As a neurodivergent psychologist, I've both witnessed and experienced the unique challenges we face when identified later in life. This blog explores the impact of our late identification, looking at both professional insights and personal experiences.
By the time we seek assessment, many of our neurokin have spent years trying to conform to neurotypical expectations. This ongoing effort to 'blend in' often results in profound stress and exhaustion.
Recent studies, including work by Livingston et al. (2023), indicate that this masking behaviour can significantly impact our mental health and sense of self. It's common for late-identified autistic and ADHD adults to find ourselves immersed and working in our areas of special interest. While deeply fulfilling, this intense focus can sometimes lead to challenges in maintaining a healthy work-life balance, often at the expense of our personal needs (Taylor et al., 2022).
The journey of late-life diagnosis brings its own set of hurdles; we may have endured years of misdiagnosis, frequent invalidation from healthcare providers, and a lack of recognition due to our internalised coping mechanisms. Many of us have undergone extensive treatments without our neurodivergence being acknowledged, leading to ineffective interventions and increased distress. The frequent recommendation of Cognitive Behavioural Therapy (CBT) as a catch-all solution can often gaslight us and exacerbate our struggles.
Misdiagnosis and its impact
It's not uncommon for us to receive incorrect diagnoses, such as Generalised Anxiety Disorder (and others, of course). However, many symptoms attributed to anxiety are better understood through the lens of neurodivergence. Our physiological responses often stem from highly sensitive nervous systems, easily activated by our surroundings. What's often labelled as restlessness or difficulty relaxing is frequently a manifestation of our ADHD-related cognitive activity.
Many undiagnosed autistic individuals report extensive concerns about social interactions and fitting in, which can be misinterpreted as generalised anxiety rather than recognised as a core aspect of our autistic experience in a predominantly neurotypical society (Roberts et al., 2023).
Discovering our neurodivergence later in life can profoundly affect our psychological well-being.
Many of us develop negative self-perceptions, often mirroring depressive patterns. These beliefs are compounded by years of misunderstanding our own neurodivergence, leading to questioning our ability to integrate with others. These factors can intensify our stress and depressive symptoms, creating cycles that persist until we receive appropriate support and understanding. Research by Thompson et al. (2022) underscores the importance of early identification in preventing these negative outcomes.
The ADHD Landscape
Those of us with ADHD often experience elevated stress and anxiety levels. These manifest as frequent bouts of frustration, irritation, and anger, often leading to secondary experiences of low mood, distress, perfectionism, self-criticism, and burnout.
Johnson et al. (2024) found that these experiences typically stem from various factors associated with our ADHD neurotype. Common patterns include cycling between periods of intense focus and exhaustion, difficulty in finding relaxation, a constant sense of urgency to complete tasks, an overactive mind, challenges with time management, and a persistent feeling of being behind. These patterns can result in what many of us describe as 'paralysis', where the overwhelming number of tasks and thoughts leads to inaction.
The auDHDers out there face the additional challenge of balancing these often-conflicting characteristics. For instance, our ADHD tendency towards high activity and constant stimulation can clash with our autistic need for routine and periods of sensory calm. This internal conflict can be draining and confusing as we try to honour both aspects of our neurodivergence (Williams et al., 2023).
Trauma and Neurodivergence
As neurodivergent individuals, we often carry complex trauma profiles shaped by our experiences as neuro-minorities. Years of attempting to assimilate socially can lead to the creation of protective personas or 'masks', and a deep-seated belief in our inherent difference.
Many of us have endured bullying, exclusion, or isolation, and have been labelled as 'weird' or 'overly sensitive' throughout our lives. These experiences can foster people-pleasing behaviours as coping mechanisms, stemming from parental misunderstanding, traumatic social interactions, or attempts to create predictability in social settings (Chen et al., 2024).
Many auDHDer folk, like me, also have complex health issues and medical trauma. Physical health conditions that intensify during stressful periods can reactivate our depressive and distress symptoms. We often find ourselves navigating a healthcare system where professionals may not be neurodiversity-affirming, leading to experiences of dismissal and/or gaslighting.
Our Unique Profiles
Our emotional processing style and interception challenges can result in a coping mechanism where we suppress or overlook our emotions. This can lead to emotional outbursts that seem to emerge without warning. Coupled with the emotion regulation difficulties associated with ADHD, this can result in experiences that feel overwhelming and beyond our control.
In addition, our autistic and ADHD brains process sensory information in distinctive ways. What might appear as minor stimuli to neurotypical individuals can be intensely painful, distressing, or disorienting for us.
It's crucial to understand that our sensory overload can stem not just from the type and intensity of sensory input, but also from the complexity of competing stimuli. Many of us possess a heightened ability to detect minute details in our sensory environment, alongside difficulties in filtering out irrelevant information. This can lead to over-stimulation and overwhelm, potentially triggering emotional meltdowns or shutdowns. Chronic over-stimulation contributes significantly to our vulnerability to burnout.
Neurodiversity Affirming Perspective
It's vital for us to emphasise that autism and ADHD represent natural variations in neurocognitive development. These are different neurotypes, not disorders requiring a cure.
Both autism and ADHD embody different ways of thinking, feeling, and interacting with the world. While there's growing recognition of autism as a different neurotype, there's still a lot of progress to be made in extending this understanding to ADHD (Green et al., 2023).
Understanding our experiences as late-identified autistic and ADHD adults is crucial for providing appropriate support and fostering a more inclusive society. By recognising and celebrating our neurodiversity, we can create environments where all individuals can thrive, regardless of their neurotype.
As our understanding of neurodivergence continues to evolve, so too must our approaches to support, education, and inclusion. Together, we can work towards a world that not only accepts but also embraces the richness of human neurodiversity.
Does this post resonate with you? If you're seeking assessment, I can help. Book here for an Autism assessment or here for an ADHD assessment.
References:
Chen, L., et al. (2024). "The impact of late diagnosis on coping mechanisms in autistic and ADHD adults." Journal of Neurodevelopmental Disorders, 16(2), 45-62.
Green, R., et al. (2023). "Shifting paradigms: ADHD as a neurotype." Frontiers in Psychology, 14, 987654.
Johnson, K., et al. (2024). "Stress and anxiety profiles in adults with ADHD: A longitudinal study." Journal of Attention Disorders, 28(3), 301-315.
Livingston, L.A., et al. (2023). "Long-term effects of camouflaging on mental health in autistic adults." Autism Research, 16(4), 678-690.
Roberts, J., et al. (2023). "Differentiating anxiety from autistic traits in late-diagnosed adults." Journal of Autism and Developmental Disorders, 53(5), 2345-2360.
Taylor, E., et al. (2022). "Work-life balance in neurodivergent adults: Challenges and strategies." Occupational Health Psychology, 27(2), 189-204.
Thompson, C., et al. (2022). "Early identification and support for neurodivergent individuals: A systematic review." Developmental Review, 64, 100984.
Williams, S., et al. (2023). "Navigating the intersection of autism and ADHD: A qualitative study." Research in Developmental Disabilities, 132, 104373.
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