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By Esme G, AXA Health Insurance
Note: I, as a CIS woman, can only speak from my own experience but I want to highlight that some of the references made in this article refer to “women” due to this gender group being impacted at a higher rate than men are overall. This doesn’t mean that some men or other genders don’t have the same or similar experiences.
I also want to mention that when I speak about women, this is inclusive to transmen/ transwomen, non-binary people, and anyone who may have similar mindsets, biology or experiences meaning the content is relatable.
This is a common sentence we hear when describing our neurodivergent traits to others, either post diagnosis or while we are contemplating our assessment. The answer to this statement is that yes, you will experience these traits too. There are two main reasons (I am sure there are many more, but I am going to address the main ones here):
Reason one:
Traits associated with ADHD, Autism, Dyspraxia, and all other ND conditions are normal for EVERYONE to experience. Sensory issues, stimming, literal thinking, forgetfulness, overwhelm and many other traits, are not exclusively experienced by neurodivergent people.
The difference is the frequency, and how they affect the individual. You may be neurotypical and walk into a room one day and forget why you’re there, you may feel discomfort at hearing someone scratch a blackboard or find strobe lights annoying. What you need to question here is, do these things cause you physical distress and impact your life daily? If so, maybe you have a condition that presents in a similar way.
There are many conditions and situations that will bring out similar traits, these symptoms can be a sign of something else:
Anxiety and depression can cause issues with focus, restlessness, sleep issues and trouble regulating emotions.
Dyslexia can be mistaken for Autism due to the reaction to change (this is more to do with the sheer amount of planning someone with dyslexia has to do in advance rather than not liking the unfamiliar)
CPTSD has such similar symptoms to ADHD and ASD that it can be easily misdiagnosed, especially later in life (this doesn’t mean you can’t have both CPTSD and a ND condition)
BPD, like CPTSD, has symptoms that are so similar, it’s commonly (more so than CPTSD from my understanding) misdiagnosed, especially in women seeking a later diagnosis.
Being a parent, carer or anything that makes you mentally tired and/or overwhelmed will cause similar symptoms. You may be forgetful or feel so overwhelmed that you can’t focus.
Many chronic conditions like hypothyroidism, diabetes, depression, menopause /perimenopause and many autoimmune conditions, can cause brain fog and forgetfulness. “fun fact”, coeliac disease (an autoimmune condition) is so common with ADHD that there is argument for it to be considered a symptom, which might be why some of the symptoms are so similar:
Association of Attention-Deficit/Hyperactivity Disorder and Celiac Disease: A Brief Report - PMC (nih.gov)
I have several chronic and autoimmune conditions, and as someone who needs ALL the information, I hyper focused on each of my conditions so I know A LOT about them. This isn’t something everyone does apparently, so it’s possible that you may have one of the above conditions and not know everything about it. As an example, hypothyroidism can cause slurred speech, something I get from my ADHD as well, due to my mouth not working as fast as my brain. I knew this was related to hypothyroidism, assumed that whenever my speech was slurred, my thyroid was to blame and never considered ADHD until about a year ago.
This lack of understanding is not helped when you go to your GP to discuss a new symptom, and their immediate response is to blame it on your already diagnosed condition, rather than consider investigating further.
So maybe you can relate, maybe you have a medical condition that presents similarly, maybe you are chronically anxious. Or maybe you THINK you can relate but instead, you are underestimating the level of impact those traits have on someone neurodivergent who experiences them all day, every day, and not just on the odd occasion. So, maybe you actually don’t really relate at all?
It is important to think carefully when you say things like “I do that too, it doesn’t mean you are ND” to someone who is either considering a diagnosis or already diagnosed as it can feel really invalidating whether that is your intention or not. It also makes it hard for that person to tell you if/when they do get a diagnosis or when they need support.
Reason two – you are neurodivergent and just undiagnosed:
There are stats everywhere on this and they change constantly due to the growing awareness and new studies being done all the time, I will refer to some of the stats I have seen over the years of researching but please take with a pinch of salt as its forever changing! And feel free to do your own research.
Autism and ADHD was not something that girls/women were really considered for until the 90’s and even then, it was extremely unlikely that a girl, let alone a woman, would be assessed for a neurodiversity. Research was (and still is) rare for this demographic and ADHD and Autism were considered conditions that males experienced only. This has led to a huge amount of people being missed with a recent study showing that 80% of autistic women are undiagnosed and 50-75% ADHD women are undiagnosed. Additionally, we previously (still recently though) thought that the ratio for gender related diagnosis was 4:1 male to female but due to recent findings and developing theories, this is thought to be more like 4:3 or even 50% being women depending on where you are researching.
Women aren’t the only people who are missed though, many boys and men go undiagnosed as well, so with the various stats from difference sources, there is an estimated 430,000 to 1.2 million people in the UK who are currently undiagnosed with Autism and up to a massive 2 million with undiagnosed ADHD.
We tend to “find” each other. Its like “gaydar” but for neurodiversity. We flock together because we see similarities in each other and feel a kind of comfort and safety in being ourselves. So, one person who is autistic and/or ADHD, may have several friends who are unknowingly neurodiverse, hence why they relate to each other so well and say things like “yes, but I do that too”.
It’s the same in families. It’s not uncommon for someone to tell their parent that they think they might have ADHD, Autism or another ND condition, only to be shot down because; “no, that’s normal, I do that, we all do that”. And, well, that’s very likely because there are genetic links, and the parent is probably just undiagnosed, hence why they wouldn’t necessarily spot it in their own children. It’s so common that some psychiatrists are now saying that parents should also be referred for assessments if their child is diagnosed or in the process of being diagnosed.
Stats on genetics range from 25% to 75% chance of passing an ND condition on to your kids. From my point of view, my parents are both ND (either Autistic or AuDHD suspected), all 3 of my siblings have ADHD and at least 2 of them are suspected Autistic. One of my siblings has 4 children who are either diagnosed or on the wait list for ADHD, Autism and/or PDA. My own child has been referred for assessments for Autism as well. This to me sounds more like 100% so its worth thinking about that when you are considering whether you are neurodiverse.
Identifying whether you are on the spectrum can be extremely hard. For example, if you have inattentive type ADHD (more common in women/girls), then most of the characteristic are different to the classically known symptoms of ADHD. This isn’t common knowledge, so is regularly missed, even by those who have a level of responsibility to identify it (Drs, teachers and surprisingly many psychiatrists and therapists):
Inattentive type ADHD manifests differently, it’s presented more internally than the more commonly known “Hyperactive/Impulsive” type of ADHD, which is the one we see and hear more about. It’s usually found more in boys. Some things to think about when considering inattentive ADHD:
Hyperactivity can look like excessive talking, interrupting or blurting things out. Random spring cleaning at 2am, or just researching subjects of interest for hours and hours (falling down the rabbit hole).
Attention difficulties can look like daydreaming or getting “emotional”, crying a lot, forgetting words mid-sentence, losing things and being easily distracted.
Emotional regulation is often internalised and can lead to serious self-esteem issues. Masking these regulation issues and internalising them can also lead to explosive ADHD meltdowns.
Impulsivity will look different as well, someone may decide to book a holiday without consulting their family, just on a whim. They might overspend, impulse buy a whole new wardrobe or getting that 6th tattoo. They might decide one day to shave their hair off or dye it purple all of a sudden.
Fidgeting and stimming will be less disruptive. This could be for various reasons both primitive (to keep safe and concealed) and societal (to take up less space or be more “lady like” or “demure” and less “bother”). So it may go unnoticed if its suppressed or adapted to be hidden from others.
Masking is more common in women and those with inattentive ADHD, and they are also much better at it most of the time, so won’t be spotted as easily as their male counterparts.
All these symptoms are heightened with those who have female reproductive organs around menstruation, ovulation, puberty, perimenopause, menopause, and pregnancy.
If you are in one of the minority groups who are heavily underdiagnosed, then you, along with the majority of society (when it comes to misconceptions of neurodiversity traits), may consider that instead, you are lazy, over sensitive, dramatic or any of the other misconceptions that we tend to internalise. You may be someone who has masked so well that you don’t even realise you are doing it like I was.
My story
If you’re anything like me, then you will not think you’re neurodiverse without a lot of prompting. I masked everything to the point where I didn’t know I was even masking (and still don’t always notice I am doing it) due to the environment I was raised in.
As a kid who had loud and disruptive stims, I was called “annoying” frequently. I internalised this and hyper-focused on it. I stopped any stims that may irritate people around me, I made sure to not be too loud in most environments and spent years of my life re-wording and practicing how to say things to not be misunderstood or upsetting with my naturally blunt approach. I was (and still am sometimes) the ultimate people pleaser.
My home family have all got ADHD. Growing up this meant lots of missed activities or appointments, chaotic events, lots of mess, lateness, and so much disorganisation, along with constant misunderstanding of each other. This type of environment will lead to some hardcore emotions being displayed. It was a very hectic, loud, and busy household. So, for several reasons, at a really young age, I took it upon myself to be the organiser. I was the one who made sure everyone was invited to events, everyone was emotionally supported, activities were organised and not forgotten. I was the translator for misunderstandings and the diplomat, I was the responsible one, the sensible one and the quiet one. Not the norm for a middle child.
I did these things because the chaos and the fallout caused me so much anxiety that I couldn’t cope. My “helpful” approach to my family life was not born out of kindness, I was helping myself to have a less disruptive home life and avoid the anxiety of the chaos and overwhelm.
Additionally, I have too much empathy. It’s often thought that autistic people have a lack of empathy, this might be the case for a few of us, but its actually more often the other way around. I feel other people’s emotions to the point where it can cause me quite a lot of distress. It has moulded me into one of those people who wants to help, rescue, and fix the problems of those around me. The other person can then feel happier, and I can stop feeling their negative emotions. I did this a lot at home, for my siblings but also for my mum. Let’s face it, imagine being a single mum who is unaware of their own neurodiversity with 4 undiagnosed neurodivergent kids, working full time in the late 80’s/early 90’s with a very small/non-existent support unit……… that’s a stressful situation and those are going to be some serious emotions.
I didn’t want my mum feeling those emotions, so I did what I could to take the pressure and burden off. This anxiety avoidance explains why I have overridden so much of my ADHD (its extremely hard work mentally, I don’t recommend it!). I think ultimately, my autistic need for structure and security and my extreme anxiety, overpowered my ADHD traits of disorganisation.
In order to deal with constantly being misunderstood or misunderstanding others, I hyper focused on psychology, communication, and body language. Learning this and being in a constant state of hyper-vigilance lead me to get extremely good at assessing the room.
I can see your micro-expression when you try to hide your boredom at my rant on pockets or when my mask slips and I say something silly or start stimming accidentally. I can spot a narcissist 99% of the time within minutes of meeting them and I notice the red flags in the people around me very easily compared to most.
As a result, I have helped many of my friends and family learn about their own mental health struggles and identify their neurodivergence literally years before I even considered I would be part of that group. I would make their Drs appointments, remind them to go, and send them documents they could use to advocate for themselves or go with them so they would be taken seriously. I literally said to my sister “I can’t imagine how hard is it to have ADHD, I totally relate to all these traits, it’s exhausting” ….. I mean, seriously, that was about 6 years before I got diagnosed!
What I did is a classic faun response. If someone is unable to be their authentic self without ridicule, shame or anxiety inducing chaos, and they are not in a position to defend themselves, they will adapt to their surroundings as a method of survival. For an AuDHD person like me, this involved ignoring or overriding sensory issues, overwhelm, meltdowns (seriously not something I would recommend), ultimately coming across as neurotypical and/or high functioning. This comes at a cost which I will cover in more detail in another chapter.
The faun response is more common in women which, if you think about it, makes total sense. In the cave man age, if there was danger, we had to adapt to keep ourselves and our babies/future babies safe. We are less likely to adopt the fight or flight response if there is even a tiny chance we may get beaten or might not be fast enough to escape. In modern context, your cave man brain doesn’t know the difference between an angry bear or the person laughing at you because you’re swinging your body around erratically to feel g-force or making cat sounds as a vocal stim. You adapt your movements and sounds to not be noticed, to fit your surroundings and be safe.
So, if last time you had a meltdown (whether you knew what it was or not) you got punished or shamed, you won’t risk that again and it will pave the way for you to adapt yourself to all future social interactions. The earlier you put that mask on, the harder it will be for you to identify you even have one.
I thought my meltdowns were a rage issue. I thought my sensory issues were me being oversensitive or weak, I thought my impulses and emotional regulation issues were “annoying” and just a character flaw.
I suspected I had ADHD in 2021, got my diagnosis in January 2022 and only really considered I may be autistic during my ADHD coaching through work. I got autism and dyspraxia diagnosed in May 2022. So, I went my whole life wondering why I couldn’t perform like others and putting myself down because of the misconceptions we have in society around neurodiversity. It is so important that we raise awareness around this so we can identify neurodiversity in ourselves and our loved ones so we can avoid the mental health fall out that comes from late diagnosis.
What I am trying to say is, it’s not beyond the realms of possibility that a person can have no idea that they are neurodiverse. It’s acceptable to consider that you relate to someone who is on the spectrum because, so are you and you just didn’t know.
Neurodiversity is under researched and misunderstood by so many, from neurodiverse people and neurotypical people, to doctors, teachers, and psychiatrists. This complete lack of understanding has led to thousands of people in the UK going undiagnosed and struggling for most of their lives. The assessment model is pretty much the same as what it always has been, an assessment for middle class white boys. Not surprising that so many go undiagnosed when the assessment is irrelevant for MOST of the world.
I have heard of people being refused a referral for ADHD by their GP for the following ridiculous and unfounded reasons:
No history of drug/alcohol abuse or criminal/antisocial behaviour.
They have an education or qualifications or a successful career.
They are an adult and “ADHD only effects kids”.
They are high masking so are “able to cope”.
They are overweight.
I have heard of people being refused a referral for ASD by their GP for the following similarly ridiculous and uneducated reasons:
They can make eye contact.
They have an education or qualifications or a successful career.
They can express empathy.
They are high masking so are “able to cope”.
This highlights a pretty serious issue. If a medical professional is so uneducated on something like this, then it’s a scary prospect to consider. It also helps to explain why people of colour, women, girls, and gender variant people are missed or refused so often, because we don’t fit the ADHD stereotype of a young, naughty, white boy (extremely out of date!) or the Autistic stereotype of a young disruptive white boy who can’t make eye contact.
As someone who is autistic (and I mean – “would have been diagnosed as a small child if I was a boy” level “obvious autistic”), ADHD with dyspraxia and suspected PDA. If I can subconsciously fool myself and everyone around me that I am a well-functioning neurotypical person (even after I literally hyper focused on it for years!), then so can anyone.
If you have read this and it’s made you think that you may be neurodivergent, feel free to contact us at info@gaintogether.org and speak to one of us confidentially. We are always willing to help! Just understand that some of us have ADHD so apologies in advance for our delayed reply!
Thank you to Esme G for being so open and honest about their story and believing in, and championing for our neurodiverse community.
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