Where Neurodiversity Meets Mental Health
posted 10th October 2022
Let me start with my own little (probably neurodivergent) bugbear here; the term 'Mental Health' is used really incorrectly. Everyone has Mental Health like we all have Physical Health. Some people have much better / stronger / more desirable / healthier Physical Health than that of others and this is also true of Mental Health. So, when people are talking about Mental Health, they are generally referring to Mental Health issues or difficulties.
Semantics matter, even if you don't want me at your dinner party now!
Neurodiversity often gets lumped in with Mental Health issues, but I don't think they actually belong together, though they often make unhappy bedfellows. The simplest explanation that works for me is:
Neurodiversity is an alternative way the mind operates to the neurotypical mind and Mental Health issues are ways in which healthy development or thought processes have been skewed or compromised.
I am not a psychiatrist (apparently no matter how many times I watch Fraiser) but I believe these Mental Health issues are usually caused by trauma or hormonal / chemical issues. I am sure there are other reasons to, but I would guess these are the most common causes.
The distinction between Mental Health issues and neurodiversity is important because we are now starting from the supposition that neurodiversity is not a faulty neurotypical brain but just an alternative operating system that given the right environment can thrive.
Similarly, we can also assume that Mental Health issues are going to cause us difficulties with or without the best environment. (Of course, let's be very clear that the environment can absolutely make life much harder or indeed easier for those struggling with Mental Health issues.)
Another distinction that is important is that the individual's personality cannot be untangled from the neurodiversity while they can be from their Mental Health issue. One of the distinctions I make for my clients when they want to understand if a particular behaviour comes from their trauma or their ND, I will share that trauma can be healed but ND cannot. Of course, everything is nuanced.
This is why you may hear people say they are autistic while they have anxiety, for instance.
What can get complicated is how many conditions can present so similarly and can also be present together. We know that there is a higher rate of Mental Health issues within the ND community than the neurotypical community, and particularly present within those who are Autistic, ADHD, and Dyslexic. Can you live within this hectic productivity obsessed world as a ND individual and not be traumatised to some degree?
Mental Health issues range from the mild to debilitating; the common to the rare. We find these individual, nuanced experiences within ND also.
Some of the Mental Health issues that can be confused for ND include Bipolar; Personality Disorders; OCD; Anxiety; and Depression. All of these Mental Health issues have similarities to elements of ND, and they can also all be co-occurring conditions present within a ND individual. Are we surprised by this? Can you be ND in this society and not be anxious? I'm not convinced you can.
I've heard before that untreated ADHD can develop into serious Mental Health issues such as Bipolar. I haven't seen the research regarding this, but I wouldn't be surprised if there is evidence to support it. I would argue that it an alarmist, ableist, and over-medicalised position. I'm interested in what 'untreated' means because many ADHD individuals live successfully without medication, without even a formal diagnosis. Does 'treating' ADHD mean creating a stabilising and regulated environment for people to be free enough to stim as needed, to focus on their interests, to overtalk and not talk at all when they choose?
If this idea of consequences of untreated ADHD developing into a Mental Health concern worries you (and I think it might because I often have ADHDers, particularly women, ask me if they actually have a personality disorder rather than ADHD) please know that the very best way to protect yourself from this, in my opinion, is to know yourself deeply and to get to know your needs and work towards creating a life that supports you rather than squeezing yourself into this super restrictive neurotypical world.
Please remember that those conducting research may not be as informed in the nuanced experience of ND individuals and their circumstances. I would also be interested in the whether those studied were filtered out due to trauma experiences as this would naturally skew the findings.
It's also very true that ADHD can be misdiagnosed as a Mental Health condition such as Bipolar when actually the medical professional hasn't spotted the dysregulated behaviour is due to a neurological difference in that person. It is extremely common for girls with ADHD to be misdiagnosed as having anxiety and / or depression in adolescence because the hormonal changes impact the underlying neurodivergence significantly. The anxiety and / or depression can be treated but not resolved or fully understood because the neurodivergence is entirely missed or ignored. The individual can then understand themselves through this Mental Health issue rather seeing the much larger picture of how their different brain wiring means they different needs.
I am really advocating for therapists to only with neurodiversity if they are very well informed and ideally also ND. This is because it takes a really well-informed eye to see between these co-occurring issues and identify what may help and what may be ableist and encourage masking behaviours that do more damage in the long run.
I don't offer this suggestion lightly as I don't believe therapists can only work with things they have experienced, but ND means that our brains literally operate differently. The mental gymnastics that it takes to function in the world is not something you need to be spending spoons on in the therapy room as a client. I want for you to have this skilled professional that can jump into your experience more quickly than a NT therapist who doesn't know what it feels like internally. Who may view your normal and health behaviour as avoidant or erratic. Who would pathologize your healthy presentation due to viewing it through a neurotypical lens.
The truth is I can't tell you within a piece of writing that X definitely means you are a ND or that Y means you absolutely have a Mental Health condition. It is a nuanced human experience that needs exploring with a skilled and trained professional that can help you to understand yourself.
I do ultimately believe that whatever the cause or reason for anyone's difference if you find something that helps you manage your life in a healthy way and it isn't hurting anyone, that has to be a good thing, right?
I also believe that self-diagnosis is 100% valid. The medical model is a minefield for our neurodivergent brains to navigate and I believe that having existed within it for the majority of my career! If you read and explore more out neurodiversity and it rings true for you, I believe you. If you find strategies that help you live your life, fantastic.
If you think there are Mental Health issues also present, or perhaps after exploring ND you think it may only be MH issues, I would encourage you to talk to someone professional and informed.
Know that you are no less worthy because of your brain wiring, your trauma story, or hormones.
You are a complete wonderful nuanced special human and the world is all the better for you being in it.
