly helping, but you are denying it?

• In a book I read, the author Tracy Otsuka mentions that whenever you get the impulse to buy something, you add 5 or 10 bucks to your savings, which can trigger a dopamine hit. I have tried this, and it works! Waiting three days (I typically wait a month, but you can figure out how much time works for you) before you buy can help you think more clearly about whether buying that item is actually wanted

  
  

Hyperfixations, routines, and special interests are always there to pick back up if you stop doing them. It is hard to be consistent with these areas of life, and it is common to jump between areas of interest and coping skills.

Food: Food, naturally, increases our dopamine and serotonin levels. I have seen where some ADHD coaches and therapists recommend diets like intermittent fasting. I very much disagree with this advice. Diets, including intermittent fasting, don’t work 95% to 97% of the time. Using restriction with food in order to stop dopamine seeking only makes it more likely for bingeing, creating an atmosphere of shame and overwhelm. Your body needs food to survive (so comparing it to drugs and alcohol doesn’t work), therefore, you can’t be addicted to it, and labeling food as “bad” or “unhealthy” does not matter to the survival part of your brain; it will still make you hungry and crave certain foods. The survival part of your brain doesn’t know you are labeling food as good or bad; it just knows you are restricting (physical restriction = not having certain foods in your home, mental restriction = “I shouldn’t have this food or I will eat less for lunch or I burn this off when I workout tonight.”) and so it puts your into a famine state where your matabolism slows and eventually your hunger and craving increase. You can’t control or fix what your survival is trying to help you, and fr fr corporations want you to spend your money and time worrying about weight, food, or in this case, dopamine seeking. It benefits them for you to be distracted with dieting and lack the wherewithal to be concerned with bigger issues, such as politics (”Where is your rage?! “Where is your anger?!”)

• Instead, I suggest making snacks and meals easily accessible. Create or buy snacks that you can eat on the go. Make meals with only a few steps, and items like Instapots help with meal prepping. Frozen vegetables and fruits help reduce costs and improve storage. Nothing is wrong with processed foods; they do contain nutrients and are yummy, and we need food to be yummy, or what is called the satiation quotient. Don’t force yourself to eat food you don’t actually want; otherwise, you are more likely to binge. If you can’t afford the yummy foods, look for off-brands that are cheaper, or places like Aldi that are much less expensive.

• Eating when you are bored is not bad. Give yourself permission to eat whenever. If you start applying rules to when you should or shouldn’t eat, that is restriction, and it leads to shame and bingeing. If you are bored and have the urge to eat, I suggest you do so and let yourself enjoy it. Fuck the arbitrary rules! Life is absurd, and we are in meat suits on a rock in a universe that is somehow expanding, so let food be easy and enjoyable. If you are unsatisfied with life in general, which is creating boredom and more food consumption, seek out a therapist to process. Not to eat less, but to understand yourself, find meaning in life (in this meaningless void aka existentialism), your relationship with food, and emotional regulation skills.

• Food helps us emotionally regulate by producing those happy chemicals I mentioned, and that is a good thing because if it didn’t produce joy or comfort, we wouldn’t naturally be inclined to eat. What I would suggest is to build other emotional regulation skills alongside food. You’re not replacing eating with these skills; you are adding more to your mental health toolkits. Be aware of those sneaky restrictive thoughts, such as “I won’t use food to emotionally regulate as often.”

• This with neurodivergence struggle with object or/and emotional permanance. This happens with food in our fridge. If we can’t see it, we will forget that it is there.

• Stares into my fridge blankly “I guess I’ll starve!”

• For me, using lists on my phone doesn’t work; I need to write items down and categorize them by how the store is set up (in my case, Aldi), and I keep that list in my purse. I pick out recipes on Sunday (and I am slowly but surely writing those meals in a recipe book), and then I shop Monday morning or sometimes Monday evening because Sundays are overstimulating and Saturdays are for funsies (“Let’s hear it for the girls!”) I know some people order groceries or use a pickup option, and if that would work better for you, try it out. There are probably cost-efficient ways to do that; I haven’t researched it yet. Building a routine with cooking and shopping took time, and I had to stop trying to force myself to do it the “normal way.” I shop when it works for me, I cook what I want and how I want (mostly pasta with a variety of ingredients, easy steps, and in bulk for the week), and I lean into tactics that work for me, like handwritten lists. If you don’t like cooking, frozen and prepared food is going to be besties with you. Nothing is wrong or bad about eating frozen or prepared food; it is nutritious and satisfying.

• If you have chronic health issues like diabetes or stomach issues, my suggestion would be to seek out an intuitive eating dietitian and an intuitive eating therapist. Stress can make eating unpleasant and increase a person’s likelihood of having a self-fulfilling prophecy = stomach issues. Diabetes is not caused by being fat, and there is no such thing as “prediabetic”. Someone can have a predisposition to diabetes and then experience life in such a way that it triggers diabetes (nature vs. nurture). Dieting and yo-yo dieting stress the body out, and are correlated with triggering diabetes (high blood pressure, heart issues, sleep issues).

• If you believe differently and whatever diet you are on is working, then that is your journey, and there is no need to want to fight me on the facts I am giving. Maybe you are a part of the 3% to 5% of people for whom diets work. You have body autonomy, and if you want to restrict, then go ahead, no judgment here. These facts are from my years of training, research, and practice.

  
  

Emotional Permanence and Memory: Often, those with N.D. struggle with object and emotional permanence. We can get tunnel vision about what’s going on in our immediate surroundings and forget about other people or responsibilities. Accountability buddies and finding ways of reminding yourself of important dates that works for you are helpful. Also, if you can schedule phone chats or Discord chat on a repeating schedule that will help you not to forget and prevent task paralysis that can come with needing to schedule every week or whatever the frequency is. If you can’t do a continuous time time slot, then whenever you have an appointment or chat with a loved one, then scheduel the next one at the end of your appointment.

Demand Avoidance: When someone asks an N.D. person to do something, it triggers a feeling that our autonomy is being taken away, so our immediate response is “No!” fumes. So, if you can reframe it as something that will improve your life and attach it to positive emotions, you’ll have more motivation. Sit down with your significant other, partners, or roommates and go over everyone’s skill base. See where things can be divided up among yourselves. If you like being by yourself, have realistic expectations, and be aware of relationalizing your way out of necessary responsibilities, such as cleaning or doing homework for class.

Task initiation/Task paralysis: Task paralysis occurs due to the capital O: Overwhelm. I will link to a way to break down important tasks, whether they are boring or exciting, at the end of this blog post. I wish I had known about this while writing my dissertation because I was intensely burned out from just “pushing through”. Overwhelm comes from issues with time management, such as seeing the tasks as due all at once. “Time doesn’t exist, but it still dictates our lives.” Because of time blindness, we will often push off tasks, thinking we have more time than we actually do. Procrastination, at first, can trigger a dopamine rush due to the time crunch, but over time, dopamine levels decline and cortisol/stress rise (hello burnout).

I give tips for helping with this later, and the same with other descriptions of N.D.

Task Switching: Going between Creativity Chill Time and Productivity Tasks. We can struggle with going from relaxing or creative time to productivity tasks. We are much more likely to get stuck in-between our thoughts and feelings. Here is where our enjoyment of pondering can turn into a spiral of limiting beliefs and intense feelings.

Interceptive Awareness vs Alexithymia: How do I feel in my body? Physically and emotionally? I know that is a broad question and can overwhelm those who are disconnected from their bodies, which is called alexithymia. Often, those with neurodivergence feel disconnected from their bodies. This disconnection often starts in childhood, when parents tell their children they are being too much or not enough, or that they don’t feel the way they feel, or that their own feelings are more important than their child’s needs. Building back body wisdom takes time, and usually therapy is needed to make it happen due to issues such as trauma in the past (whether little t or big T trauma). Chronic dieting, yo-yo dieting, or eating disoders which are correlated with nuerodivergence also disconnect folks with their body wisdom and make it so that these individuals don’t trust themselves. If you can’t trust your body to tell you when you are hungry or what you are craving, how can you trust it to tell you how you feel? Trauma, chronic pain, chronic health issues, disordered anxiety, and other issues can affect interceptive awareness.

Big Feels: Often, those with neurodivergence have an intuition that they are not aware of due to how society and family have treated them. Intuition is a sixth sense; the ability to read a room or have a gut feeling about how someone else is feeling. What can happen is that when we try to communicate that to someone who is neurotypical or a dissociated neurodivergent person, or perhaps they have internalized neurodivergent biases, we are told that we are being weird, too much, or completely ignored, which can lead to self-doubt and ignoring what our intuition is telling us. If you are overwhelmed by this intuition, it can help to know that you are not automatically wrong but that you have insight that others don’t have, and that this can help you connect with others (hold onto that insight rather than impulsively telling someone what you know because you are bored and want to get to the interesting part of the conversation) but timing has to be right (again, overwhelm). We typically want to jump right into what we intuitively see, but if the other person isn’t aware of that, then we can be labeled as rude or blunt. Conversations need to warm up just like sex needs forplay and yes, small talk can be boring (unlike foreplay! ;)) but it is also necessary for relationships to grow. Be humble (Kendrick Lamar! IYKYK) and let the urge to express your insights pass before you act.

“It’s not about feeling better, it’s about getting better at feeling.”

• What can also help here is finding your chosen family, who will typically be others who are neurodivergent. Sometimes this is easy because we naturally gravitate towards each other. We are some weird, esoteric, eccentric, witty folks! This will help you feel accepted and connected with others and feel safe to express your intuition.

  
  

Hypersensitivity: this can occur due to auditory, emotional, tactile, and visual sensitivities. Earplugs like Loops, comfortable clothes, and transitional objects (toys, plushies, or whatever else) can help with hypersensitivity. Women or female-presenting folks’ hypersensitivity is more likely to include visual stimuli like blood and gore on TV. And they are more likely to have hypersensitivity manifest as ruminating on all the thoughts happening in their head (also OCD can be correlated here).

Justice Sensitivity: Hypersensitivity, Big Feels, and Interceptive Awareness are all connected to it. This is where N.D. folks tend to see life, situations, people, and experiences in a black-and-white, good-versus-bad construct. It can be extremely difficult to see nuance in sensitive situations, and N.D. people are more likely to cut others off for actions they judge as unforgivable, which can lead to a lack of friends if done often enough. There can be a sense of justification for retaliation when feeling wronged, and a need for punishment to make the other person pay for their actions or to make them understand.

• Justice Sensitivity can be a strength, helping others and driving social change. Lots of N.D. folks find their special interest within the Justice Sensitivity.

• If you are finding that your Justice Sensitivity is leading to difficult relationships and/or resentment and anger issues, then ponder this: morals are subjective and an individualized/collective experience. Morals are complex and have to do with a myriad of variables i.e. family history, childhood experiences, trauma, culture, socioeconomic status, social-emotional process, marginalized groups’ identities, etc. Survival will always take precedence over our ability to think, to have empathy/compassion, and to align with our morals and values. We are animals at our most basic, and that part of our brain has been around much longer than our ability to be thoughtful and morally just. Survival will almost always take over when we feel threatened (both imagined and real. Imagined being made up in your head, and real being “omg, a bear is trying to attack me”)

• Examples of Survival and Morality are given at the end of this article.

• For this reason, morals are a privilege, and imposing them on others can be seen as self-righteous, judgmental, and rigid. There is no way to know what you would do in another’s situation unless you were them and going through the same experience. Empathy is putting yourself in someone else’s shoes, rather than your own, and trying to understand their actions from their point of view. We have more in common with each other than we do differences, and we are all manifestations of the same emotional process. At the same time, empathy is not always possible; everyone has a threshold for how understanding and compassionate they can be.

• Our survival instincts can make us want to villainize others. “They are an asshole/terrible person/monster,” and that can make it easier to cope with a situation (end of relationship, trauma, politics).

• Moral rigidity appears in all sorts of contexts, such as Christianity, to cancel culture, and when we burned witches at the stake. “History is trapped in us, and we are trapped in history.”

• Examples of having and/both nuanced stances are given at the end of this article.

  
  

Rejection Dysphoria: As social animals, being accepted and belonging to a community/relationships are part of our survival. Being rejected or abandoned can be triggering for most people. Those with rejection dysphoria, the trigger from rejection is much more intense, comes with flight or fight, and ruminations on limiting beliefs such as “I am worthless,” “I am not good enough,” “I am too much,” “I am dumb,” “I’ll never fit in or be liked,” etc. The “stomach drop” or feeling of dread, “doom and gloom,” comes with rejection dyphoria, and, as mentioned, this can be a real threat (someone breaking up with you) or an imagined threat (your boss asking for a meeting or your parting seeming distant). Therapy that helps process childhood experiences and trauma, along with mindfulness and exposure tactics, helps with lessening impact of rejection on our mental health.

Tips:

Boring Tasks: Make them more interesting. I am stimulus-seeking, so I will have music or a podcast playing while I do chores, paperwork/taxes/finances/mandatory CEUs, etc.

Body Doubling: Before I even knew this term existed or that I indeed had ADHD, I did it naturally by going to my college library or a coffee shop. It was stimulating, and the other people working motivated me. I rarely worked at home because I was so easily distracted. If you have a task buddy or can create a stimulating environment, do it! Having a group or friend you can message when you need to regulate impulses or get reminders to drink water/eat food/stretch/self-compassion.

Time Blocking: There are actual physical time blocks you can use for structuring time. They range from 5 mins to an hour. They are small and aesthetically pleasing. I set mine for 15 minutes, and it helps initiate tasks. I can do anything for 15 minutes, and once the time is up, I start again. Time passes, and without even realizing it, I have worked for an hour. This also works for me because it is not in my phone, so I am much less likely to get distracted.

Track Time Backwards: Write down when something is due or when an event is, then track what all needs to be done beforehand and how much time each task will take. If you have a party to go to a week from now, maybe you need to get a gift, pick out your clothes, shower, do your makeup, check traffic, get gas, pack your bags, etc. How much time does each of these tasks take? If you don’t know, time them. Can you make a game out of these tasks, such as beating the time it usually takes (like the time crunch procrastination, but without the stress)? Make the tasks enjoyable or stimulating? Remind yourself of why it is important to do these tasks. Connect them with your values.

Internal Values: With any given tasks, rather than shaming yourself, use positive emotions and values to motivate yourself. For example, I remind myself that I work better in a clean area (not in a perfectionistic way) and that the relief I will feel later, once it is done, helps too. I value taking care of my items, my environment, my health, and my relationships. Intuitive Movement: “I want to be strong” rather than “I want to lose weight.”

Between Tasks: As mentioned before, we are more likely to get stuck in between, when moving from creative chill time to productive tasks, ruminating and spiraling (limiting beliefs, doubt, and big feels/anxiety). What helps is a small activity (not your phone!) such as stretching, drinking some cold water, dancing to a song, or going outside to take a deep breath. These activities help jolt our brains out of ruminating and focus on the task we need to get done.

Starting Small: With ADHD, we can often jump into the deep end with a task or interest. I did this a ton with psychology, where I thought I would specialize in one area only to get overwhelmed and burnt out by it. I realized later that I need variety (a handful of special interests) in order to stay interested and stimulated. I also know that I can feel motivated for something and pile on the tasks rather than starting small, such as “I am going to work out 5 times a week or deep clean 4 times a month.” Those are too high expectations, and starting small helps with motivation (along with internal motivations). “I am going to work out once a week because I want to more stamina (rather than lose weight).”

Look Up Examples: Look up how others have done it. The only way I was able to declutter my space when I lived alone was through Marie Kondo. I needed someone to break it down for me in easy manigable steps. Bit-sized progress. If that overwhelms you when you see a bunch of steps laid out, again, use mindfulness to breathe through it and focus on the first step. I am a kinesthetic learner, meaning I learn through hands-on tasks such as discussion, talking out loud to myself, and writing notes. Auditory learning does nothing for me, in one ear and out the other, so I don’t force myself to learn that way. Handwriting is better for my learning than typing, because it slows my brain down, but it’s not always doable.

Routine Struggles: They are sometimes hard to come by with N.D., and here is another area where you can start small. Make things accessible, like water and pills on your nightstand. A favorite water bottle. A fun pill organizer. Put on a song or podcast to do tasks like showering. Knowing when you will have the energy or at least some to brush your teeth and shower.

Acceptance and Self-Compassion: Acceptance of having ADHD and its traits is a necessary part of working with your ADHD rather than against it. I am much better at cleaning than I used to be, but I know I will always have a bit of clutter. I won’t always keep up with my routines, and at times, I am clumsy and don’t have spatial awareness, I have chronic health issues, and sometimes it is progress just getting out of bed. That’s okay! Therapy will always be a part of my life. That I don’t function well in hustle culture, where there is a constant need for self-improvement and “fixing” oneself. Life is a cyclical journey of self-discovery, and mistakes are a necessary part of it. “Nature doesn’t rush, yet it gets things done.” Often, clients tell me that “self-compassion” feels like letting themselves off the hook because they have been beating themselves up for so long, often because of internalized authority figures like parents or teachers. You can start with neutral statements rather than loving ones, and there are tons of meditations to help with this process. Self-compassion isn’t about letting go of accountability; it’s the opposite. It helps to let go of perfectionism and self-doubt.

Mind-Body Awareness: Lie down or get into whatever comfortable position you desire. There are many body-scanning meditations, and I suggest starting with a 5 to 10-minute guided meditation.

https://neurodivergentinsights.com/bundles/emotional-awareness-bundle/

It can be helpful to look up how others describe certain feelings and how it feels in their body.

Here is a helpful pain scale that isn’t just emojis: https://www.painscale.com/article/mankoski-pain-scale

Mindfulness:

RAIN meditation: https://www.tarabrach.com/rain/

Check out my blog for more information and other blog posts

https://drdevondunn.substack.com/p/neurodiversity