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- Psychedelics and Neurodivergence: Understanding Current Research and Integration Needs
Written by Dr Sara Tookey A True North Psychology Publication Key Takeaways Research on psychedelics and neurodivergence is in early stages Recent studies show 23% of adults with ADHD symptoms self-treat with psychedelics Recent studies show preliminary potential for improving challenges associated with ADHD, but more research is needed Many landmark psychedelic clinical trials have focused on treatment-resistant depression (TRD), which may overlap with undiagnosed neurodivergence Individual sensory processing differences require special consideration Professional support and careful preparation are essential Integration approaches must be adapted for neurodivergent needs Comprehensive ethical frameworks must guide research, training and clinical practice Summary This article explores how psychedelics might affect people with ADHD and autism. While the research is still in it's infancy, we're seeing interesting patterns. This article suggests safety considerations and adaptations to psychedelic-assisted therapy that take into account the needs of neurodivergent individuals seeking this alternative therapy. Recent research found that people with ADHD are nearly four times more likely to have tried psychedelics compared to those using conventional medication (Haijen et al., 2024) - highlighting an important pattern that needs further investigation. A significant consideration is the overlap between treatment-resistant depression (TRD) and neurodivergence. Many major psychedelic clinical trials have focused on TRD, including landmark studies by Carhart-Harris (2021), COMPASS Pathways (Goodwin et al., 2023), and ketamine research teams. However, TRD and conditions like autistic burnout can present with similar symptoms while requiring fundamentally different treatment approaches. Research published in the British Journal of General Practice (White, 2019) emphasizes the importance of considering undiagnosed autism in TRD patients, making this relationship particularly relevant for the future of psychedelic therapy research and practice. Note on possible connection between Autism and Treatment Resistant Depression - as relevant to psychedelic science research added 25/2/25. If you like this article you might enjoy reading our other psychedelic-assisted therapy related articles: Navigating the Ethical Landscape of Psychedelic Therapy , by Dr Sara Tookey Psychedelic Harm Reduction and Integration for Mental Health Professionals , by Dr Sara Tookey Psychedelic Integration: What is it and who can benefit from it? by Dr Sara Tookey Psychedelic Integration Tools and Techniques by Dr Sara Tookey Psychedelic Preparation: What is it and who can benefit from it? by Dr Sara Tookey Beyond the Hype: A Balanced Look at Psychedelic Therapy Risks by Dr Sara Tookey Exploring the Psychedelic Renaissance: Psychedelic Therapy, a Crucial Conversation for Mental Health by Dr Sara Tookey Key Terms Defined: Neurodivergence : A term encompassing various natural variations in human brain function and behavioral traits. This includes conditions such as autism spectrum conditions, ADHD (Attention Deficit Hyperactivity Disorder), dyslexia, and other neurological variations. These conditions often co-occur and share common features in how individuals process sensory information, regulate emotions, and experience social interactions. Microdosing : Taking very small, sub-perceptual amounts of psychedelics that do not cause psychedelic effects. Unlike traditional psychedelic experiences, microdosing involves taking approximately one-tenth of a standard dose, aiming to produce subtle effects without altering consciousness. Read more about microdosing research and implications → Integration : The process of making meaning from and incorporating insights from psychedelic experiences into daily life. This involves processing and understanding the experience, as well as implementing any relevant insights or changes. For neurodivergent individuals, this process may require specific adaptations to support different processing and communication styles. Introduction The intersection of psychedelic therapy and neurodiversity is an important emerging area of scientific enquiry, with prominent research institutions examining how these compounds may impact neurodivergent individuals, particularly autistic and ADHD individuals. While research specifically focused on neurodivergent experiences with psychedelics remains limited, recent studies are revealing important insights about how these powerful compounds may affect neurodivergent individuals differently, and what this means for therapeutic support and integration. Psychedelics and Neurodivergence Research: Historical Context (1960s) The relationship between psychedelics and neurodiversity research dates back to the 1960s, when researchers first explored LSD's effects on autistic adults and children. While these initial studies showed promise in improving social behaviour and reducing anxiety and depression, they also revealed important limitations and potential risks ( Markopoulos, et al., 2022 ). This early work laid the groundwork for understanding the need for careful, individualised approaches to psychedelic therapy with neurodivergent individuals. Recent Developments Modern research has begun to approach this field with greater sophistication and rigor. A groundbreaking 2018 study at UCLA demonstrated that MDMA-assisted therapy could improve social confidence in autistic adults, with benefits persisting for months after treatment ( Danforth et al., 2018 ). This research helped reignite scientific interest in how psychedelics might support neurodivergent individuals. Current Research Currently, King's College London is conducting the first systematic investigation of psilocybin in adults with autism. Led by Professor Grainne McAlonan, this landmark study is exploring how psilocybin affects serotonin pathway functioning in autistic adults, involving 70 participants receiving varying doses in carefully controlled settings. In response to anecdotal reports of ADHD individuals self-medicating with microdoses of psychedelics, recent studies have expanded into examining microdosing effects on various neurodivergent conditions. Haijen and colleagues (2024) investigated microdosing compared to conventional medications in adults with ADHD. Their research found that after just four weeks, people who microdosed experienced notable improvements in ADHD symptoms and emotional expression. Remarkably, those who microdosed scored below clinical thresholds on all ADHD measures, while those on conventional medication remained above threshold on most measures. The microdosing group was also nearly four times more likely to have prior psychedelic experience (82.2% vs 21.6%), suggesting a pattern worth investigating. While promising, these early findings need confirmation through controlled trials to rule out placebo effects. Understanding How Psychedelics Might Work for Neurodivergent Brains Scientists are discovering several ways psychedelics might affect neurodivergent brain function: The REBUS Model: Loosening Rigid Patterns According to the REBUS model (Relaxed Beliefs Under pSychedelics) , these substances temporarily relax fixed patterns of thinking and neural activity ( Carhart-Harris & Friston, 2019 ). For neurodivergent individuals, particularly those with deeply-engrained or rigid patterns, this flexibility could allow new perspectives and ways of experiencing the world. Serotonin Pathways: Affecting Key Brain Chemistry Psychedelics primarily work through serotonin, a neurotransmitter that influences: Mood regulation Social interaction How we process sensory information Research suggests that differences in serotonin processing may contribute to some characteristics of autism ( Muller et al., 2016 ). Psychedelics activate specific serotonin receptors (5-HT2A), which are linked to social understanding and sensory processing in autism ( Martin et al., 2021 ). Key Brain Regions: Targeting ADHD-Related Areas Recent brain imaging research shows psychedelics affect the frontal and parietal regions - areas specifically involved in ADHD-related challenges ( Ramos et al., 2024 ; Wojdas, et al., 202 3). T his suggests potential for addressing specific ADHD symptoms by influencing activity in these brain networks, though this research is still in early stages. These emerging insights are helping researchers understand how psychedelics might benefit neurodivergent individuals in unique ways. Safety Considerations: What Neurodivergent Individuals Should Know When it comes to psychedelics and neurodivergence, safety and ethics are requires attention. While research suggests psychedelics are generally safe for many people, neurodivergent individuals need specific considerations: Sensory Differences Matter Neurodivergent people often experience sensory information differently. A recent study by ( Evans and collegues, 2023) found that individual responses to psychedelics can vary significantly. What feels pleasant or manageable for one person might be overwhelming for someone with sensory sensitivities. The Importance of Professional Support Research consistently shows that having trained professionals and an appropriate setting are crucial safety components ( Pilecki et al., 2021 ). This becomes even more important for neurodivergent individuals who may: Process sensory information differently Have unique communication needs Benefit from specialised support strategies Having knowledgeable guides who understand neurodiversity can make the difference between a healing experience and a challenging one. Making Sense of the Experience: Integration for Neurodivergent Individuals After a psychedelic experience, the process of making meaning and incorporating insights (called " integration ") needs to be tailored for neurodivergent individuals. This requires understanding how psychedelic experiences interact with each person's unique sensory processing and communication style. Creating Sensory-Friendly Support Effective integration might include: Explaining potential sensory effects beforehand Adjusting the environment to individual comfort levels Providing sensory tools like weighted blankets or adjustable lighting Creating spaces that accommodate sensory needs Communication and Processing Support Since people process and express experiences differently, integration support should offer: Multiple ways to express insights beyond just talking Written options for those who prefer processing through text Creative expression through art, movement, or music Adjustable session lengths and pacing The key is flexibility—allowing each person to process their experience in ways that work best for their unique neurology. A truly neurodiversity-affirming approach recognizes there isn't a one-size-fits-all method for integration. Looking Ahead: Where Research Needs to Go The intersection of psychedelics and neurodiversity represents an important frontier in mental health research. While early findings show promise, research remains in it's infancy. The most important needs going forward include: Research designed with and by neurodivergent individuals Studies that examine varied response patterns across different neurodivergent experiences Development of protocols specifically designed for neurodivergent individuals Long-term safety studies with diverse neurodivergent participants For neurodivergent individuals interested in psychedelic experiences, the current evidence suggests three essential principles: Thorough preparation with experienced guides Professional support from providers who understand neurodiversity Individualised integration approaches that honour sensory and processing differences As this field develops, we need to ensure neurodivergent voices remain central to the research process. We'll continue updating this information as new studies emerge in this rapidly evolving area. Note: Treatment-Resistant Depression and Neurodivergence An important consideration in psychedelic research is the often-overlooked connection between treatment-resistant depression (TRD) and neurodivergence. This connection is particularly relevant as a substantial portion of modern psychedelic clinical research has focused specifically on demonstrating efficacy for treating TRD. Several landmark studies exemplify this focus: The 2021 New England Journal of Medicine study comparing psilocybin with escitalopram for depression (Carhart-Harris et al., 2021) COMPASS Pathways' Phase 2b trial of psilocybin therapy for TRD, showing significant reductions in depression scores (Goodwin et al., 2023) The RAPID clinical trials demonstrating ketamine's efficacy for TRD (Zarate et al., 2006; Murrough et al., 2013) The FDA's breakthrough therapy designation for psilocybin specifically for TRD in 2018 Recent evidence suggests TRD and conditions like autistic burnout can present similarly but require fundamentally different approaches. In fact, research published in the British Journal of General Practice highlights that "clinicians need to be mindful of the possibility of undiagnosed autism in all patients with TRD" (White, 2019). This observation has profound implications for psychedelic therapy, as treatments beneficial for neurotypical depression may not be appropriate—and could potentially be harmful—for someone experiencing neurodivergent burnout. These conditions share overlapping symptoms but have distinct causes: TRD is primarily a mood disorder resistant to conventional treatments Autistic burnout results from chronic stress of navigating neurotypical expectations Sensory processing differences in neurodivergent individuals may alter psychedelic experiences This intersection has significant implications for psychedelic therapy safety, efficacy, and ethical practice. We'll be exploring this topic in depth in an upcoming blog post titled "The Hidden Connection: Psychedelic Therapy at the Intersection of Treatment-Resistant Depression and Neurodivergence." References: White, M. J. (2019). Treatment-resistant depression: consider autism. British Journal of General Practice, 69(678), 14. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. We welcome your thoughts and reflections on this article. Support Resources Professional Organisations Neurodiversity Foundation The Autistic Psychedelic Community : They offer a weekly meetings via Zoom on Sundays at 2pm (EST), 11am (Pacific Time), 7pm (GMT) MAPS (Multidisciplinary Association for Psychedelic Studies) ICEERS (International Center for Ethnobotanical Education, Research & Service) The True North Psychology At True North Psychology, we offer preparation, harm-reduction and integration support using a neurodiversity-affirming framework, inline with emerging research findings. Our approach: Recognises neurological differences as natural variations Works with, rather than against, individual processing styles Maintains rigorous safety standards Upholds protocols of good clinical practice Our integration support considers: Individual sensory needs Personal communication preferences Unique processing styles Individual emotional regulation patterns Stay Connected Further Resources Visit our Integration Therapy Page to learn more about: Preparing for psychedelic experiences Making sense of your journey Integration techniques Managing residual effects Initial consultations Neurodiversity-affirming therapy and assessments Specialised integration therapy Ongoing therapeutic support Personal Support Book a therapy consultation to explore: Preparation guidance Integration support Psychedelic-informed therapy Stay Updated Subscribe to our mailing list to receive first access to our upcoming workshops, related resources and content. Be part of the conversation in the evolving field of Psychedelic Science and mental health. Are you curious about psychedelic experiences or wish to join a supportive community to integrate non-ordinary states of consciousness? READ MORE from our Blog HERE! Book in your 30-min Discovery Call with our Integration Specialist Psychologists Need one to one support? Want to explore preparation, integration, and psychedelic-informed therapy for yourself. Book a FREE Discovery Call with one of our Psychedelic-integration specialist therapists or book a Comprehensive Initial Consultation with our Clinical Director, Dr Sara Tookey. NEED IMMEDIATE SUPPORT FOR A CHALLENGING PSYCHEDELIC EXPERIENCE? Note: TNP does not offer crisis support. Contact Fireside Project Peer Support Helpline : 62-FIRESIDE Our TNP DISCLAIMER: Our site provides information for educational purposes only, and is a platform to connect people with qualified therapists. It does not provide professional mental health or medical advice. We do not offer psychedelic-assisted therapies or access to illegal substances. Requesting such services is prohibited. We cannot help locate psychedelic-assisted therapy, guided sessions, or retreats. We may provide publicly available information about eligible clinical research trials for research participation purposes only. Our therapists provide support which adopts a harm reduction perspective and does not encourage illicit substance use. We do not work with individuals experiencing active psychosis, although we can assist in making sense of past psychotic episodes for those under professional care. We do not act as experts on psychedelics or altered states, nor provide advice on their use. We are not liable for risks associated with using information from our site. Psychedelic Science Resources and References- created by True North Psychology, protected image References References Peer-Reviewed Articles Bouso, J. C., Dos Santos, R. G., Alcázar-Córcoles, M. Á., & Hallak, J. E. C. (2022). Serotonergic psychedelics and personality: A systematic review of contemporary research. Neuroscience & Biobehavioral Reviews , 134, 104532. Brun, G., et al. (2023). Sensory processing and social cognition in autistic adults following psychedelic experiences: An observational study. Journal of Autism and Developmental Disorders . Danforth, A. L., Grob, C. S., Struble, C., et al. (2018). Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: A randomized, double-blind, placebo-controlled pilot study. Psychopharmacology , 235, 3137–3148. https://doi.org/10.1007/s00213-018-5010-9 Evans, J., Robinson, O. C., Argyri, E. K., et al. (2023). Extended difficulties following the use of psychedelic drugs: A mixed methods study. PLoS One , 18(10), e0293349. https://doi.org/10.1371/journal.pone.0293349 Haijen, E. C. H. M., Hurks, P. P. M., & Kuypers, K. P. C. (2024). Effects of psychedelic microdosing versus conventional ADHD medication use on emotion regulation, empathy, and ADHD symptoms in adults with severe ADHD symptoms: A naturalistic prospective comparison study. European Psychiatry , 67(1), e18, 1-14. https://doi.org/10.1192/j.eurpsy.2024.8 Hartogsohn, I. (2017). Constructing drug effects: A history of set and setting. Drug Science, Policy and Law , 3, 2050324516683325. Kuypers, K. P. (2024). Microdosing psychedelics in the treatment of ADHD and comorbid disorders. European Psychiatry , 67(S1), S7-S8. https://doi.org/10.1192/j.eurpsy.2024.44 Markopoulos, A., Inserra, A., De Gregorio, D., & Gobbi, G. (2022). Evaluating the potential use of serotonergic psychedelics in autism spectrum disorder. Frontiers in Pharmacology , 12, 749068. https://doi.org/10.3389/fphar.2021.749068 Martin, D. A., & Nichols, C. D. (2021). The effects of hallucinogens on gene expression. Current Topics in Behavioral Neurosciences , 36, 137-158. Muller, C. L., Anacker, A. M. J., & Veenstra-VanderWeele, J. (2016). The serotonin system in autism spectrum disorder: From biomarker to animal models. Neuroscience , 321, 24–41. https://doi.org/10.1016/j.neuroscience.2015.11.010 Murphy, R., et al. (2022). Therapeutic alliance and rapport modulate responses to psilocybin assisted therapy for depression. Frontiers in Pharmacology , 12, 788155. Pilecki, B., Luoma, J. B., Bathje, G. J., Rhea, J., & Narloch, V. F. (2021). Ethical and legal issues in psychedelic harm reduction and integration therapy. Harm Reduction Journal , 18(1), 40. Ramos, L., & Vicente, S. G. (2024). The effects of psilocybin on cognition and emotional processing in healthy adults and adults with depression: A systematic literature review. Journal of Clinical and Experimental Neuropsychology , 46(5), 393–421. https://doi.org/10.1080/13803395.2024.2363343 Soares, C., Gonzalo, G., Castelhano, J., & Castelo-Branco, M. (2023). The relationship between the default mode network and the theory of mind network as revealed by psychedelics – A meta-analysis. Neuroscience and Biobehavioral Reviews , 152, 105325. Wojtas, A., Bysiek, A., Wawrzczak-Bargiela, A., Maćkowiak, M., & Gołembiowska, K. (2023). Limbic system response to psilocybin and ketamine administration in rats: A neurochemical and behavioral study. International Journal of Molecular Sciences , 25(1), 100. Online Resources NIHR, Maudsley Biomedical Research Centre. (2022). NIHR Maudsley BRC researchers lead first study of psilocybin in adults with autism. https://www.maudsleybrc.nihr.ac.uk/posts/2022/may/nihr-maudsley-brc-researchers-lead-first-study-of-psilocybin-in-adults-with-autism/ search
- AuDHD: Understanding the Intersection of Autism and ADHD
Written by Dr Sara Tookey Key Highlights : What You Need to Know About AuDHD It's Real, Not a Trend : 40-70% of autistic individuals also meet criteria for ADHD, with up to half of those with ADHD showing autistic traits The "Living Contradiction" : AuDHD individuals experience internal conflicts between competing neurological needs (routine vs. novelty, structure vs. flexibility) Masking Effect : ADHD and autism traits can hide each other, making diagnosis challenging and often leading to misidentification Unique Strengths : AuDHD brains offer exceptional pattern recognition, creative problem-solving, and innovative thinking that combines structure with flexibility Cyclical Patterns : Unlike either condition alone, AuDHD follows distinctive cycles of high energy followed by crashes Professional Recognition Growing : Increasing numbers of specialists are trained to recognise and assess this intersection What Is AuDHD? Not a Trend: The Science Behind AuDHD T he Lived Experience of AuDHD How ADHD and Autism Mask Each Other Strengths and Abilities: The AuDHD Advantage Moving Forward : Stay Connected / Get Help Now References for this article Resources & Further Reading What Is AuDHD? Until relatively recently (2013), Autism and Attention-Deficit/Hyperactivity Disorder (ADHD) were considered distinct conditions that couldn't be diagnosed together. However, research has increasingly revealed significant overlap between these conditions, leading to growing recognition of what many now call "AuDHD" - the co-occurrence of both autism and ADHD in the same person. This article explores what it's actually like to live with this intersection, why it's not just a trend, and the unique experiences that characterise the AuDHD brain. New to AuDHD? This article focuses on understanding the lived experience and provides practical steps about diagnosis and support. Not a Trend: The Science Behind AuDHD Despite some dismissive commentary suggesting that AuDHD is "just a TikTok diagnosis," the scientific evidence tells a different story: The Research Shows: 40-70% of autistic individuals also meet criteria for ADHD Up to half of those with ADHD show autistic traits ( Boyle, 2024 ; Waldren et al., 2024 ) Twin studies show a genetic overlap becoming stronger as people age—suggesting that many of the same genes that contribute to autism also contribute to ADHD ( Ronald et al., 2008 ; Reiersen et al., 2008 ). Research by Taylor et al. (2015) found that autistic individuals who experienced communication differences had the strongest genetic overlap with ADHD traits. As Siân Boyle notes in an article in The Guardian: "...some critics like to describe ADHD – and more recently autism – as a 'fashionable' diagnosis, a misinformed excuse for life's struggles" ( Boyle, 2024 ). This criticism overlooks substantial research and real lived experiences. Why They Overlap: Both autism and ADHD involve: Differences in executive functioning (e.g. attention and impulsivity) Sensory processing differences Challenges with emotional regulation Social communication differences Often co-occur with anxiety and depression Involve masking behaviours as coping strategies The Lived Experience of AuDHD The "Living Contradiction" Many individuals with AuDHD describe feeling like a "living contradiction." As one person shared with ADDitude Magazine : "I often feel like a living contradiction. I want order but cannot maintain it. I want to be systematic and precise but struggle with it, which leaves me constantly feeling not good enough" ( ADDitude Editors, 2024 ). Samantha Stein's 5 Key AuDHD Characteristics Samantha Stein , a late-diagnosed AuDHDer and advocate describes five key experiences of AuDHD in her viral YouTube video (2+ million views): 1. Internal Conflict: Stein’s words depict this very clearly - "You might feel constant inner conflict with yourself which often results in becoming frequently frustrated with yourself. You may crave order and routine but be unable to maintain it; You might get overstimulated as much as you get under stimulated, and sometimes this might even happen at the same time or in a very short space of time" ( Stein, 2024 ). 2. Traits Balance Each Other Out: "The opposing actions of autistic and ADHD traits can seem to balance each other out or maybe even conceal each other... the social awkwardness aspect of my autism often kind of gave in to the chattiness and sociability of my ADHD, so from the outside I kind of just appeared as if I was shy at first and then took a little bit of time to warm up to people. But that wasn't what was happening inside, both of those people were me" ( Stein, 2024 ). 3. Different Versions in Different Environments : Stein describes how her AuDHD traits shift depending on her environment: "Out of the house I'm getting some kind of novelty and stimulation so the ADHD monster within is pretty satisfied... But the things that I can't control out of the house is the sensory environment and it's a less predictable social environment too and those are the things that my autistic self starts to struggle with" ( Stein, 2024 ). 4. Varied Special Interests and Hyperfixations "If you're also an ADHDer, you may be more likely to have more intense special interests for a shorter time... to use up the dopamine before switching to another one. Possibly, alongside longer running special interests... that are more stable and less prone to being suddenly bored with it" ( Stein, 2024 ). 5. Relating to Other AuDHDers "I feel like I am often, dare I say, a little bit too much for autistic people. I talk a lot and I get excited... So I do actually tend to have more friends who are just ADHDers. The irony is that these people are often too much for me. So I tend to find myself needing more downtime from socialising and more social recovery time than they do" ( Stein, 2024 ). A Walking Contradiction: Competing Needs Common internal conflicts include: Autistic Brain Wants ADHD Brain Wants Result Routine and predictability Novelty and spontaneity Internal tension Deep focus on interests Variety and stimulation Attention conflicts Quiet, controlled environments Social interaction and buzz Sensory over/underwhelm Structure and order Flexibility and freedom Planning struggles To understand the AuDHD experience it’s essential to take into account not just the external “symptoms” or behaviours linked to Autism or ADHD, but to take into account the internal experiences which are often in conflict. Stein captures this eloquently when she says in her video: "These two sides of me are both there, they're both part of me but sometimes they have completely opposite desires and needs" (Stein, 2024). The Cyclical Nature of AuDHD Mattia Maurée , an AuDHD coach and composer, highlights a unique characteristic: AuDHD follows a cyclical pattern with big bursts of energy followed by crashes ( Boyle, 2024 ). This differs from either condition alone, creating rhythms that individuals must learn to navigate. This may be a reason why we often see depression, burnout and anxiety as a common experience for AuDHD individuals. How ADHD and Autism Mask Each Other One of the most fascinating aspects of AuDHD is how each condition can effectively hide the other, creating complex presentations that often confuse both individuals and professionals. Dr. Khurram Sadiq (AuDHD psychiatrist and lived-experience expert) describes three distinct types of AuDHD presentations that help explain why diagnosis can be so challenging, and highlights the need for specialised training for clinicians who are diagnosing ADHD and or Autism effectively. ADHD-Prominent Presentation - When ADHD Masks Autism ADHD traits mask autistic features. ADHD characteristics like impulsivity, social chattiness, and emotional expressiveness can directly contradict stereotypical views of autism. A person might be: Too socially engaged to "seem autistic" Too spontaneous to fit the rigid, routinised autism stereotype Too emotionally expressive to match the "flat affect" often associated with autism Professionals often fail to look beyond single neurodivergent presentation, like ADHD, to identify underlying autistic traits. Autism-Prominent Presentation - When Autism Masks ADHD Conversely, when autism is the dominant presentation, autistic traits can effectively disguise ADHD: Intense focus on special interests might mask the difficulty sustaining attention typical in ADHD Preference for routine might contain the disorganisation associated with ADHD Social difficulties might be attributed solely to autism, missing the impulsivity and rejection sensitivity of ADHD 3. The Seesaw Presentation This mixed presentation happens when someone constantly oscillates between the two conditions. This may be experienced as an internal tension between the need for social interaction but exhaustion with social engagement, or between the desire for order and the reality of disorganisation. Dr. Sadiq notes, "ADHD can actually serve as 'a friend to autism' by preventing someone from becoming too reclusive, while autism can provide structure that helps contain ADHD's scattered energy" (ADHD Chatter). View the complete interview with Dr Sadiq on ADHD Chatter (in resources section) to learn more. Why Professionals Miss It In one case, Dr. Sadiq realised within 15 minutes that a patient referred for ADHD was actually autistic: "If I had no lived experience of autism and ADHD I would have missed it completely. I would have diagnosed either social anxiety or a personality disorder" ( Boyle, 2024 ). Strengths and Abilities: The AuDHD Advantage While challenges exist, AuDHD individuals often possess unique strengths: Cognitive Strengths: Pattern recognition across diverse contexts Creative problem-solving with systematic thinking Hyperfocus capabilities on interests Innovative thinking combining structure with flexibility Strong memory for specialised topics Social and Emotional Strengths: Deep empathy and emotional insight Strong sense of justice and authenticity Unique perspectives that challenge norms Attention to detail others miss Paul Dyson , CTO and co-founder of Singletrack, describes his AuDHD experience: "I may find it near-impossible to focus on any task that doesn't capture my interest, but give me something that does and I can hyperfocus on it, completing work in a few hours that most people would require days to do" (Dyson, 2022). Living Authentically with AuDHD Understanding AuDHD is about more than diagnosis—it's about authentic living that honours both sides of your neurotype. Key Principles for AuDHD Life: Embrace the paradox : You contain multitudes, and that's your strength Honour both sides : Create space for both autism and ADHD needs Build flexible structure : Systems that provide security with room for spontaneity Practice self-compassion : Be kind to yourself through the internal conflicts Find your community : Connect with others who understand the intersection If you see yourself in these experiences, know that: You're not broken – your brain works differently Recognition matters – understanding can transform self-perception Support exists – professionals are increasingly trained in AuDHD You're not alone – there's a growing community of AuDHD individuals Diagnosis isn't always necessary, but self-understanding can transform challenges into strengths and help support a brighter direction forward. One of our AuDHD clients describes the impact of having a diagnosis: "For years I blamed myself for things I couldn't control. This label helps me understand myself and show myself compassion." - Anonymous AuDHD Client, True North Psychology Seeking Assessment and Support Wondering if you might be AuDHD? 🔸 If you're seeking diagnosis: Research AuDHD-informed assessors in your area or online (keep this within the country or state where you live to ensure your diagnosis is recognised by local services) Collect childhood evidence and current examples Prepare questions about their assessment process Consider bringing a support person 🔸 If you're newly diagnosed: Give yourself time to process, greive and develop an understanding Connect with AuDHD communities online Explore accommodations for work/school Consider therapy with an AuDHD-informed professional 🔸 If you're supporting someone else: Educate yourself about AuDHD experiences Validate their internal conflicts and contradictions Help them find appropriate professional support Be patient with their unique rhythms and needs Finding the Right Assessment for You If you suspect you may have AuDHD, comprehensive, compassionate assessment can provide clarity and direction. What to Look For in Assessment Providers Essential Qualities: ✅ Experienced with both ADHD and autism ✅ Understand gender differences in presentation ✅ Take a strengths-based, neurodiversity-affirming approach ✅ Consider the impact of masking and a person's internal experiences ✅ Provide comprehensive post-diagnosis support At True North Psychology, we provide neurodiversity-affirming assessment and support specifically designed for individuals exploring or living with AuDHD. Our approach recognises the unique intersection of autism and ADHD while honouring your individual experience. Book a free screening call with our lead Psychologist and ADHD/ AuDHD Assessor, Dr Sara Tookey to see if our approach to assessment and therapy would be a good fit for you Questions to Ask Potential Assessors About their experience: How many AuDHD assessments have you conducted? What training do you have in both autism and ADHD? How do you assess masking behaviours and internal experiences? About their process: How long does the assessment take? Do you include breaks and accommodations? How do you handle contradictory presentations? About support: What happens after diagnosis? Do you provide resources and follow-up? Can you recommend appropriate therapists? Preparing for Assessment Collect evidence if you can: School reports and feedback Work performance reviews Examples of special interests/hyperfixations Sensory sensitivities and preferences Masking strategies you've used Bring support: Someone who knew you as a child Partner or close friend who understands your traits Written examples if verbal communication is challenging Fidget toys, comfort item, anything that will help to support you during your appointment Professional Support & Self-Management Assessment and Diagnosis Comprehensive evaluation by professionals familiar with both conditions Recognition of how symptoms interact and mask each other Understanding of gender and cultural differences in presentation Therapeutic Approaches Therapy adapted for neurodivergent individuals Occupational therapy for sensory needs and daily living skills Social skills support that acknowledges both conditions Medication management when appropriate and desired Specialised Services Neurodiversity-affirming therapists who understand AuDHD Trauma-informed care for those with complex histories Relationships therapy (family/ couples) to help those close to you understand AuDHD Executive Functioning Support Visual schedules and reminders that accommodate both structure and flexibility Breaking tasks into smaller steps with clear endpoints Creating flexible routines that allow for both predictability and novelty Using technology like apps, timers, and organisational tools Sensory Regulation Identifying individual sensory needs and triggers Creating environments that support both regulation and stimulation needs Using tools like noise-canceling headphones, fidgets, or weighted blankets Planning for sensory breaks and recovery time Social Support Building understanding support networks who "get" AuDHD Learning to recognise and respect personal limits Developing self-advocacy skills for different environments Finding community with other AuDHD individuals Daily Life Management For the home environment: Create sensory-friendly spaces that satisfy both ADHD stimulation needs and autistic regulation needs Use timers and visual cues for transitions Have both structured routines and flexibility built in For work/school: Advocate for accommodations that address both conditions Use movement breaks and fidget tools as needed Create systems that work with your unique brain patterns Finding balance: Seek friends who understand neurodivergence broadly Communicate your needs clearly and kindly Build in recovery time after social activities Remember that quality matters more than quantity in relationships Conclusion and Summary AuDHD represents a significant and growing area of understanding within neurodiversity research and practice. Far from being a trend, the co-occurrence of autism and ADHD reflects genuine differences that create unique experiences, challenges, and strengths. Key insights from this exploration include: Scientific Validity : Research consistently shows substantial overlap between autism and ADHD, with 40-70% of autistic individuals also meeting ADHD criteria Complex Presentations : The interaction between autism and ADHD creates "living contradictions" where individuals experience competing neurological needs Diagnostic Challenges : Each condition can mask the other, requiring specialists trained in recognising these complex intersections Unique Strengths : AuDHD individuals possess distinctive cognitive and social abilities that combine systematic thinking with creative flexibility Individual Journey : Understanding and support must be personalised, recognising that each person's AuDHD experience is unique Moving forward , the most important elements are: Self-compassion through the internal conflicts and contradictions Professional support from AuDHD-informed practitioners Community connection with others who understand the intersection Flexible strategies that honour both neurotypes simultaneously Whether you're exploring your own neurodivergence, supporting a loved one, or working professionally in this field, understanding AuDHD requires embracing complexity, celebrating difference, and recognising the extraordinary capabilities that emerge from this unique neurological intersection. Remember: Your brain isn't broken – it's beautifully, complexly different. And in that difference lies tremendous potential for innovation, insight, and authentic living. This article is part of True North Psychology's commitment to providing accessible, evidence-based information about neurodiversity. All content is for educational purposes and should not replace professional medical advice. Resources & Further Reading 🔗 Related Reading From Our Blog: Why Self-Compassion is So Essential to Late-Diagnosed ADHD Adults - The relationship between shame and compassion in ADHD adults The Hidden Struggle: When High-Functioning ADHD in Adulthood Leads to Burnout and Breakthrough - How high achievement can mask neurodivergence until crisis points Neurodivergent Pride and Mental Wellness for LGBTQIA+ Communities - Intersections of identity and neurodivergence Psychedelics and Neurodivergence: Understanding Current Research and Integration Needs - Explore how psychedelics might affect people with ADHD and autism and considerations for safety and integration 📺 Educational Videos 5 Signs You Have ADHD and Autism - Yo Samdy Sam - Stein's detailed explanation of AuDHD internal experiences ADHD Chatter Podcast - Dr. Khurram Sadiq on AuDHD - Expert clinical insights on assessment and presentation ADHD Chatter - Dr. Becky Quicke on AuDHD in Women - Specialized focus on women and girls ADHD Chatter - Dr. Samantha Hiew on AuDHD Research - Latest research perspectives 📚 Essential Books: " Explaining AuDHD " by Dr. Khurram Sadiq - Expert-led guide to understanding the intersection " AuDHD: Blooming Differently " by Leanne Maskell - Personal journey and practical insights " Different, Not Less " by Chloe Hayden - Neurodivergent guide to embracing your true self " Divergent Mind " by Jenara Nerenberg - Thriving in a world not designed for neurodivergent minds " How Not to Fit In " by Jess Joy and Charlotte Mia - Unapologetic guide to navigating autism and ADHD " UNMASKED " by Ellie Middleton - Ultimate guide to ADHD, autism and neurodivergence " The Neurodivergent Friendly Workbook of DBT " by Sonny Jane Wise - Practical skills workbook 🌐 Online Communities & Professional Resources Neurodivergent Practitioners Directory - neurodivergentpractitioners.org AuDHD support forums - Connect with others sharing similar experiences NHS UK list of autism resources and support for individuals, families, and employers The Autistic Self Advocacy Network (ASAN) is a leading advocacy organisation run by and for autistic individuals. Their website provides extensive information and resources on autism acceptance and neurodiversity. AuDHD blog run by AuDHD Clinical Psychologist: https://unnormal.substack.com/p/answering-your-questions 📱 Immediate Support Crisis helplines if you're experiencing mental health difficulties Online AuDHD communities for peer support and validation https://neurodivergentpractitioners.org/listing/silvia-audhd-autistic-and-adhd-support-group-for-adults/ Neurodiversity-affirming therapists directory searches 🏥 Assessment and Therapeutic Support Services True North Psychology ( Dr Sara Tookey's Practice) Neurodiversity-affirming therapy and assessments (ADHD & AuDHD) for adults (with specialisms in high-functioning, high-masking adults and LGBTQIA++ intersections) https://www.truenorth-psychology.com/adhd-assessments-and-support 👨👩👧👦 For Families & Partners Understanding AuDHD in relationships - Communication strategies and support approaches https://embrace-autism.com/audhd-and-relationships-part-i/ Parenting as neurodivergent parents - Resources neurodivergent parents: https://www.theneurodiversitypractice.com/ THINK YOU MIGHT BE AUDHD? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology, we provide neurodiversity-affirming assessment and support specifically designed for individuals exploring or living with AuDHD. Our approach recognises the unique intersection of autism and ADHD while honouring your individual experience. Ready to explore assessment or support? Contact us to learn more about our neurodiversity-affirming approach → Our AuDHD-Informed Services Include: Comprehensive assessments that understand masking and trait interaction Post-diagnosis support to help you understand and integrate your diagnosis Therapy approaches adapted for the AuDHD experience Family/partner support to help your loved ones understand your neurotype Book a FREE 30-minute Therapy Discovery Call with one of our neurodivergent-affirming Psychologists Today. Book your FREE Assessment Screening or Therapy Discovery Call STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! Subscribe to our newsletter to keep up to date on the latest news, events, resources and features from True North Psychology References ADDitude Editors. (2024). AuDHD Medication Side Effects: When Stimulants Unmask Autism Traits. ADDitude Magazine . https://www.additudemag.com/audhd-medication-side-effects/ Boyle, S. (2024, April 4). The sudden rise of AuDHD: what is behind the rocketing rates of this life-changing diagnosis? The Guardian . https://www.theguardian.com/lifeandstyle/2024/apr/04/audhd-what-is-behind-rocketing-rates-life-changing-diagnosis Embrace Autism. (2024). AuDHD & stimulant medication. https://embrace-autism.com/audhd-and-stimulant-medication/ Mackereth, L. (2025). Uncovering Autism and ADHD in Gifted Adults: Burnout as a Diagnostic Catalyst. https://lindseymackereth.substack.com/p/adult-autism-andor-adhd-diagnosis Maskell, L. (2024). Assessments, Answers & Acceptance: ADHD & Autism. LinkedIn . https://www.linkedin.com/pulse/assessments-answers-acceptance-adhd-autism-leanne-maskell-bj2we Quicke, B. (2019). Dr Becky Quicke - Clinical Psychologist & Founder - Autistic Girls. LinkedIn . https://www.linkedin.com/in/dr-becky-quicke-965268b5/ Saline, S. (2022). Self-Compassion Practice for ADHD Shame. ADDitude Magazine . https://www.additudemag.com/self-compassion-practice-adhd-shame/ Saporito, K. (2024). ADHD, Autism, and Neurodivergence Are Coming Into Focus. ADDitude Magazine . https://www.additudemag.com/saporito-adhd-autism-neurodivergence/ Stein, S. (2024). 5 Signs You Have ADHD and Autism [Video]. YouTube . https://www.youtube.com/watch?v=pMx1DnSn-eg Waldren, L. H., Leung, F. Y., Hargitai, L. D., Burgoyne, A. P., Liceralde, V. R., Livingston, L. A., & Shah, P. (2024). Unpacking the overlap between Autism and ADHD in adults: A multi-method approach. Cortex , 160, 172-190. https://www.sciencedirect.com/science/article/pii/S0010945224000145?via%3Dihub
- Unlocking ADHD Motivators: The INCUP Framework for High-Functioning ADHD Minds
Written by Dr Sara Tookey For ADHD adults, finding motivation can sometimes feel like searching for a hidden switch that mysteriously activates only under certain conditions. If you've ever wondered why you can focus intensely on certain activities whilst struggling to begin others, you're not alone. This inconsistency in motivation is a fundamental aspect of how the ADHD brain works—and understanding it can transform how you approach daily tasks and long-term goals. Key Learning Points: Interest-Based vs. Importance-Based: Adults with ADHD typically operate with an interest-based nervous system rather than the importance-based system most productivity advice assumes. INCUP Framework: Interest, Novelty, Challenge, Urgency, and Passion are the five key motivational triggers for the ADHD brain. Interest: Activities that naturally spark interest provide essential dopamine, making engagement possible or even effortless for ADHD minds. Novelty: The ADHD brain responds strongly to what's new and different; changing environments or approaches can boost motivation. Challenge: The right level of challenge creates flow states that bypass typical ADHD attention difficulties. Urgency: Time pressure often triggers intense focus in ADHD minds; creating artificial urgency through timers can help initiate tasks. Passion: Connecting tasks to core values and larger purpose provides sustained motivation beyond immediate interest. Self-Compassion: Understanding your ADHD motivational patterns as different (not deficient) is key to developing effective strategies. Environmental Design: Intentionally create spaces and routines that incorporate INCUP elements whilst minimising unhelpful distractions. Working with Your Brain: Success with ADHD isn't about forcing neurotypical approaches, but leveraging your unique motivational profile. Read more about ADHD in adulthood and learn strategies that can help you thrive with your unique mind. See our related articles: " 12 Most Damaging Myths About Adult ADHD: Facts About ADHD in Adulthood" , By Dr Sara Tookey " LGBTQIA+ and Neurodivergent: Shining a Light on Intersectionality and Mental Health" , By Dr Sara Tookey " The Hidden Struggle: When High-Functioning ADHD in Adulthood Leads to Burnout and Breakthrough" , By Dr Sara Tookey ' Is Adult ADHD the Latest Trend? ', By Dr Sara Tookey " Why Self-Compassion is Essential for High-Functioning and Late-Diagnosed ADHD Adults ", By Dr Sara Tookey " Psychedelics and Neurodivergence: Understanding Current Research and Integration Needs ", By Dr Sara Tookey " Do You Need a Formal Diagnosis of ADHD or Autism in Adulthood? A Neurodivergence-informed Perspective ", By Dr Sara Tookey " The Neurodiversity Paradigm: How Embracing Cognitive Diversity Transforms Workplace Culture " , By Dr Sara Tookey The Interest-Based Nervous System and High-Functioning ADHD Traditional approaches to productivity often assume everyone operates with an importance-based nervous system —one that responds reliably to deadlines, consequences, and obligations. However, many ADHD adults function primarily through an interest-based nervous system , which responds to entirely different motivational factors (Volkow et al., 2011). This difference isn't about willpower or character; it's about neurobiology. The ADHD brain typically has altered dopamine functioning, which affects how we experience motivation, reward, and the ability to initiate and sustain attention (Volkow et al., 2009; Hoogman et al., 2017). Introducing INCUP: The Five Motivational Keys for ADHD Minds Psychologist Dr William Dodson proposed the INCUP framework to describe the five primary factors that effectively motivate the ADHD brain (Dodson, 2021). Understanding these can help you work with your neurobiology rather than against it. Interest For the ADHD brain, genuine interest is perhaps the most powerful motivator. When something captures your interest, your brain releases dopamine—the neurotransmitter associated with pleasure, reward, and attention—allowing you to engage more fully. Why it matters : People with ADHD typically have lower baseline levels of dopamine. Activities that naturally spark interest provide that crucial dopamine boost, making engagement possible and sometimes even effortless (Luman et al., 2010; Sonuga-Barke, 2005). Practical application : Look for aspects of necessary tasks that genuinely interest you. Can you approach a work project from an angle that engages your curiosity? Can you connect routine responsibilities to larger interests or values that matter to you? Novelty The ADHD brain is particularly responsive to what's new and different. Novel experiences and approaches can trigger dopamine release, making it easier to engage with tasks that might otherwise feel mundane. Why it matters : The pursuit of novelty isn't merely preference—it's a neurobiological response that can significantly impact your ability to focus and engage (Kooij et al., 2019; Tegelbeckers et al., 2016). Practical application : Introduce new elements to routine tasks. Work in different environments, use different tools, or approach familiar tasks from new angles. Even small changes can stimulate the novelty response. Challenge Many adults with ADHD find themselves remarkably focused when facing the right kind of challenge. When a task requires problem-solving and stretches your abilities (without overwhelming them), it can become intrinsically motivating. Why it matters : The right level of challenge creates a state of flow and engagement that can bypass typical attention difficulties (Csikszentmihalyi, 1990; Østergaard et al., 2021). Practical application : Break larger tasks into smaller challenges with clear completion points. Set challenges for yourself with meaningful rewards. Remember that the challenge should be sufficient to engage your problem-solving abilities without triggering avoidance. Urgency The approaching deadline, the last-minute preparation—these scenarios often trigger intense focus and productivity in ADHD minds. While this isn't always the healthiest motivation pattern, understanding it can help harness its power more effectively. Why it matters : The urgency response often creates what many with ADHD describe as "11th-hour clarity"—a sudden ability to focus intensely when time pressure becomes real (Rubia et al., 2009; Toplak et al., 2013). Practical application : Create artificial urgency through timers, accountability systems, or breaking work into smaller "urgent" segments. The Pomodoro Technique (working in focused 25-minute intervals) can be particularly effective for creating manageable urgency. Passion When something deeply matters to you—when it connects to your values, identity, or vision—the motivation often follows. Passion can create sustained interest that overcomes typical ADHD barriers to engagement. Why it matters : Passion creates meaning, and meaningful activities are more likely to sustain attention even through difficult aspects of the work (Sedgwick et al., 2019; Hupfeld et al., 2019). Practical application : Connect tasks to your core values and larger purpose whenever possible. Look for ways your work or responsibilities contribute to what matters most to you. Beyond Understanding: Creating INCUP-Friendly Environments Understanding these motivation factors is only the beginning. The next step is intentionally designing your life and work to incorporate them: Environmental design : Create spaces and routines that naturally incorporate novelty and interest whilst minimising distractions that don't serve you. Task restructuring : Break larger responsibilities into smaller, more challenge-oriented components with clear completion points. Motivation mapping : Identify which INCUP factors work best for different types of tasks. Some may respond better to urgency, whilst others might need a passion connection. Self-compassion practice : Recognise that your motivational patterns are different, not deficient. Working with your neurobiology rather than against it is both more effective and kinder to yourself. The Role of ADHD Treatment Whilst understanding and applying the INCUP framework can significantly improve your relationship with motivation, effective ADHD management often requires a comprehensive approach. ADHD medications work directly on dopamine systems, helping to address the neurobiological factors that affect motivation (Faraone et al., 2021; Cortese et al., 2018). Therapeutic approaches such as Cognitive Behavioural Therapy and coaching can also provide valuable strategies for implementing INCUP principles in daily life (Young et al., 2020; Lopez et al., 2018). At True North Psychology, we take a holistic approach to ADHD support, combining medication management (where appropriate) with psychological strategies tailored to your unique brain. True North Psychology protected image, 2025 Conclusion: Working With Your Brain, Not Against It Living successfully with ADHD isn't about forcing yourself to operate like a neurotypical brain. It's about understanding your unique motivational profile and creating environments where you can thrive. The INCUP framework offers a compassionate and effective way to approach productivity and engagement. Rather than seeing inconsistent motivation as a personal failing, recognise it as valuable information about how your brain works best. By intentionally incorporating interest, novelty, challenge, urgency, and passion into your life and work, you can unlock motivation patterns that feel more natural and sustainable. This isn't just about getting things done—it's about honouring your neurodiversity whilst creating a life that works with your brain rather than against it. Final Point: What Everybody Needs to Know About Neurodivergence Whether diagnosed or not, neurodivergent individuals often face systemic barriers and vulnerabilities. Whether professionally diagnosed or self-identified, it's crucial to remember that being neurodivergent is not a choice. For those who self-diagnose later in life, traits may become more apparent as they feel safer to be themselves. Supporting individuals on their journey of self-discovery, regardless of their diagnostic status, is essential for their well-being and self-acceptance. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. WANT TO LEARN MORE? Read Our Related Articles " 12 Most Damaging Myths About Adult ADHD: Facts About ADHD in Adulthood" , By Dr Sara Tookey " LGBTQIA+ and Neurodivergent: Shining a Light on Intersectionality and Mental Health" , By Dr Sara Tookey " The Hidden Struggle: When High-Functioning ADHD in Adulthood Leads to Burnout and Breakthrough" , By Dr Sara Tookey ' Is Adult ADHD the Latest Trend? ', By Dr Sara Tookey " Why Self-Compassion is Essential for High-Functioning and Late-Diagnosed ADHD Adults ", By Dr Sara Tookey " Psychedelics and Neurodivergence: Understanding Current Research and Integration Needs ", By Dr Sara Tookey " Do You Need a Formal Diagnosis of ADHD or Autism in Adulthood? A Neurodivergence-informed Perspective ", By Dr Sara Tookey " The Neurodiversity Paradigm: How Embracing Cognitive Diversity Transforms Workplace Culture " , By Dr Sara Tookey Curious About ADHD in yourself or someone you know? Book a free screening call with Dr. Tookey to learn about our compassionate assessment approach At TNP we specialise in High-Functioning ADHD and other non-typical presentations of ADHD. Explore our neurodiversity-affirming therapy services If you're looking for support with ADHD, including assessment, diagnosis, or management strategies, our team at True North Psychology offers neurodiversity-affirming psychological services. Contact us today to learn how we can help you work with your unique brain. STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. NEED THERAPEUTIC SUPPORT? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology we provide a neurodiversity-affirming and inclusive approach to therapy - listening to neurodivergent voices and providing appropriate accommodations and approaches to supportive our clients and staff. Psychologists on our platform have experience of working with neurodiverse individuals and some have special interests and expertise in the areas of ADHD and Autism. Book a FREE 30-minute Therapy Discovery Call with one of our neurodivergent-affirming Psychologists Today. Get Started & Book your Therapy Discovery Call References Cortese, S., Adamo, N., Del Giovane, C., Mohr-Jensen, C., Hayes, A. J., Carucci, S., et al. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 5(9), 727–738. Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. Harper & Row. Dodson, W. (2021). How ADHD ignites rejection sensitive dysphoria. ADDitude Magazine. https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-emotional-dysregulation/ Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., et al. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. Hoogman, M., Bralten, J., Hibar, D. P., Mennes, M., Zwiers, M. P., Schweren, L. S., et al. (2017). Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: A cross-sectional mega-analysis. The Lancet Psychiatry, 4(4), 310–319. Hupfeld, K. E., Abagis, T. R., & Shah, P. (2019). Living "in the zone": Hyperfocus in adult ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11, 191-208. Kooij, J. J. S., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balázs, J., et al. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56(1), 14–34. Lopez, P. L., Torrente, F. M., Ciapponi, A., Lischinsky, A. G., Cetkovich-Bakmas, M., Rojas, J. I., et al. (2018). Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, 3. Luman, M., Tripp, G., & Scheres, A. (2010). Identifying the neurobiology of altered reinforcement sensitivity in ADHD: A review and research agenda. Neuroscience & Biobehavioral Reviews, 34(5), 744–754. Rubia, K., Halari, R., Christakou, A., & Taylor, E. (2009). Impulsiveness as a timing disturbance: Neurocognitive abnormalities in attention-deficit hyperactivity disorder during temporal processes and normalization with methylphenidate. Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1525), 1919–1931. Sonuga-Barke, E. J. S. (2005). Causal models of attention-deficit/hyperactivity disorder: From common simple deficits to multiple developmental pathways. Biological Psychiatry, 57(11), 1231–1238. Tegelbeckers, J., Bunzeck, N., Duzel, E., Bonath, B., Flechtner, H.-H., & Krauel, K. (2016). Altered salience processing in attention deficit hyperactivity disorder. Human Brain Mapping, 37(6), 2244–2257. Volkow, N. D., Wang, G.-J., Kollins, S. H., Wigal, T. L., Newcorn, J. H., Telang, F., et al. (2009). Evaluating dopamine reward pathway in ADHD: Clinical implications. JAMA, 302(10), 1084–1091. Volkow, N. D., Wang, G.-J., Newcorn, J. H., Kollins, S. H., Wigal, T. L., Telang, F., et al. (2011). Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Molecular Psychiatry, 16(11), 1147–1154. Young, Z., Moghaddam, N., & Tickle, A. (2020). The efficacy of cognitive behavioral therapy for adults with ADHD: A systematic review and meta-analysis of randomized controlled trials. Journal of Attention Disorders, 24(6), 875-888.
- Psychedelic Therapy, a Crucial Conversation for Mental Health
Written by, Dr Sara Tookey Psychedelic Renaissance - created by True North Psychology, protected image Perhaps you've heard the term “psychedelics” being discussed more openly across mainstream spaces lately? This is largely due to a phenomenon known as the ‘Psychedelic Renaissance’, which has been gaining momentum, capturing the attention of scientists, mental health professionals, policymakers and the general public. This renaissance marks a revival of research into psychedelic substances such as psilocybin, LSD, and MDMA, focusing on their potential therapeutic benefits, especially for mental health conditions. In some regions psychedelics are being approved for medical use, decriminalised or are obtaining full legalised status. As a therapist involved in psychedelic research, I’ve witnessed the power these experiences can have when applied therapeutically. In this article, we'll delve into what's driving this renewed interest in psychedelic-assisted therapy and why it's such a crucial conversation for the future of mental healthcare. The Comeback of Psychedelic Science How Psychedelic Therapy Works Questions and Challenges The Necessity of Clinical Standards of Care The Importance of Preparation and Integration Conclusion The Comeback of Psychedelic Science Psychedelics have been around for thousands of years. They have been held as sacred for many cultures and demonised and subsequently made illegal by others. In the 1950s psychedelic drugs were the subject of extensive psychiatric research in the US. By 1960, they had been found to be non-addictive, to have remarkable safety profiles, and with the potential to treat a range of psychological conditions. However, in 1968, the possession of psychedelics was criminalised by the US federal government. As the “War on Drugs” was forged, research into psychedelics was halted for decades and psychedelics became known as dangerous recreational drugs with no medical value. Now we are seeing psychedelics undergo a major scientific renaissance. Researchers around the world are rigorously re-examining these compounds as potential breakthrough treatments for conditions like depression, anxiety, OCD, anorexia, PTSD, addiction and existential distress at end-of-life. This burgeoning field has been termed the “ psychedelic renaissance ” . Recent early clinical trials have produced remarkable results in treating mental illnesses that conventional methods often struggle with. For example, studies have found that a few guided sessions with psilocybin can rapidly reduce anxiety and depression symptoms in people with cancer and the benefits last for months (See the research studies here Griffiths et al., 2016 ; Ross et al., 2016 ). Other research found MDMA-assisted therapy helped participants overcome PTSD, including hard-to-treat dissociative PTSD (See the research studies here Mitchell et al., 2021 ; Mithoefer et al., 2019 ). Research findings show significant improvements in depression for people where no other treatment has been successful (See the research studies here Carhart-Harris et al., 2021 ; Davis et al., 2021 ; Goodwin et al., 2022 ). Findings have also indicated that ketamine, which has some psychedelic effects, can lift people from severe depression within hours when other treatments have failed. Mental illnesses are typically treated with pharmaceuticals or talking therapy, or a combination of the two. The first-line of treatment is often SSRIs , with many being prescribed by a family doctor or general practitioner, NOT a psychiatrist or a trained mental health professional. These drugs can take weeks to take effect, they often have unpleasant side effects and for many they simply don’t work. Remission rates vary from 30 to 45 percent (Carvalho et al., 2007) - meaning that for 55 to 70 percent of people, SSRIs do not alleviate their depression. Compared to existing pharmaceuticals that require daily, lifelong use, for some people psychedelics appear to yield durable relief after limited doses. This challenges the standard psychiatric paradigm. The profound changes psychedelics catalyse feel wholly different from conventional therapies. Research is currently underway to determine the long-term efficacy of this approach to treatment. However, many participants involved in these studies have described their psychedelic sessions as among the most meaningful experiences of their lives (See and research here Griffiths et al., 2008 ). Who can say that about SSRI-effects? Psychedelics and the mind, created by True North Psychology- protected image How Psychedelic-Assisted Therapy Works Despite the use of psychedelics over centuries and the recent resurgence of research into this area, how psychedelics work remains debated. Proposed theories include: Default Mode Network Disruption: Psychedelics may relax a person’s beliefs, by reducing activity in the default mode network (DMN) in the brain (See the research here Carhart-Harris & Friston, 2019 ; Gattuso et al., 2023 ). The DMN consists of interconnected brain areas involved in introspective processes like self-reflection and rumination. This network is involved when the mind wanders, when we imagine the future and when we empathise with others. Overactivity in the default mode network has been associated with conditions like depression, anxiety and OCD. This theory proposes that the intense psychedelic experience seems to temporarily weaken engrained thought patterns underlying conditions like depression. This allows old perspectives to move out of focus and new outlooks and emotions arise. With guidance and dedication to the process, patients can integrate these insights after sessions and have the opportunity to sustain positive changes in their worldview and mental health ( See the research here Barber & Aaronson, 2022 ). Social Cognition and Theory of Mind : A recent analysis has added an additional layer to the DMN theory. It found psychedelics activate overlapping regions involved in self-reflection, autobiographical memory and social thinking. Rather than disabling the DMN, psychedelics seem to alter how brain systems underlying our sense of self and social cognition interact (Soares et al., 2023). This suggests psychedelics may increase empathy, emotional openness and feelings of connection by changing neural networks that shape our perceptions of ourselves and others. Reopening Critical Periods: Recent animal research found psychedelics can temporarily reopen "critical periods'' in the mouse brain when it is highly receptive to learning from the environment (Nardou et al., 2023). Critical periods are times of heightened neural plasticity when the brain readily forms new connections, like in childhood development. It's believed that psychedelics have a unique ability to facilitate new learning and personal growth, which could be at the core of their therapeutic effects. While intriguing theories exist about how psychedelics impact the brain, there's still a lot we don't understand about how they work. More research is needed to unravel the complex interplay between acute psychedelic drug effects, changes in brain activity and the psychotherapy process. It's tricky to tease apart how much of the benefits come from the psychedelic experience versus the therapy sessions that guide them. The widely accepted theory about the importance of “Set and Setting” highlights the crucial role that psychological mindset and environmental context play in shaping psychedelic experiences. "Set" refers to the mental state, intentions, expectations and personality of the person having the experience. "Setting" is the physical, social and cultural environment in which the psychedelic session takes place ( Hartogsohn, 2017 ). This theory proposes that set and setting profoundly influence the subjective effects of psychedelics as well as the outcomes. A supportive set and setting can facilitate healing, growth and positive outcomes ( Carhart-Harris et al., 2018 ). However, challenging set or setting factors may precipitate difficult, even traumatic experiences ( Johnson et al., 2008 ). Extensive preparation of set, optimising setting for comfort and safety, and integration practices afterwards are considered crucial for safe, beneficial psychedelic-assisted therapy. The quality of the therapist-patient relationship also interacts with set and setting. Trust and compassionate care from guides can help anchor challenging psychedelic journeys ( Murphy et al., 2022 ; Watts et al., 2017 ). In summary, set, setting and a trusting therapeutic relationship are crucial contextual factors mediating psychedelic effects. Carefully considering them is key for therapeutic applications. Developing a more comprehensive understanding of how the subjective psychedelic experience is connected with changes in the brain and the role of the psychotherapeutic processes involved will be key. For now, it’s wise to keep an open yet sceptical mindset about explanations proposed for how psychedelics lead to psychological changes. Careful research can continue uncovering deeper insights into these multifaceted substances. Nevertheless, we have more to learn about how they exert their powerful influences on the mind, brain and behaviour. Questions and Challenges While the research findings are promising, many questions remain unanswered about psychedelic-assisted therapies. Most study participants so far have been white, highlighting the urgent need to study psychedelics across diverse populations (see research article here Thrul & Garcia-Romeu, 2021 ) . There is still much to learn regarding how psychedelics work, who they can help most, and the best ways to deliver treatment equitably and effectively. In addition to testing efficacy and safety through larger trials, responsible implementation poses philosophical and practical challenges. As these treatments move towards mainstream acceptance, avoiding commercialisation and the 'hype' crucial. The psychedelic experience is hard to quantify and doesn't fit biomedical models neatly. As research protocols continue to test and refine techniques, retaining a sense of awe and open-minded inquiry will be important. Even if clinical techniques are sound, applying them thoughtfully in complex social contexts requires wisdom and flexibility. Advocates will need to be discerning to integrate psychedelics responsibly into mental healthcare and society. It is also vital we honour the Indigenous roots of most psychedelics. These compounds initially emerged through deep traditional relationships with plant medicines. As Western science explores their healing potential, preventing extractive dynamics and embracing Indigenous wisdom practices on their own terms are imperatives. Indigenous philosophies can guide this renaissance toward an equitable future where communal healing spaces thrive alongside clinical applications. It is important to acknowledge that there are alternative contexts outside of clinical treatment that offer therapeutic psychedelic experiences. These may include spiritual or religious settings. This article merely focuses more on clinical perspectives, since this is the area I can speak from with my knowledge and experience. On a practical level, training of psychedelic therapists and careful screening will be key to ensure safety and ethical care. Holistic approaches in tune with psychedelics’ multifaceted impacts are ideal. Despite remaining questions, this revival represents long-overdue re-evaluation of mental healthcare. With care and wisdom, psychedelics could help alleviate the suffering of many. The Necessity of Clinical Standards of Care in Psychedelic Therapy The growing popularity of psychedelic therapies has led to a rapid increase in retreats and clinics offering these treatments. However, many do not establish or follow rigorous clinical standards of care, which can endanger participants and the potential for these therapies. Psychedelic therapy is not without its risks ( Evans et al., 2023 ; we address these risks in our Aug 2024 article ). Implementing ethical and clinical standards is critical. This should include: Ensuring Participant Safety: Careful screening, medical supervision and appropriate dosing guidelines to minimise risks and promote safe environments. Promoting Ethical Practices: Clear informed consent, confidentiality and professionalism protocols to prevent potential for exploitation and to build patient trust. Facilitating Effective Treatment: While it’s important to understand how psychedelic-assisted therapies can be applied across various settings (like in clinics, retreats, etc), clinical research trials need to continue to develop and implement clearly defined protocols and allow for controlled comparisons to learn how psychedelic-assisted therapies can be most effective and for whom. The Importance of Preparation and Integration Psychedelic-assisted therapy can be a major catalyst for change, but it is not the magic cure. Work is often required after the psychedelic session to make sense of one’s experience and integrate insights into their daily life. In addition to clinical standards during sessions, properly preparing participants beforehand and integrating insights afterwards is equally important. People embarking on psychedelic therapy must learn to navigate potential challenges and set supportive intentions. Post-session integration through self-reflection, non-directive integration sessions or sharing circles, and or psychedelic-informed psychotherapy ( which I plan to write more about in a future post ) can support lasting wellbeing improvements. Psychedelics alone are not therapy — support before, during and after facilitates the healing in psychedelic-assisted therapy. You can learn more about preparation, integration and psychedelic-informed therapy from our integration therapy page and related blog articles . Conclusion & Summary In summary, the psychedelic renaissance offers new optimism and questions. There is still much more to learn about how psychedelics work, who they can help most, and the best ways to deliver treatment equitably and effectively. These substances display unique potential for mental health, but realising benefits requires responsible science, attending to possible risks and implementing compassionate care. By proceeding thoughtfully and prioritising ethics and the wellbeing of individuals receiving these treatments above all, psychedelic-assisted therapies could offer a desperately-needed shift to the existing model of mental healthcare. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. Stay Connected Are you curious about psychedelic experiences or wish to join a supportive community to integrate non-ordinary states of consciousness? Join our monthly online integration group or schedule a consultation to explore preparation, integration, and psychedelic-informed therapy. We welcome your thoughts and reflections on this article. EMBODI Integration Community Project JOIN our monthly online integration group, taking place typically on the last Wednesday of each month. Need one to one support? Want to explore preparation, integration, and psychedelic-informed therapy for yourself. Book a FREE Discovery Call with one of our Psychedelic-integration specialist therapists or book a Comprehensive Initial Consultation with our Clinical Director, Dr Sara Tookey. Subscribe to our newsletter to keep up to date on the latest news, events, content, resources and features from True North Psychology Our TNP DISCLAIMER: Our site provides information for educational purposes only, and is a platform to connect people with qualified therapists. It does not provide professional mental health or medical advice. We do not offer psychedelic-assisted therapies or access to illegal substances. Requesting such services is prohibited. We cannot help locate psychedelic-assisted therapy, guided sessions, or retreats. We may provide publicly available information about eligible clinical research trials for research participation purposes only. Our therapists provide support which adopts a harm reduction perspective and does not encourage illicit substance use. We do not work with individuals experiencing active psychosis, although we can assist in making sense of past psychotic episodes for those under professional care. We do not act as experts on psychedelics or altered states, nor provide advice on their use. We are not liable for risks associated with using information from our site. Psychedelic References and Resources- created by True North Psychology, protected image References Barber, G. S., & Aaronson, S. T. (2022). The emerging field of psychedelic psychotherapy. Current Psychiatry Reports, 24(10), 583–590. https://doi.org/10.1007/s11920-022-01363-y Carhart-Harris, R. L., Bolstridge, M., Day, C. M. J., Rucker, J., Watts, R., Erritzoe, D. E., Nour, M., Conway, C., Rickard, J. A., Forbes, B., Feilding, A., Taylor, D., Pilling, S., Curran, V. H., & Nutt, D. J. (2018). Psilocybin with psychological support for treatment-resistant depression: Six-month follow-up. Psychopharmacology, 235(2), 399–408. https://doi.org/10.1007/s00213-017-4771-x Carhart-Harris, R. L., & Friston, K. J. (2019). REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics. Pharmacological Reviews, 71(3), 316–344. https://doi.org/10.1124/pr.118.017160 Carvalho, A. F., Cavalcante, J. L., Castelo, M. S., & Lima, M. C. (2007). Augmentation strategies for treatment-resistant depression: A literature review. Journal of Clinical Pharmacy and Therapeutics, 32(5), 415-428. https://doi.org/10.1111/j.1365-2710.2007.00846.x Cavarra, M., Falzone, A., Ramaekers, J. G., Kuypers, K. P. C., & Mento, C. (2022). Psychedelic-assisted psychotherapy—A systematic review of associated psychological interventions. Frontiers in Psychology, 13, Article 887255. https://doi.org/10.3389/fpsyg.2022.887255 Doblin, R. (2021). MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27(6), 1025-1033. https://doi.org/10.1038/s41591-021-01336-3 Fadiman, J. (2011). The psychedelic explorer's guide: Safe, therapeutic, and sacred journeys. Park Street Press. Gattuso, J. J., Perkins, D., Ruffell, S., Lawrence, A. J., Hoyer, D., Jacobson, L. H., Timmermann, C., Castle, D., Rossell, S. L., Downey, L. A., Pagni, B. A., Galvão-Coelho, N. L., Nutt, D., Erritzoe, D., & Watts, R. (2023). Default mode network modulation by psychedelics: A systematic review. International Journal of Neuropsychopharmacology. Advance online publication. https://doi.org/10.1093/ijnp/pyac074 Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181–1197. https://doi.org/10.1177/0269881116675513 Griffiths, R. R., Richards, W. A., Johnson, M. W., McCann, U. D., & Jesse, R. (2008). Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. Journal of Psychopharmacology, 22(6), 621–632. https://doi.org/10.1177/0269881108094300 Hartogsohn, I. (2017). Constructing drug effects: A history of set and setting. Drug Science, Policy and Law, 3, 2050324516683325. https://doi.org/10.1177/2050324516683325 Johnson, M., Richards, W., & Griffiths, R. (2008). Human hallucinogen research: Guidelines for safety. Journal of Psychopharmacology, 22(6), 603–620. https://doi.org/10.1177/0269881108093847 Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., Ot'alora G, M., Garland, E. L., Howard, M. O., Hope, S., Roberts, J., Lamson, K., Barker, S., Cortes, M. A., Cooper, M., Gorman, I., Frank, I., Bartlett, M., Malone, T. C., Iosifescu, D. V., Poulter, B., Aristizábal, J. C., Strassman, R. J., Quirk, G. J., Trujillo, K. A., St John, H., Hubble, M. A., & Doblin, R. (2021). MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27(6), 1025-1033. https://doi.org/10.1038/s41591-021-01336-3 Mithoefer, M. C., Feduccia, A. A., Jerome, L., Mithoefer, A. T., Wagner, M., Walsh, Z., Hamilton, S., Yazar-Klosinski, B., Emerson, A., & Doblin, R. (2019). MDMA-assisted psychotherapy for treatment of PTSD: Study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology, 236(9), 2735–2745. https://doi.org/10.1007/s00213-019-05249-5 Murphy, R., Kettner, H., Zeifman, R., Giribaldi, B., Kartner, L., Martell, J., Read, T., Murphy-Beiner, A., Baker-Jones, M., Nutt, D., Erritzoe, D., Watts, R., & Carhart-Harris, R. (2022). Therapeutic alliance and rapport modulate responses to psilocybin assisted therapy for depression. Frontiers in Pharmacology, 12, Article 788155. https://doi.org/10.3389/fphar.2021.788155 Nardou, R., Sawyer, E., Song, Y.J., Page-Harley, L. & Roth, B.L. (2023). Psychedelics reopen the social reward learning critical period. Nature, 618, 790–798. https://doi.org/10.1038/s41586-023-06204-3 Soares, C., Gonzalo, G., Castelhano, J., & Castelo-Branco, M. (2023). The relationship between the default mode network and the theory of mind network as revealed by psychedelics – A meta-analysis. Neuroscience and Biobehavioral Reviews, 152, 105325. https://doi.org/10.1016/j.neubiorev.2023.105325 Thrul, J., & Garcia-Romeu, A. (2021). Whitewashing psychedelics: Racial equity in the emerging field of psychedelic-assisted mental health research and treatment. Drugs: Education, Prevention and Policy. Advance online publication. https://doi.org/10.1080/09687637.2021.1897331 Trope, A., Anderson, B. T., Hooker, A. R., Glick, G., Stauffer, C., & Woolley, J. D. (2019). Psychedelic-assisted group therapy: A systematic review. Journal of Psychoactive Drugs, 51(2), 174–188. https://doi.org/10.1080/02791072.2019.1593559 Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-Harris, R. (2017). Patients’ accounts of increased “Connectedness” and “Acceptance” after psilocybin for treatment-resistant depression. Journal of Humanistic Psychology, 57(5), 520–564. https://doi.org/10.1177/0022167817709585
- Navigating the Ethical Landscape of Psychedelic Therapy
Written by Dr Sara Tookey A True North Psychology Publication Key Points Indigenous wisdom and practices must be respected and acknowledged in modern psychedelic therapy Clear professional boundaries and safety protocols are essential, particularly regarding consent and touch Equity in access and representation is crucial to avoid perpetuating healthcare disparities Balanced communication about benefits and risks is necessary to avoid sensationalisation Comprehensive ethical frameworks must guide research, training and clinical practice If you like this article you might enjoy reading our other psychedelic-assisted therapy related articles: Psychedelic Harm Reduction and Integration for Mental Health Professionals , by Dr Sara Tookey Psychedelic Integration: What is it and who can benefit from it? by Dr Sara Tookey Psychedelic Integration Tools and Techniques by Dr Sara Tookey Psychedelic Preparation: What is it and who can benefit from it? by Dr Sara Tookey Beyond the Hype: A Balanced Look at Psychedelic Therapy Risks by Dr Sara Tookey Exploring the Psychedelic Renaissance: Psychedelic Therapy, a Crucial Conversation for Mental Health by Dr Sara Tookey Introduction As psychedelic-assisted therapy gains momentum in mental health research and moves closer to mainstream practice in several regions worldwide, it brings important ethical considerations to the forefront. This article builds upon our previous discussion of risks and harm reduction in psychedelic therapy to explore key ethical challenges facing the field today. The increasing commercialisation of psychedelic-assisted therapy raises complex ethical concerns that extend beyond the clinical realm. A recent consensus statement from the Hopkins-Oxford Psychedelics Ethics (HOPE) Working Group highlights several key ethical considerations ( Jacobs et al., 2024 ). Historical Roots and Indigenous Recognition Ancient Wisdom in Modern Practice Archaeological evidence reveals a 10,000-year history of structured psychedelic use in human societies. As noted by UC Berkeley researcher Yuria Celidwen, what we call 'psychedelics' were known as 'spirit medicines' in indigenous traditions, serving not only healing purposes but also strengthening community bonds and maintaining ecological balance. This long history of safe and effective use offers important lessons for modern practice ( Celidwen et al., 2023 ). The psychedelic research community must acknowledge the contributions of Indigenous communities with long histories of psychedelic use. Efforts should be made to engage with these communities in respect, reciprocity and appropriate benefit-sharing. This includes ensuring Western medical practices and health policies respect rather than interfere with traditional and spiritual uses ( Celidwen et al., 2023 ). Cultural Preservation and Indigenous Rights The surge in interest in psychedelic therapy has raised serious concerns about impacts on indigenous communities. Current challenges include: The rise of 'psychedelic tourism' disrupting traditional practices Concerns regarding cultural appropriation and exploitation of indigenous knowledge Questions surrounding intellectual property rights as Western companies patent psychedelic compounds The pressing need for protection of traditional practices and knowledge systems Safety and Professional Standards in Psychedelic-Therapy Clinical Guidelines and Risk Assessment Whilst classic psychedelics are generally safer than previously thought, their risks require careful consideration. Researchers and regulatory bodies must ensure rigorous collection of both benefit and adverse effect data, particularly regarding long-term and 'nonstandard' effects ( Breeksema et al., 2022 ). The informed consent process presents unique challenges given the nature of psychedelic experiences. Clinicians must carefully balance discussing potential transformative benefits with the risks of adverse effects or disappointment. The framing of information during consent may significantly impact patient experiences by influencing their mindset and the therapeutic environment ( McGuire et al.,2024 ). Professional Boundaries and Touch The altered state induced by psychedelics creates distinct challenges for maintaining professional boundaries, particularly regarding physical touch. Whilst indigenous healing traditions may have different cultural protocols, Western clinical settings require specific guidelines, especially given recent cases of abuse in North American psychedelic research ( McGuire et al.,2024 ). Clinical practice distinguishes between three types of touch: Safety-related touch (necessary and permitted) Supportive/'therapeutic' touch (requires careful consideration) Sexual touch (strictly prohibited) Current best practices require explicit discussion of touch during informed consent, shared decision-making, ongoing consent protocols and thorough practitioner training in boundary maintenance. These guidelines must balance potential therapeutic benefits with patient safety whilst remaining culturally appropriate. Equity and Access of Psychedelic Therapy Addressing Systemic Barriers The path towards mainstream acceptance raises critical questions about who can access these treatments and under what conditions. As Hughes and Garcia-Romeu (2024) emphasise, an equity-oriented approach must be central to both research and clinical practice to avoid perpetuating existing healthcare disparities. Ensuring equity requires meaningful representation of marginalised groups across research, training and policy development ( Fogg et al., 2021 ). Building trust demands culturally competent protocols, reduced financial and geographic barriers to access, and targeted outreach to underserved communities. and targeted outreach and education efforts. Professional Gatekeeping and Regulation As psychedelic therapies move towards approval, the field must carefully balance safety through appropriate regulation with the need for broad access ( McGuire et al.,2024 ). Key considerations include determining who will have authority to prescribe and administer treatments, what qualifications and training will be required, how to ensure diverse representation among practitioners, and whether practitioners should have personal psychedelic experience ( Viligger, 2024 ). Clear professional codes of conduct and accountability structures are essential, particularly given patients' heightened vulnerability during psychedelic experiences ( McGuire et al.,2024 ). These frameworks must address both clinical safety and cultural competency. Communication and Public Education Researchers, practitioners and media have a responsibility to provide accurate, transparent and non-sensationalised information about psychedelics, acknowledging both potential benefits and risks. Jules Evans (Director of the Challenging Psychedelic Experiences Project ) and colleagues have noted that adverse experiences sometimes occur because psychedelic states are foreign to secular Western culture. This highlights the importance of developing better integration frameworks and public education about the nature of these experiences. The Way Forward The psychedelic renaissance holds immense promise, but it must be undertaken with great care, responsibility and humility. We must resist the lure of the 'psychedelic miracle' and adopt a nuanced, empirically grounded approach that prioritises ethical practices, participant well-being and harm reduction. Through ongoing research, ethical frameworks, public education and open dialogue, we can develop a more robust understanding of psychedelics and how they could be used safely and effectively in mental healthcare. This requires: Continuing rigorous research into benefits and risks Developing comprehensive ethical guidelines Ensuring adequate practitioner training and supervision Maintaining open dialogue about challenges and best practices Providing balanced public education Respecting indigenous wisdom and practices Addressing equity and access issues Carefully considering regulatory frameworks Conclusion The psychedelic renaissance presents both immense promise and significant ethical challenges. As we navigate this complex landscape, it is crucial to prioritise patient safety, respect for indigenous wisdom, equitable access and scientific integrity. By maintaining a balanced, ethically-grounded approach, we can work towards realising the therapeutic potential of psychedelics whilst mitigating risks and respecting the complex cultural and historical contexts surrounding these substances. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. We welcome your thoughts and reflections on this article. NEED IMMEDIATE SUPPORT FOR A CHALLENGING PSYCHEDELIC EXPERIENCE? Note: TNP does not offer crisis support. Contact Fireside Project Peer Support Helpline : 62-FIRESIDE Stay Connected Subscribe to our mailing list to receive first access to our upcoming workshops, related resources and content. Be part of the conversation in the evolving field of Psychedelic Science and mental health. Are you curious about psychedelic experiences or wish to join a supportive community to integrate non-ordinary states of consciousness? READ MORE from our Blog HERE! Visit our integration therapy page to learn more about preparing for, making sense of, integrating, and coping with the residual effects and impact of experiences with non-ordinary states of consciousness. Need one to one support? Want to explore preparation, integration, and psychedelic-informed therapy for yourself. Book a FREE Discovery Call with one of our Psychedelic-integration specialist therapists or book a Comprehensive Initial Consultation with our Clinical Director, Dr Sara Tookey. Our TNP DISCLAIMER: Our site provides information for educational purposes only, and is a platform to connect people with qualified therapists. It does not provide professional mental health or medical advice. We do not offer psychedelic-assisted therapies or access to illegal substances. Requesting such services is prohibited. We cannot help locate psychedelic-assisted therapy, guided sessions, or retreats. We may provide publicly available information about eligible clinical research trials for research participation purposes only. Our therapists provide support which adopts a harm reduction perspective and does not encourage illicit substance use. We do not work with individuals experiencing active psychosis, although we can assist in making sense of past psychotic episodes for those under professional care. We do not act as experts on psychedelics or altered states, nor provide advice on their use. We are not liable for risks associated with using information from our site. Psychedelic Science Resources and References- created by True North Psychology, protected image References References from research cited: References: Breeksema, J. J., Kuin, B. W., Liechti, M. E., Kaelen, M., van Amsterdam, J., Roseman, L., & Schenberg, E. E. (2022). Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review. Journal of Psychopharmacology, 36(10), 1100-1117. https://pubmed.ncbi.nlm.nih.gov/36017784/ Celidwen, Y., Redvers, N., Githaiga, C., Habek, N., Wyndham, J. M., & Nicholas, G. (2023). Ethical principles of traditional indigenous medicine to guide western psychedelic research and practice. The Lancet Regional Health–Americas, 18. https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(22)00227-7/fulltext Fogg, C., Michaels, T. I., de la Salle, S., Jahn, Z. W., & Williams, M. T. (2021). Ethnoracial health disparities and the ethnopsychopharmacology of psychedelic-assisted psychotherapies. Experimental and Clinical Psychopharmacology, 29(5), 539-554. https://pubmed.ncbi.nlm.nih.gov/34096755/ Hughes, M. E., & Garcia-Romeu, A. (2024). Ethnoracial inclusion in clinical trials of psychedelics: a systematic review. EClinicalMedicine, 74, 102711. https://www.thelancet.com/action/showPdf?pii=S2589-5370%2824%2900290-6 Jacobs, E., et al. (2024). The Hopkins-Oxford Psychedelics Ethics (HOPE) Working Group Consensus Statement. Bioethics Today. https://doi.org/10.1080/15265161.2024.2342764 McGuire AL, Cohen IG, Sisti D, et al. Developing an Ethics and Policy Framework for Psychedelic Clinical Care: A Consensus Statement. JAMA Netw Open. 2024;7(6):e2414650. doi:10.1001/jamanetworkopen.2024.14650 McNamee S, Devenot N, Buisson M. Studying harms is key to improving psychedelic-assisted therapy—participants call for changes to research landscape. JAMA Psychiatry . 2023;80(5):411-412. doi: 10.1001/jamapsychiatry.2023.0099 Villiger, D. (2024). Personal psychedelic experience of psychedelic therapists during training: should it be required, optional, or prohibited? International Review of Psychiatry, 1–10. https://doi.org/10.1080/09540261.2024.2357669 Links/articles referenced in text: Cox, D. (2024). What Western medicine can learn from the ancient history of psychedelics. BBC online publication. https://www.bbc.com/future/article/20240910-the-ancient-history-behind-healing-trauma-with-psychedelics Labate, B. & Antunes, H.F. (2024). Where Is the Psychedelic Movement Headed Next? https://doubleblindmag.com/where-is-the-psychedelic-movement-headed-to-next/ Evans, Jules: Challenging Experiences Project. https://challengingpsychedelicexperiences.com/about-us-and-our-research
- Why Self-Compassion is Essential for High-Functioning and Late-Diagnosed ADHD Adults
Written by Dr Sara Tookey Imagine constantly swimming against the current while others seem to float effortlessly downstream. For adults with ADHD—especially those with high-functioning ADHD, diagnosed later in life—this struggle can feel all too familiar: a daily battle not just with external challenges, but with an often harsh and unforgiving internal voice. What if there was a powerful tool that could transform this inner dialogue and help you thrive with your neurodivergent mind? Self-compassion might be the missing piece in your ADHD journey. Research shows that cultivating kindness toward yourself isn't just a nice idea—it's a science-backed approach that can significantly improve focus, emotional regulation, and overall wellbeing for adults with ADHD. Key Learning Points: The Compassion Paradox : Discover why self-compassion is crucial for ADHD success, yet often misunderstood and difficult to achieve. Unmasking Hidden Criticism : Learn to recognise self-criticism disguised as motivation—and why it's holding you back. The Neuroscience of Kindness : Explore how self-compassion improves challenges often associated with ADHD, leading to better focus and improved emotional regulation. Beyond Positive Thinking : Get practical, ADHD-friendly techniques to cultivate genuine self-compassion. Redefining ADHD Success : See how a compassionate approach leads to sustainable growth and authentic self-acceptance. Read more about the importance of the compassion focused approach from our related articles: ' The Power of Self-Compassion: An Introduction to Compassion Focused Therapy ', By Dr Sara Tookey Men’s Mental Health: Challenging stigma, learning vulnerability and giving compassion , By Dr Sara Tookey 1. Why Self-Compassion is So Challenging for High-Functioning ADHD Adults The Compassion Paradox Research shows that ADHD individuals often experience significantly lower levels of self-compassion compared to their neurotypical peers ( Beaton et al., 2020 ; Beaton et al., 2022 ; Willoughby and Evans, 2019 ) . This isn't just about being "too hard on yourself"—it's a complex interplay of: Neurological differences affecting emotional regulation Lifetime experiences of perceived failures and criticism Internalising external judgements about ADHD traits Feeling fundamentally "different" from others ADHD adults often report feeling disconnected from others, scoring higher on isolation scales and lower on common humanity measures. As one ADHDer put it: "What I felt was I was actually a bad person... I was not an adequate human being" ( Stenner et al., 2019 ). The Cycle of Criticism and Masking Many late-diagnosed adults with ADHD have endured decades of messages like: "You're just not trying hard enough." "It's not that hard, just do it." "You're just being lazy." "What's the matter with you?" Dr. Sharon Saline (2022) , Clinical Psychologist and expert in supporting families with ADHD, describes how "criticism from others and themselves accumulates and is internalised into beliefs about self-worth." Many end up feeling "less-than" or unworthy compared to neurotypical peers who seem to struggle less or make fewer mistakes”, creating "a recipe for a mental health crisis." Masking emerges as a protective response to this criticism. To avoid judgement, many ADHDers develop elaborate strategies to hide their authentic selves and ADHD traits—exhausting themselves in the process and only worsening their shame. The mask becomes both shield and prison, protecting from external judgement while reinforcing internal criticism. When Self-Criticism Masquerades as Motivation This internalised criticism becomes particularly insidious because: It's Sneaky : Self-criticism doesn't always manifest as harsh words directed at oneself. It can appear as seemingly innocent questions, simple instructions, disguised as encouragement, or even exist as wordless feelings of shame. It Masquerades as Motivation : Especially for high-achieving individuals with ADHD, self-criticism can be so ingrained that it's mistaken for motivation. What starts as "You can do better than that. Try harder. Just focus" translates internally to a core belief of never being enough or being damaged and deficient in some way. It's Below Conscious Awareness : This internalised criticism becomes a lens through which individuals view themselves and their actions, reinforcing negative self-perceptions and making it difficult to cultivate self-compassion. It Can Feel Necessary : Some people become so accustomed to self-criticism that they believe it's essential for their functioning in day-to-day life, or essential in allowing them to achieve their goals in life. Letting go of self-criticism can feel too much of a risk. Dr. William Dodson estimates that at least 95% of adults with ADHD experience Rejection Sensitive Dysphoria (RSD ) —an intense emotional response to perceived criticism or rejection ( Dodson, 202 3, 2025 ) . This sensitivity can make self-compassion feel not just difficult but potentially dangerous—as if kindness toward oneself might lead to complacency or failure. Over time, many ADHDers come to believe that being hard on themselves is necessary for success. 2. What is Self-Compassion and Why It's Valuable for ADHD The Three Elements of Self-Compassion Self-compassion isn't self-pity or letting yourself off the hook. According to Dr. Kristin Neff (2003 ), it has three core components: Self-kindness instead of self-judgement : Being gentle and understanding with yourself Common humanity instead of isolation : Recognising everyone faces challenges; you're not alone Mindfulness instead of over-identification : Balanced awareness of your thoughts without being consumed by them For those with ADHD—who often experience heightened self-criticism, isolation, and emotional reactivity—these elements address exactly what's needed. The Neuroscience: Self-Compassion Physically Rewires the ADHD Brain Self-compassion isn't just a feel-good practice—it actually changes your brain. Neuroimaging studies show that self-compassion activates care-giving and self-awareness regions of the brain that are often under-active in ADHD individuals ( Lutz et al., 2008 ). Research has linked self-compassion practices to: Reduced depression and anxiety symptoms ( MIllard et al., 2023 ) Lower addiction relapse rates ( Craig et al. 2020 ; Chen et al., 2019 ) Buffered emotional reactivity to stress ( Cosely et al., 2010 ; Kirby et al., 2017 ) Decreased shame and self-criticism ( Kotera et al., 2019 ) Increased motivation toward self-improvement ( Breines and Chen, 2012 ) Increased self-insight and life satisfaction ( Frank et al., 2021 ) Reduction in physiological pain perception ( e.g. Maratos et al., 2020 ). For ADHD brains—which often struggle with emotional regulation, attention, and motivation—these benefits can be transformative. 3. Practical Applications: Building Self-Compassion with ADHD Developing self-compassion with ADHD requires approaches that work with your brain, not against it. Here are evidence-based strategies tailored for the ADHD mind: The ADHD-Friendly Self-Compassion Toolkit 1. The 30-Second Self-Compassion Break : When you make a mistake or feel overwhelmed: Place your hand on your heart or another soothing spot Take three deep breaths Say to yourself: "This is difficult right now. Everyone struggles sometimes. How can I be kind to myself in this moment?" 2. Name Your Inner Critic: Give your critical inner voice a name or character. This creates distance and makes it easier to recognise when it's talking. "Oh, that's just Critical Carl talking again—I don't have to believe everything he says." 3. The Friend Perspective Shift : When self-criticism hits, ask: "What would I say to a friend in this exact situation?" Then direct that same compassionate response toward yourself. 4. Compassion Anchors : Create physical reminders of self-compassion—a special stone in your pocket, a bracelet, or a phone background—that prompt you to pause and offer yourself kindness throughout the day. 5. Counter Perfectionism with "Good Enough" : Practise intentionally doing things "good enough" rather than perfectly. This directly challenges the perfectionistic tendencies common with ADHD. 6. Self-Compassionate Movement : Physical movement that feels good—walking, stretching, dancing—while consciously sending kindness to your body can bypass mental resistance to self-compassion. Dr. Saline's Four-Step Framework Dr. Sharon Saline suggests this ADHD-friendly approach: Normalise : Remember everyone struggles; making mistakes is human Understand : Get curious about your reactions rather than condemning them Identify "Stinking Thinking" : Recognise and challenge negative thought patterns Externalise Shame : Give shame a name or image to create distance from it 4. Redefining ADHD Success Through Self-Compassion From Perfection to Progress Self-compassion transforms how we define "success" with ADHD. Instead of: Perfect execution Unwavering focus Never making "careless" mistakes Achieving neurotypical standards We embrace: Consistent effort and progress Recovery from distractions Learning from mistakes Honouring your unique brain wiring Success Without Masking Self-compassion creates safety to unmask—to be authentically yourself rather than exhausting yourself trying to appear neurotypical. This shift conserves the mental and emotional energy typically spent on masking, making more resources available for what truly matters to you. Research suggests self-compassion actually increases motivation and resilience ( Breines and Chen, 2012 ). By treating ourselves with kindness, we create an internal environment conducive to genuine growth and sustainable success. As Dr. Saline beautifully puts it: "Self-compassion allows you to be good enough as you are, with your warts, with your foibles, sometimes off-balanced, sometimes more reactive than you'd like, sometimes disorganised, but fundamentally perfectly imperfect as a human being, just like everyone else." Conclusion: From Shame to Strength The journey to self-compassion for late-diagnosed ADHD adults isn't always easy, but it's transformative. By recognising the unique challenges you face, unmasking hidden self-criticism, and practising evidence-based compassion techniques, you can change your relationship with ADHD from one of shame to one of strength. Self-compassion doesn't eliminate ADHD challenges, but it creates a foundation from which you can approach those challenges more effectively. It's the difference between swimming against the current while also fighting yourself, versus accepting the current and finding your own way to navigate it. Remember, your ADHD mind isn't a flaw to be fixed—it's a unique way of experiencing and interacting with the world. By cultivating self-compassion, you're not just managing symptoms; you're embracing your whole self and unlocking your true potential. The next time you make an "ADHD mistake," try responding with kindness instead of criticism. Your brain—and your wellbeing—will thank you. [Note on Language: This article uses neuro-affirming language, recognising ADHD as a natural variation in human brains and how we process information.] Final Point: What Everybody Needs to Know About Neurodivergence Whether diagnosed or not, neurodivergent individuals often face systemic barriers and vulnerabilities. Whether professionally diagnosed or self-identified, it's crucial to remember that being neurodivergent is not a choice. For those who self-diagnose later in life, traits may become more apparent as they feel safer to be themselves. Supporting individuals on their journey of self-discovery, regardless of their diagnostic status, is essential for their well-being and self-acceptance. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. WANT TO LEARN MORE? Read our related articles: The Power of Self-Compassion: An Introduction to Compassion Focused Therapy Men's Mental Health: Challenging stigma, learning vulnerability and giving compassion Need Support with ADHD? Book a free screening call with Dr. Tookey to learn about our compassionate assessment approach At TNP we specialise in High-Functioning ADHD and other non-typical presentations of ADHD. Explore our neurodiversity-affirming therapy services This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. NEED THERAPEUTIC SUPPORT? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology we provide a neurodiversity-affirming and inclusive approach to therapy - listening to neurodivergent voices and providing appropriate accommodations and approaches to supportive our clients and staff. Psychologists on our platform have experience of working with neurodiverse individuals and some have special interests and expertise in the areas of ADHD and Autism. Book a FREE 30-minute Therapy Discovery Call with one of our neurodivergent-affirming Psychologists Today. Get Started & Book your Therapy Discovery Call References Beaton, D. M., Sirois, F., & Milne, E. (2020). Self-compassion and Perceived Criticism in Adults with Attention Deficit Hyperactivity Disorder (ADHD). Mindfulness, 11, 2506–2518. https://link.springer.com/article/10.1007/s12671-020-01464-w Beaton, D. M., Sirois, F., & Milne, E. (2022). The role of self-compassion in the mental health of adults with ADHD. Journal of Clinical Psychology, 78(12), 2497-2512. https://doi.org/10.1002/jclp.23354 Breines, J. G., & Chen, S. (2012). Self-compassion increases self-improvement motivation. Personality and Social Psychology Bulletin, 38(9), 1133-1143. https://doi.org/10.1177/0146167212445599 Dodson, W. (2023). New insights into rejection sensitive dysphoria. ADDitude. https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-emotional-dysregulation/ Lutz, A., Brefczynski-Lewis, J., Johnstone, T., & Davidson, R. J. (2008). Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PloS one, 3(3), e1897. https://doi.org/10.1371/journal.pone.0001897 Millard, L. A., Wan, M. W., Smith, D. M., & Wittkowski, A. (2023). The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis. Journal of Affective Disorders, 326, 168-192. https://doi.org/10.1016/j.jad.2023.01.010 Stenner, P., O'Dell, L., & Davies, A. (2019). Adult women and ADHD: On the temporal dimensions of ADHD identities. Journal for the Theory of Social Behaviour, 49(2), 179-197. https://doi.org/10.1111/jtsb.12198
- The Neurodiversity Paradigm: How Embracing Cognitive Diversity Transforms Workplace Culture
Written by Dr Sara Tookey TNP created image, True North Psychology, 2025 - multicoloured artwork image of painted silhouettes of faces looking in different directions As we celebrate Neurodiversity Celebration Week, organisations have a unique opportunity to reconsider how they think about cognitive differences in the workplace. The neurodiversity paradigm—a term coined by sociologist Judy Singer—represents a fundamental shift in how we understand human neurological variation, with profound implications for workplace inclusion, innovation, and productivity. What is the Neurodiversity Paradigm? The neurodiversity paradigm views neurological differences such as autism, ADHD, dyslexia, and others as natural variations in the human genome rather than deficits or disorders. This perspective goes beyond specific diagnoses to recognise that all human brains are unique, with different strengths, challenges, and ways of processing information. Neurodiversity in the Workplace: Organisations embracing neurodiversity gain significant advantages: Access to untapped talent pools with unique cognitive strengths Enhanced problem-solving through diverse thinking styles Increased innovation through different perspectives Improved products and services that work for more diverse users Stronger, more adaptable teams with complementary cognitive styles When workplace environments are designed to support the different ways neurodivergent employees think, process information, and experience the world, organisations unlock tremendous potential. Neurodivergent professionals bring valuable perspectives, skills, and approaches that can drive innovation and provide competitive advantages. Rather than viewing neurodivergence as something to "work around," forward-thinking organisations recognise that these diverse cognitive styles are essential assets to any high-performing team. Moving Beyond the Accommodation Model: Traditional approaches to neurodiversity in the workplace have focused on accommodations for diagnosed conditions. While important, this approach is limited by: Requiring disclosure and formal diagnosis Placing the burden of adaptation on neurodivergent individuals Maintaining a deficit perspective rather than recognising strengths Missing opportunities to improve workplace practices for everyone Implementing a Neurodiversity-Affirming Workplace: Forward-thinking organisations can: Create flexible work environments that support different cognitive styles Develop communication approaches that accommodate diverse processing needs Build teams that leverage complementary thinking patterns Recognise and reward different paths to successful outcomes Train managers to value and support neurological differences Conclusion: The neurodiversity paradigm is not simply about accommodating diagnosed conditions—it's about recognising that cognitive diversity is a valuable asset. By embracing this perspective, organisations can create environments where all employees can bring their authentic selves to work and contribute their unique cognitive strengths. This Neurodiversity Celebration Week, consider how your organisation might move beyond traditional models to truly embrace the full spectrum of human cognition. True North Psychology Ltd., 2025 - protected image; Image shows TNP logo as black and white compass with arrows and a background of evergreen trees. How True North Psychology Can Help Your Organisation At True North Psychology, we provide specialised consultancy services to help organisations develop truly neurodiversity-affirming workplaces. Our approach moves beyond basic compliance to create environments where neurodivergent talent can thrive and contribute their unique strengths. Our workplace consultancy offerings include: Neurodiversity Awareness Training : Interactive workshops for teams and leaders to understand the neurodiversity paradigm and its practical applications Workplace Environment Assessments : Comprehensive evaluation of physical spaces, policies, and practices with actionable recommendations Communication Protocol Development : Creating inclusive communication systems that work for diverse cognitive styles Leadership Coaching : Supporting managers to effectively lead and leverage neurodivergent talent Policy Development : Crafting neurodiversity-affirming HR practices and policies We tailor our approach to your organisation's specific needs, culture, and goals. Whether you're just beginning your neurodiversity inclusion journey or looking to enhance existing initiatives, our team of experienced psychologists can provide the guidance and practical strategies you need. Contact us today to discuss how we can help your organisation harness the full potential of a neurodivergent workforce. Email drsaratookey@truenorth-psychology.com to schedule a consultation. Final Point: What Everybody Needs to Know About Neurodivergence Whether diagnosed or not, neurodivergent individuals often face systemic barriers and vulnerabilities. Whether professionally diagnosed or self-identified, it's crucial to remember that being neurodivergent is not a choice. For those who self-diagnose later in life, traits may become more apparent as they feel safer to be themselves. Supporting individuals on their journey of self-discovery, regardless of their diagnostic status, is essential for their well-being and self-acceptance. Looking for a Comprehensive ADHD Assessment? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. WANT TO LEARN MORE? For those interested in deepening their understanding of ADHD and autism in adulthood and/or the neurodiversity perspective, the following resources may be helpful: Wise, S. (2024). The Neurodiversity Smorgasbord: An Alternative Framework for Understanding Differences Outside of Diagnostic Labels. https://www.livedexperienceeducator.com/blog/theneurodiversitysmorgasbord ADHD Works : Provides free templates for requesting "reasonable adjustments" at work and knowing your rights as a neurodivergent individual at work. The ADHD Women's Project - A website offering resources and community for women with ADHD. The Autistic Self Advocacy Network (ASAN) is a leading advocacy organisation run by and for autistic individuals. Their website provides extensive information and resources on autism acceptance and neurodiversity. Foundations for Divergent Minds (USA based) International Badass Activists For those interested in exploring the intersection of neurodivergence and other aspects of identity, our article "LGBTQIA+ and Neurodivergent: Shining a Light on Intersectionality and Mental Health" https://www.truenorth-psychology.com/post/neurodivergent-pride-mental-wellness-for-lgbtqia-communities Tookey, S. (2024). Is Adult ADHD the Latest Trend? True North Psychology. https://www.truenorth-psychology.com/post/is-adult-adhd-the-latest-trend Tookey , S. (2024). The Hidden Struggle: When High-Functioning ADHD in Adulthood Leads to Burnout and Breakthrough. True North Psychology. https://www.truenorth-psychology.com/post/hidden-struggle-of-high-functioning-adhd-in-adulthood Tookey , S. (2024). Celebrating Neurodiversity: Understanding the Autism Spectrum. True North Psychology. https://www.truenorth-psychology.com/post/celebrating-neurodiversity-understanding-the-autism-spectrum Books about Neurodiversity "NeuroTribes: The Legacy of Autism and the Future of Neurodiversity" by Steve Silberman is a highly acclaimed book that explores the history, science, and politics of autism and the neurodiversity movement. Different, Not Less: A Neurodivergent's Guide to Embracing Your True Self and Finding Your Happily Ever After - by Chloe Hayden Divergent Mind: Thriving in a World That Wasn’t Designed For You - by Jenara Nerenberg How Not to Fit In: An Unapologetic Guide to Navigating Autism and ADHD - by Jess Joy and Charlotte Mia UNMASKED: The Ultimate Guide to ADHD, Autism and Neurodivergence - by Ellie Middleton The Neurodivergent Friendly Workbook of DBT (Dialectical Behaviour Therapy) Skills - by Sonny Jane Wise The Pocket Guide to Neurodiversity by Daniel Aherne The Power of Different: The Link Between Disorder and Genius - by Gail Saltz STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. NEED THERAPEUTIC SUPPORT? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology we provide a neurodiversity-affirming and inclusive approach to therapy - listening to neurodivergent voices and providing appropriate accommodations and approaches to supportive our clients and staff. Psychologists on our platform have experience of working with neurodiverse individuals and some have special interests and expertise in the areas of ADHD and Autism. Book a FREE 30-minute Therapy Discovery Call with one of our neurodivergent-affirming Psychologists Today. Get Started & Book your Therapy Discovery Call
- The Hidden Struggle: When High-Functioning ADHD in Adulthood Leads to Burnout and Breakthrough
Written by Dr Sara Tookey Imagine a swan gliding gracefully across a lake - serene and composed on the surface, yet beneath the water, its feet are paddling frantically to maintain that illusion of effortless movement. This image perfectly encapsulates the experience of many adults with high-functioning ADHD. On the outside, they appear successful, put-together, and "normal," but internally, they're expending enormous energy to keep up this facade. Attention Deficit Hyperactivity Disorder (ADHD) isn't just a childhood condition. For many adults, ADHD traits persist or even appear to emerge later in life (Barkley, 2015). This is particularly true for those with "high-functioning ADHD," who have managed to achieve success in various life areas despite their underlying neurodivergence. However, like our swan metaphor, the constant effort to maintain this appearance of effortless success can lead to exhaustion and burnout. Understanding High-Functioning ADHD The Tipping Point: When Strategies Fall Short Burnout and High-Functioning ADHD Recognising ADHD Strengths Recognising the Signs of ADHD in Adulthood Burnout: The Catalyst for Discovery The Path to Diagnosis and Support Taking Action: Understanding and Embracing Your Neurodivergent Mind Conclusion COMING SOON: Resources Stay Connected References for this article Understanding High-Functioning ADHD High-functioning ADHD is not a formal diagnosis. It describes [undiagnosed] individuals who meet the criteria for ADHD yet manage to but manage to function effectively in their daily lives ( Lesch, 2018 ). They may experience challenges with focus, time management, and impulsivity, but are able to compensate for these difficulties. These individuals often excel in their careers, maintain relationships, and appear to have their lives "together" on the surface. They've developed impressive compensatory strategies that mask their symptoms , such as: Creating highly structured environments Relying heavily on reminders and organisational tools Choosing careers that align with their strengths and interests Developing strong support systems However, maintaining this facade comes at a cost. The constant effort to appear "normal" can lead to burnout, anxiety, and depression. Over time, many find themselves becoming "secret flailers," struggling internally while maintaining an outward appearance of success. Think You Might Be A High-Functioning ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists. BOOK A DISCOVERY CALL TODAY The Tipping Point: When Strategies Fall Short Major life changes or increased responsibilities can overwhelm even the most robust coping strategies. It's like adding weights to our swan - eventually, no amount of frantic paddling can keep it afloat. Many adults with ADHD report a specific life event coinciding with the onset or worsening of their symptoms, such as: Starting a new job or receiving a promotion Becoming a parent Experiencing a significant loss or trauma Entering a new romantic relationship Hormonal changes (like the menopause ) Burnout and High-Functioning ADHD For adults with high-functioning ADHD, the constant effort to maintain performance can lead to burnout. Burnout is a state of mental, physical, and emotional exhaustion caused by prolonged exposure to stress and is characterised by overwhelming exhaustion, detachment and a lack of sense of personal accomplishment ( Maslach et al., 2006 ). It's the moment when our swan can no longer keep up the graceful appearance and starts to sink. Adults with ADHD are three to six times more likely than their neurotypical peers to experience one or multiple burnouts ( Brattberg, 2006 ). The Struggle to Keep Up The exhaustion that comes from trying to fit into a neurotypical world cannot be overstated. Many adults with ADHD describe feeling like they're constantly swimming against the current, expending enormous energy to meet societal expectations that don't align with their natural cognitive style. This struggle often leads to internalised shame and self-doubt. Years of undiagnosed ADHD can result in a belief that one is inherently flawed or "not trying hard enough," when in reality, they're expending tremendous effort just to keep up ( Pawaskar et al., 2020 ). Recognising ADHD Strengths Adults with ADHD succeed when they work mostly in their areas of strength, and that they can overcome many challenges at work with the right accommodations . It's crucial to acknowledge that ADHD brains aren't deficient - they're different, and that difference can bring unique strengths. In fact, research has shown that adults with ADHD are overrepresented in high-level executive positions and entrepreneurial roles ( Lerner et al., 2019 ). This suggests that certain ADHD traits can be advantageous in leadership roles. Creativity and innovation: Many with ADHD excel at generating novel ideas and solutions ( White & Shah, 201 1 ) Hyperfocus: While ADHD is often associated with difficulty focusing, many individuals with ADHD can enter states of intense concentration on tasks they find interesting or challenging. This "hyperfocus" can lead to high productivity and creative problem-solving ( Sedgwick et al., 2019 ) Cognitive flexibility: Research suggests people with ADHD may have enhanced cognitive flexibility, allowing them to adapt quickly to new situations and think outside the box ( Nordby, et al., 2023 ) Resilience: Many adults with ADHD develop strong resilience and problem-solving skills as a result of facing and overcoming challenges throughout their lives ( Nordby, et al., 2023 ; Sedgwick et al., 2019 ) Risk-taking: The impulsivity associated with ADHD can translate into a willingness to take risks, which can be advantageous in pursuing innovative ideas and new opportunities that have the potential for high rewards - often advantageous in entrepreneurial settings ( Muûls et al., 2023 , Wiklund et al., 2017 ) Recognising the Signs of ADHD in Adulthood For adults who have successfully managed their ADHD symptoms for years, recognising when these strategies are no longer effective can be challenging. Many adults with ADHD who sought diagnosis later in life experienced a gradual accumulation of symptoms, with many citing a specific life event as the tipping point that led them to seek help. Common emerging ADHD symptoms in adulthood include: Increased challenges with prioritisation, organisation and time management Procrastination followed by intense periods of hyperfocus Difficulty "quieting" an active mind Overthinking and decision paralysis Emotional intensity and heightened sensitivity to rejection Relationship struggles Chronic feelings of overwhelm or underachievement Increased forgetfulness and difficulty completing tasks Heightened sensitivity to stress Sleep disturbances Difficulty transitioning between tasks Difficulty maintaining work performance SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. Burnout: The Catalyst for Discovery For many adults with high-functioning ADHD, burnout often serves as the tipping point that leads to diagnosis, when their carefully constructed compensatory strategies fall apart. When the exhaustion of constant masking becomes overwhelming, and the coping mechanisms that once worked so well start to fail, many individuals find themselves facing a crisis point. This burnout can manifest in various ways: Lack of motivation: Activities once enjoyed, like exercise or spending time with family, may feel burdensome. Chronic fatigue: Feeling constantly tired, regardless of rest. Decreased performance: Difficulty focusing on tasks, even important ones. Aches and Pains: Stress-related issues like headaches or stomachaches. Irritability: Increased tendency to snap at others over minor issues. Emotional struggles: Feelings of sadness, withdrawal, or difficulty expressing positive emotions. Negativity or pessimism: Particularly about areas causing burnout. Interpersonal challenges: Feeling overwhelmed by relationships, and that colleagues, partners, or children are adding to one's burden rather than offering providing enjoyment or support. It's important to note that at least 70% of adults with ADHD also experience other mental health challenges, such as anxiety or depression, which can exacerbate burnout symptoms and hinder coping mechanisms. Paradoxically, this challenging period can be a blessing in disguise. The breakdown of long-held coping strategies often forces individuals to seek help, leading to a diagnosis that can be both illuminating and liberating. As one client shared, "Burning out was the worst and the best thing that could have happened to me." If you're experiencing burnout and suspect that ADHD might be an underlying factor, know that you're not alone. Many adults discover their ADHD precisely at this juncture. Seeking an assessment can be the first step towards understanding your unique neurotype and developing more sustainable strategies for thriving. Think You Might Be A High-Functioning ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists. The Path to Diagnosis and Support For many high-functioning adults with ADHD, seeking diagnosis or support often comes after a period of burnout - when the swan can no longer keep paddling. This moment, while challenging, can also be an opportunity for self-discovery and growth. However, despite growing awareness, many adults with ADHD face significant hurdles in recognising their condition and obtaining a diagnosis and facilitating access to effective support: The "Kids Only" Myth: Many still believe ADHD only affects children Outdated Symptom Descriptions: Official diagnostic symptom criteria often focus on childhood behaviours Masking and Coping Strategies : Adults with undiagnosed ADHD often develop coping mechanisms that mask their symptoms. Internalised Shame and Self-Blame : Years of undiagnosed ADHD can lead to deeply ingrained shame and low self-esteem. Changing Symptom Presentation : ADHD symptoms can change over time and through the many seasons of our lives. Varied Impact in Different Environments : ADHD symptoms may manifest differently depending on the person's job and lifestyle. Taking Action: Understanding and Embracing Your Neurodivergent Mind If you suspect you may have high-functioning ADHD that's becoming more problematic, consider the following steps: Educate yourself about adult ADHD and neurodiversity . See our resources section and our other adhd related articles for more learning. Additionally, staying informed about recent research can help you better understand your experiences and available treatment options. Practice mindfulness and relaxation techniques l ike mindfulness meditation, yoga, or simple breathing exercises, which can help to manage stress and improve focus . Seek a comprehensive assessment by a professional experienced in adult ADHD can provide clarity and direction. The assessment should include a detailed history, symptom evaluation, corroborating symptoms with someone who knows you well, and potentially neuropsychological testing ( Kooij et al., 2019 ). Consider ADHD-informed therapy or coaching to heal from experiences in the past and develop strategies that help you to move forward and work with your brain, not against it. Explore medication options if appropriate and desired . For many adults, medication can be a game-changer when combined with other strategies. A long-term study by Lensing et al. (2016) found that adults with ADHD who received medication treatment reported significant improvements in ADHD symptoms over a 4 year period. Develop a support network to connect with others who understand your experiences. Support groups, both in-person and online, can provide a sense of community and shared understanding. Studies have shown that being a part of peer support groups can improve self-esteem and coping skills related to ADHD ( Gnapp et al., 2023 ). Implementing lifestyle changes like adopting a balanced diet, regular exercise, good sleep hygiene and reducing one's alcohol intake can have significant positive impacts on ADHD symptoms. Reevaluate your environment: Consider whether your current job, living situation, and daily routines are supporting or hindering your ability to manage your ADHD symptoms. Sometimes, small changes in your environment can have significant impacts on your ability to function effectively. Practice self-compassion: Remember that ADHD is a neurodevelopmental condition, not a personal failing. Practising self-compassion can help reduce the stress and negative self-talk that often accompany ADHD ( Beaton et al., 2022 ). Conclusion Living with high-functioning ADHD can feel like being a secret flailer - calm on the surface but struggling and chaotic underneath. The effort to appear "normal" in a world not designed for neurodivergent brains is exhausting and often unsustainable. However, recognising this struggle is the first step towards embracing your unique cognitive style and finding more authentic ways of navigating the world. Seeking support is not admitting defeat - it's recognising that you've been swimming against the current for too long. With understanding, appropriate support, and self-acceptance, you can learn to harness your ADHD traits as strengths rather than fighting against them. The goal isn't to become a perfect swan, gliding effortlessly across the lake - it's to embrace your unique way of swimming and find environments where your paddling style is an asset, not a hidden struggle. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. Think You Might Be A High-Functioning ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists. WANT TO LEARN MORE? Below are recommended resources and supportive communities exploring Adult ADHD. ADHD Books : ADHD an A-Z: Figuring it Out Step by Step by Leanne Maskell ADHD 2.0 by Edward M. Hallowell, M.D. and John J. Ratey , M.D. Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood by Edward M. Hallowell, M.D. and John J. Ratey, M.D. It's Not A Bloody Trend: Understanding Life as an ADHD Adult by Kat Brown Scattered Minds: The Origins and Healing of Attention Deficit Disorder by Dr Gabor Mate The ADHD Effect on Marriage by Melissa Orlov Understand, Survive and Thrive - Midlife ADHD Diagnosis by Emma Mahony Your Brain’s Not Broken: Strategies for Navigating Your Emotions and Life with ADHD - by Tamara Rosier The Year I Met My Brain: A travel companion for adults who have just found out they have ADHD - by Matilda Boseley How to ADHD: An Insider's Guide to Working with Your Brain (Not Against It) - Jessica McCabe Women with Attention Deficit Disorder: Embrace Your Differences and Transform Your Life - by Sari Solden The Mindfulness Prescription for Adult ADHD: An 8-Step Program for Strengthening Attention, Managing Emotions, and Achieving Your Goals - by Lidia Zylowska Order from Chaos by Jaclyn Paul Books about Neurodiversity Different, Not Less: A Neurodivergent's Guide to Embracing Your True Self and Finding Your Happily Ever After - by Chloe Hayden Divergent Mind: Thriving in a World That Wasn’t Designed For You - by Jenara Nerenberg How Not to Fit In: An Unapologetic Guide to Navigating Autism and ADHD - by Jess Joy and Charlotte Mia UNMASKED: The Ultimate Guide to ADHD, Autism and Neurodivergence - by Ellie Middleton The Neurodivergent Friendly Workbook of DBT (Dialectical Behaviour Therapy) Skills - by Sonny Jane Wise The Pocket Guide to Neurodiversity by Daniel Aherne The Power of Different: The Link Between Disorder and Genius - by Gail Saltz Websites with free resources on adult ADHD: ADDitude - https://www.additudemag.com/ TotallyADD - https://totallyadd.world/ CHADD - https://chadd.org/ ADHD U K - www.adhduk.co.uk ADDA - https://add.org/grow/adhd-library/ Podcasts: ADHD As Females ADHD Experts ADHD Rewired Podcast Taking Control: The ADHD Podcast The ADHD Adults Podcast The ADHD Women's Wellbeing Podcast Online Forums/Groups: Reddit's ADHD Community (r/ADHD) - https://www.reddit.com/r/ADHD/ ADDitude Forums - https://www.additudemag.com/forums/ CHADD Online Support Groups - https://chadd.org/attending-a-meeting/ TotallyADD Forums - https://totallyadd.world/forums/ ADDA - https://add.org/grow/adhd-library/ Social Media: Facebook ADHD Groups (ADHD Adults, Adult ADHD Support Group, etc.) Instagram ADHD Hashtags (#ADHD, #ADHDAdults, #ADHDLife, etc.) STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. THINK YOU MIGHT BE ADHD? At TNP we specialise in High-Functioning ADHD and other non-typical presentations of ADHD. Book a Screening Call with us today to see if you'd be a good fit for our compassionate ADHD assessment approach! Learn more about our compassionate and individualised approach to Adult ADHD assessment and Book Your 15-minute, no obligations Screening Call Today ! NEED THERAPEUTIC SUPPORT? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology we provide a neurodiversity-affirming and inclusive approach to therapy - listening to neurodivergent voices and providing appropriate accommodations and approaches to supportive our clients and staff. Psychologists on our platform have experience of working with neurodiverse individuals and some have special interests and expertise in the areas of ADHD and Autism. Book a FREE 30-minute Therapy Discovery Call with one of our neurodivergent-affirming Psychologists Today. Get Started & Book your Therapy Discovery Call References Beaton, D. M., Sirois, F., & Milne, E. (2022). The role of self-compassion in the mental health of adults with ADHD. Journal of clinical psychology , 78 (12), 2497–2512. https://doi.org/10.1002/jclp.23354 Brattberg G. (2006). PTSD and ADHD: underlying factors in many cases of burnout. Stress and Health 22: 305-313 Canela, C., Buadze, A., Dube, A., Eich, D., & Liebrenz, M. (2017). Skills and compensation strategies in adult ADHD - A qualitative study. PloS one , 12 (9), e0184964. https://doi.org/10.1371/journal.pone.0184964 Ginapp, C. M., Greenberg, N. R., Macdonald-Gagnon, G., Angarita, G. A., Bold, K. W., & Potenza, M. N. (2023). The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study. SSM. Qualitative research in health , 3 , 100223. https://doi.org/10.1016/j.ssmqr.2023.100223 Kooij, J. J. S., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balázs, J., ... & Asherson, P. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56(1), 14-34. DOI: 10.1016/j.eurpsy.2018.11.001 Lensing, M. B., Zeiner, P., Sandvik, L., & Opjordsmoen, S. (2016). Four-year outcome in psychopharmacologically treated adults with attention-deficit/hyperactivity disorder: A questionnaire survey. Journal of Clinical Psychiatry, 77(4), 535-543. DOI: 10.4088/JCP.12m07714 Lerner, D.A., Verheul, I. & Thurik, R. Entrepreneurship and attention deficit/hyperactivity disorder: a large-scale study involving the clinical condition of ADHD. Small Bus Econ 53 , 381–392 (2019). https://doi.org/10.1007/s11187-018-0061-1 Lesch K. P. (2018). ‘Shine bright like a diamond!’: is research on high-functioning ADHD, at last, entering the mainstream? Journal of child psychology and psychiatry, and allied disciplines, 59(3), 191–192. https://doi.org/10.1111/jcpp.12887 Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World psychiatry : official journal of the World Psychiatric Association (WPA) , 15 (2), 103–111. https://doi.org/10.1002/wps.20311 Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52(1), 397-422. DOI: 10.1146/annurev.psych.52.1.397 Muûls, M., & Carvajal, R. (2023). Impact of Attention Deficit Hyperactivity Disorder on Entrepreneurial Behavior: A Neurobiological Approach. Journal of Applied Cognitive Neuroscience , 4 (2), e00395858. Retrieved from https://revistascientificas.cuc.edu.co/JACN/article/view/5258 Nordby , E. S., Guribye, F., Nordgreen, T., & Lundervold, A. J. (2023). Silver linings of ADHD: a thematic analysis of adults' positive experiences with living with ADHD. BMJ open , 13 (10), e072052. https://doi.org/10.1136/bmjopen-2023-072052 Pawaskar , M., Fridman, M., Grebla, R., & Madhoo, M. (2020). Comparison of Quality of Life, Productivity, Functioning and Self-Esteem in Adults Diagnosed With ADHD and With Symptomatic ADHD. Journal of attention disorders , 24 (1), 136–144. https://doi.org/10.1177/1087054719841129 Schubert, S. J., Rohr, M. K., Wessel, L., & Ziegelmann, J. P. (2020). Self-compassion and self-criticism in adults with attention deficit hyperactivity disorder (ADHD). Journal of Clinical Psychology, 76(7), 1308-1326. Sedgwick JA, Merwood A, Asherson P. The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD. Atten Defic Hyperact Disord. (2019) 11:241–53. 10.1007/s12402-018-0277-6 White, H. A., & Shah, P. (2011). C reative style and achievement in adults with attention-deficit/hyperactivity disorder. Personality a nd Individual Differences, 50(5), 673-677. https://doi.org/10.1016/j.paid.2010.12.015 Wiklund, J., Yu, W., Tucker, R., & Marino, L. D. (2017). ADHD, impulsivity and entrepreneurship. Journal of Business Venturing, 32(6), 627-656. https://doi.org/10.1016/j.jbusvent.2017.07.002 In text links: Chillemi, K. (2022, July 2). Understanding ADHD and Autistic Burnout Within the Workplace. Psychology Today. https://www.psychologytoday.com/gb/blog/functional-legacy-mindset/202207/understanding-adhd-and-autistic-burnout-within-the-workplace ADDitude (2022, July 26). The Tipping Point: Adult ADHD Diagnosis. ADDitude. https://www.additudemag.com/tipping-point-adult-adhd-diagnosis/ Kase, R. (2024, June 5). EMDR Therapy Helps People Heal From Experiences That Haunt Them. ADDitude. https://www.additudemag.com/emdr-therapy-eye-movement-desensitization-trauma-adhd/#:~:text=By%20helping%20individuals%20process%20and,some%20symptoms%20associated%20with%20ADHD . Kandola, A. (2023, February 17). What to know about psychotherapy for ADHD. Medical News Today. https://www.medicalnewstoday.com/articles/adhd-psychotherapy Miller, C. (2024, March 8). When Parent and Child Both Have ADHD. Child Mind Institute. https://childmind.org/article/help-for-parents-with-adhd/ Matlen, T. (2023, June 5). ADHD and the Menopause. ADDitude. https://www.additudemag.com/add-and-menopause-how-hormones-affect-adhd-symptoms/ Tookey, S. (2024, May 8). Is Adult ADHD the Latest Trend? True North Psychology. https://www.truenorth-psychology.com/post/is-adult-adhd-the-latest-trend Villines, Z. (2023, July 18). Does ADHD coaching work? Medical News Today. https://www.medicalnewstoday.com/articles/adhd-coaching What Is ADHD? Symptoms, Causes, Treatments. (n.d.). ADDitude. https://www.additudemag.com/what-is-adhd-symptoms-causes-treatments/ Think You Might Be A High-Functioning ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists.
- Is Adult ADHD the Latest Trend?
Written by Dr Sara Tookey Attention Deficit Hyperactivity Disorder (ADHD) has historically been viewed as a childhood condition characterised by inattention, hyperactivity, and impulsivity. However, in recent years there has been a surge in adult ADHD diagnoses. Some are wondering if adult ADHD has merely become the latest trend. The official definition of a trend is “a general direction in which something is developing or changing,” and this is true whether that something is positive or negative. The data tells us that adult ADHD is very much a real and an increasingly recognised condition, not just a passing fad. While there are conflicting views on whether it is over-diagnosed in some cases, most experts agree the rising prevalence reflects improved screening, decreasing stigma, and a better understanding of how ADHD presents across the lifespan. Let's look at some of the evidence and perspectives around this issue. The Rising Prevalence of Adult ADHD The History of ADHD (“The Fidgets”) Why Is Adult ADHD More Recognised Now? Is Adult ADHD Overdiagnosed? Getting a Diagnosis: Tips - What to Look for When Seeking an ADHD Assessment The Impacts of Missed/ Late-diagnosis Strengths of the Adult ADHDer Common Symptoms of Adult ADHD Gender Differences Compensatory Strategies / Masking What Can I Do if I Suspect I Might Have ADHD? Conclusion Recommended Readings Stay Connected / Get Help Now References for this article The Rising Prevalence of Adult ADHD Estimates vary, but research suggests around 4-5% of adults in the US and UK have ADHD, with higher rates of men being diagnosed than women. A recent research study , published in the British Medical Journal, reported approximately a twenty-fold increase in ADHD diagnoses between the years 2000 and 2018 and nearly fifty-fold increase in ADHD prescriptions in men between the ages of 18 and 29 (from 0.01% to 0.56%) ( McKechnie et al., 2023 ). Incidence of of females diagnosed in their mid-to-late 20s and 30 - 50 age range has nearly doubled fro 2020 to 2022, indicating an increase in female ADHD diagnoses, which tend to be later in life ( Russel et al., 202 3 ). Compared to childhood ADHD, which affects around 9.8% of kids, adult ADHD was relatively under-diagnosed and overlooked until fairly recently. Now, diagnosis rates in adults outpace those in children. The rising numbers likely reflect greater awareness and improved screening, not necessarily that more adults have ADHD than any other time period that's come before. Many adults lived with undiagnosed and untreated ADHD symptoms for years before receiving an evaluation. As Kat Brown suggests in her book " It's Not a Bloody Trend ": "Removing the stigma around one thing can mean someone feeling comfortable enough to seek help for something else. It doesn't mean more people necessarily claiming that for themselves, but it does mean that people who have suffered for a long time can get the support they need to end their struggle" (Brown, 2023). The History of ADHD (“The Fidgets”): It may surprise you to know that ADHD, in children and adults is not a new phenomenon. It was first documented by Scottish physician, Dr Alexander Crichton , in 1798. He was the first to characterise the condition and named it “the Fidgets”. He described the condition from behavioural observations of adults with what would now fit the criteria for a diagnosis of ADHD: “In this disease of attention, if it can with propriety be called so, every impression seems to agitate the person, and gives him or her an unnatural degree of mental restlessness. People walking up and down the room, a slight noise in the same, the mowing stable, the shutting a door suddenly, a slight excess of heat or of cold, too much light or too little light, all destroy constant attention in such patients, inasmuch as it is easily is exited by every impression.” Why Is Adult ADHD More Recognised Now? There are a few key reasons why adult ADHD has gained more attention and risen into the public consciousness: 1) Decreased Stigma Around Mental Health: As the stigma around mental health conditions has decreased, more adults have been willing to explore whether they may have ADHD and seek professional assessment. A diagnosis is no longer seen as shameful or a sign that someone is "broken". Rather, many adults now seek an ADHD diagnosis as a pathway to access support, improve symptom management, develop greater self-understanding and cultivate a more compassionate perspective toward themselves and the challenges they face with daily living. 2) Increased Awareness and Understanding of ADHD: We now know that ADHD is a lifelong neurological condition, not a childhood phase kids typically outgrow . Persistent inattention, restlessness, impulsivity and other traits can significantly impact daily functioning for adults. More people are recognising their struggles may be due to ADHD. However, as Kat Brown explains in her book, the perception of increasing neurodivergence is often due to reduced stigma rather than a rise in prevalence: "The refrain 'there didn't use to be all this' can be refuted by data on left-handedness, another form of neurodiversity" ( Brown, 2023 ). Brown explains how despite left-handers existing throughout history, stigma led to their concealment through practices like forcing right-handed writing. A 2007 study found left-handedness rates increased from 3% in the Victorian era to 11% recently ( McManus, 2007 ). The rise in identified cases of left-handedness was not due to more people being left-handed, but likely an increased acceptance, allowing people to embrace their natural inclinations without shame or coercion ( McManus, 2007 ) . Similarly, the growing rates of ADHD diagnosis likely reflect greater societal acceptance and understanding, not an actual increase in the condition's prevalence. 3) Expanded Definition of ADHD: In the past, only children who were hyperactive were diagnosed with ADHD. The definition has been expanded to include other symptoms associated with inattention. As a result, more individuals have been diagnosed with the disorder. This is particularly true in girls, who more commonly exhibit signs of inattention rather than hyperactivity and are as a consequence often overlooked by teachers as "daydreaming" in class rather than presenting with hyperactive behaviour that is often deemed "disruptive" in class (as is more often the case with boys). 4) Improved Screening and Diagnostic Practices: As clinicians understand the nuances of how ADHD manifests in adults, they are better able to accurately screen for it during assessments instead of overlooking symptoms. Adult ADHD-specific screening tools have also been developed. 5) Increased Accessibility to ADHD Information Online: The growth of short-form video content on platforms like TikTok, Instagram, and YouTube Shorts has made information about ADHD more accessible than ever before. Rather than requiring sustained focus to read through lengthy materials, these bite-sized videos cater to those who struggle with attention and concentration. The rise of blogs, social media channels, and online communities dedicated to ADHD spreads awareness and enables people to share insights about the adult experience of living with ADHD. This increased online presence makes it more likely for relevant information to reach those who need it most. Moreover, these online resources provide a way for adults with ADHD to relate to and find validation in the shared experiences of others who have gone through similar struggles. *You can find a list of online ADHD communities and resources at the bottom of this article . Is Adult ADHD Overdiagnosed? While most agree the rising rates reflect increased recognition, some people have raised concerns about potential overdiagnosis of ADHD in adults (and children). Reasons cited include: lack of clinician training in ADHD assessment, applying child criteria too broadly to adults, failing to rule out other conditions with overlapping symptoms, or mistaking normal lapses in concentration for ADHD symptoms. Overdiagnosis could potentially lead to unnecessary treatment with stimulant medications. However, many specialists argue that in regions with good clinical practices, overdiagnosis is not as prevalent a problem as underdiagnosis. These reports are consistent with findings from research , which investigates this issue directly ( Abdelnour, 2022) . When comprehensive, multi-modal evaluations are conducted by trained clinicians, accurate ADHD diagnosis is very achievable. Despite research supporting this view, some reports in the media continue to propagate the message that ADHD and other mental health conditions are overdiagnosed. While often well-intentioned, this backlash against the perceived overdiagnosis of mental health conditions like ADHD and the culture of self-diagnosis on social media has had an unintended consequence - it may instil a sense in people with severe, chronic distress that their problems are just "normal," so they don't need support. This view ignores the reality that conditions like ADHD are also underdiagnosed due to misdiagnosis and co-occurring conditions, like learning disabilities, depression, or anxiety. While often well-intentioned, this backlash against the perceived overdiagnosis of mental health conditions like ADHD and the culture of self-diagnosis on social media has had an unintended consequence - it may instil a sense in people with severe, chronic distress that their problems are just "normal," so they don't need support. This view ignores the reality that conditions like ADHD are also underdiagnosed due to misdiagnosis and co-occurring conditions , like learning disabilities, depression, or anxiety. As author and neurodiversity advocate Kat Brown notes, "Years of feeling defective, less than or a bit 'off' aren't easy to solve, especially when your level of self-trust may not be operating on the level you'd hope for a mature adult. This is partly why so many people, me included, report feeling deeply anxious ahead of our assessments in case it's found that we don't have it and that we are 'just like this' ... I am the only one who’s playing at being human because everyone else knows what they’re doing” ( Brown, 2023 ). While intended to raise awareness of overdiagnosis, some media narratives may unintentionally reinforce societal biases that compound self-doubt and avoidance of care for those in need. The re-stigmatisation risk posed by an excessive preoccupation with overdiagnosis is explored in Sam Woolfe's insightful article . It highlights the nuanced balance between legitimate concerns around overdiagnosis and the importance of de-stigmatising mental health issues. By viewing all mental health issues cynically through the lens of "overdiagnosis culture," we risk perpetuating stigma by accusing those in distress of overcautiously self-pathologising or buying into passing "fads." As the article eloquently argues, an excessive preoccupation with overdiagnosis creates additional barriers to appropriate care for many. Seeking Diagnosis: The Importance of Proper ADHD Assessment Like any medical condition, ADHD must be properly evaluated by qualified and experienced mental health professionals trained in identifying symptoms of ADHD and other mental health and neurodevelopmental conditions to facilitate ruling out of other potential causes through clinical interviews and testing . With increasing waiting lists for adult ADHD assessments in the UK's National Health Service (NHS) - often years-long, people are increasingly seeking private assessments. However, assessing the quality of these services can be challenging. Here are some key aspects to look for to ensure a reliable and comprehensive assessment. A comprehensive ADHD assessment should include (including 1 to 4 sessions to complete): Clinical interview about symptoms across multiple settings Self-report ADHD rating scales and checklists Information from partners, friends or family about observable traits Screening for co-existing conditions like anxiety, depression, etc. Testing of cognitive abilities and executive functions tied to ADHD Assessments should then provide a detailed report presenting the symptoms and difficulties and identifying where this person may or may not meet the diagnostic criteria for ADHD. This report should also include a complete neurodevelopmental, social, psychiatric, family and medical history with a treatment plan, recommendations and evaluation of potential risks posed to this person. When identified through this rigorous process, by a specialist, an adult ADHD diagnosis should be taken seriously - not dismissed as someone simply jumping on a trend bandwagon. Proper assessment and treatment can be life-changing. The Impacts of Missed/ Late-diagnosis For many adults who struggled through school, work and in relationships before receiving an ADHD diagnosis and support, a diagnosis provides a long-awaited explanation for their difficulties and a path forward. Failing to identify and treat ADHD in adults can have major negative impacts which may include: Chronic low self-esteem from being labeled lazy or underachieving Strained relationships Elevated risks developing substance misuse problems, depression, anxiety and emotional dysregulation/liability Financial stresses from disorganisation, impulsivity, procrastination Academic underachievement and dropping out of school or university Underperformance at work and in career despite intelligence When supported through education, coaching, psychotherapy, CBT, medication and/ or lifestyle adjustments, many find their ADHD symptoms are very treatable. A diagnosis allows them to finally get the support they need to reach their potential. Strengths of the Adult ADHDer It's also important to understand that ADHD is a neurological difference, NOT a dysfunction or a disease. While it presents challenges in certain aspects of life, many adults with ADHD leverage their natural abilities in creative, entrepreneurial, and fast-paced roles that are an optimal match for their ADHD traits. These may include: Hyperfocus on areas of passion or interest Creativity and out-of-the-box thinking High energy levels to sustain long work hours Strong sense of empathy Risk-taking tendencies, needed for a role as an entrepreneur for example Strong problem-solving skills Viewing adult ADHD through a neurodiversity lens , it becomes clear that these divergent cognitive traits and tendencies have real-world advantages in certain professional environments and situations. Common Symptoms of Adult ADHD While the core symptoms of ADHD are similar across the lifespan, they often present differently in adults compared to children. Common signs of adult ADHD include: Inattentive Symptoms: Poor concentration or easily distracted Difficulty following instructions Procrastination Frequently misplacing things Trouble meeting deadlines Avoidance of tasks requiring sustained mental effort Hyperactive/Impulsive Symptoms: Restlessness and fidgeting Excessive talkativeness Impatience, frequent interrupting in conversation Making impulsive decisions Feelings of restlessness or boredom Difficulty relaxing or "unwinding" Internalised hyperactivity can also include: Overthinking, rumination or racing thoughts Gender Differences in ADHD While ADHD impacts both men and women, there are some key differences in how it manifests: In Men: Research suggests that cis men are more likely to exhibit hyperactive or impulsive behaviours. They have higher rates of comorbid substance abuse issues and more coordination and learning difficulties. In Women: Cis women are more likely to be diagnosed with the inattentive subtype rather than the combined hyperactive subtype . They may have more internalised symptoms like low self-esteem. They present with higher risks of anxiety, depression, eating disorders, and show a tendency towards lower-energy or daydreaming. The presentation of commonly less visible ADHD symptoms may contribute to late-diagnosis or misdiagnosis. Hormones also may play a key role in this (a topic will be exploring in detail in an upcoming blog article). Compensatory Strategies Mask Adult ADHD One reason many adults live with undiagnosed ADHD for years or decades is their ability to develop coping strategies and mechanisms that temporarily "mask" or manage their symptoms. This compensation allows them to function, at least for a while, despite underlying ADHD. Examples of Compensatory Strategies: Relying heavily on planners, apps, and calendars Structured environments like school or the military Simplified living situations like living alone Involvement of an organised spouse or partner Working extreme hours or in highly stimulating jobs Why Masking Eventually Fails While these coping methods provide temporary relief, they are not a cure for ADHD. Over time, masking becomes more difficult as life changes, demands increase, or the individual's personal situation shifts, such as: Hormonal fluctuations (pregnancy, menopause, etc.) Trauma or significant life stressors Career transitions or new responsibilities Breakdown of relationships or living situations Lack of structure during retirement or job changes It's often at major life transitions or periods of increased stress when adults realise they need professional guidance and support. An assessment can finally pinpoint ADHD as the underlying issue or challenge. See our article on how high-functioning ADHD can lead to burnout and breakthrough . Along the path to an ADHD diagnosis, individuals are frequently misdiagnosed with other mental health conditions before receiving appropriate treatment for ADHD. Once they receive effective ADHD treatment, many experience a resolution of their previously diagnosed mental health difficulties for the first time. While coping strategies provide temporary relief, long-term management through a multimodal approach – combining medication, therapy, coaching, and lifestyle adjustments – is crucial for many adults to successfully manage ADHD's impact across all areas of life. What can I do if I suspect I have ADHD? If you or a loved one suspect ADHD may be contributing to daily challenges, seeking an evaluation from a provider specialising in adult ADHD assessment and treatment is highly recommended. Choose a clinician who specialises in the specific struggles you face to ensure the right fit for personalised treatment aligned with your values and life goals. An evaluation can definitively rule ADHD in or out, allowing you to develop an individualised care and management plan. Our psychologists at True North Psychology have experience in working with neurodiverse individuals, some with expertise, and identifying neurodiverse, with personal experience of being diagnosed with ADHD and or Autism in adulthood. Conclusion and Summary The rising rates of adult ADHD diagnosis do not reflect a passing fad, but rather a legitimate neurological condition that impacts millions worldwide. This increase is more likely attributed to several key factors: greater public awareness and decreasing stigma around mental health, an expanded clinical definition beyond stereotypical childhood hyperactivity, improved adult-specific screening methods and more clinicians trained to evaluate patients across the lifespan. With prevalence estimated at about 1 in 20 of adults, ADHD is a relatively common neurodevelopmental profile. However, comprehensive clinical assessments remain crucial to differentiate ADHD from other potential cognitive issues and avoid misdiagnosis or overdiagnosis. The growing recognition of adult ADHD represents positive strides in identifying and supporting a long-overlooked population. Think You Might Be An ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists. BOOK A DISCOVERY CALL TODAY Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. WANT TO LEARN MORE? Below are recommended resources and supportive communities exploring Adult ADHD. ADHD Books : ADHD an A-Z: Figuring it Out Step by Step by Leanne Maskell ADHD 2.0 by Edward M. Hallowell, M.D. and John J. Ratey , M.D. Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood by Edward M. Hallowell, M.D. and John J. Ratey, M.D. It's Not A Bloody Trend: Understanding Life as an ADHD Adult by Kat Brown Scattered Minds: The Origins and Healing of Attention Deficit Disorder by Dr Gabor Mate The ADHD Effect on Marriage by Melissa Orlov Understand, Survive and Thrive - Midlife ADHD Diagnosis by Emma Mahony Your Brain’s Not Broken: Strategies for Navigating Your Emotions and Life with ADHD - by Tamara Rosier The Year I Met My Brain: A travel companion for adults who have just found out they have ADHD - by Matilda Boseley How to ADHD: An Insider's Guide to Working with Your Brain (Not Against It) - Jessica McCabe Women with Attention Deficit Disorder: Embrace Your Differences and Transform Your Life - by Sari Solden The Mindfulness Prescription for Adult ADHD: An 8-Step Program for Strengthening Attention, Managing Emotions, and Achieving Your Goals - by Lidia Zylowska Order from Chaos by Jaclyn Paul Books about Neurodiversity Different, Not Less: A Neurodivergent's Guide to Embracing Your True Self and Finding Your Happily Ever After - by Chloe Hayden Divergent Mind: Thriving in a World That Wasn’t Designed For You - by Jenara Nerenberg How Not to Fit In: An Unapologetic Guide to Navigating Autism and ADHD - by Jess Joy and Charlotte Mia UNMASKED: The Ultimate Guide to ADHD, Autism and Neurodivergence - by Ellie Middleton The Neurodivergent Friendly Workbook of DBT (Dialectical Behaviour Therapy) Skills - by Sonny Jane Wise The Pocket Guide to Neurodiversity by Daniel Aherne The Power of Different: The Link Between Disorder and Genius - by Gail Saltz Websites with free resources on adult ADHD: ADDitude - https://www.additudemag.com/ TotallyADD - https://totallyadd.world/ CHADD - https://chadd.org/ ADHD U K - www.adhduk.co.uk ADDA - https://add.org/grow/adhd-library/ Podcasts: ADHD As Females ADHD Experts ADHD Rewired Podcast Taking Control: The ADHD Podcast The ADHD Adults Podcast The ADHD Women's Wellbeing Podcast Online Forums/Groups: Reddit's ADHD Community (r/ADHD) - https://www.reddit.com/r/ADHD/ ADDitude Forums - https://www.additudemag.com/forums/ CHADD Online Support Groups - https://chadd.org/attending-a-meeting/ TotallyADD Forums - https://totallyadd.world/forums/ ADDA - https://add.org/grow/adhd-library/ Social Media: Facebook ADHD Groups (ADHD Adults, Adult ADHD Support Group, etc.) Instagram ADHD Hashtags (#ADHD, #ADHDAdults, #ADHDLife, etc.) STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. THINK YOU MIGHT BE ADHD? At TNP we specialise in High-Functioning ADHD and other non-typical presentations of ADHD. Book a Screening Call with us today to see if you'd be a good fit for our compassionate ADHD assessment approach! Learn more about our compassionate and individualised approach to Adult ADHD assessment and Book Your 15-minute, no obligations Screening Call Today ! NEED THERAPEUTIC SUPPORT? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology we provide a neurodiversity-affirming and inclusive approach to therapy - listening to neurodivergent voices and providing appropriate accommodations and approaches to supportive our clients and staff. Psychologists on our platform have experience of working with neurodiverse individuals and some have special interests and expertise in the areas of ADHD and Autism. Book a FREE 30-minute Therapy Discovery Call with one of our neurodivergent-affirming Psychologists Today. Get Started & Book your Therapy Discovery Call References Abdelnour E, Jansen MO, Gold JA. ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022 Sep-Oct;119(5):467-473. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616454/ PMID : 36337990; PMCID: PMC9616454. Brown, K. (2023). It's Not A Bloody Trend: Understanding Life as an ADHD Adult . Jessica Kingsley Publishers. McKechnie DGJ, O’Nions E, Dunsmuir S, Petersen I. Attention-deficit hyperactivity disorder diagnoses and prescriptions in UK primary care, 2000–2018: population-based cohort study. BJPsych Open. 2023;9(4):e121. doi:10.1192/bjo.2023.512 McManus C. (2019). Half a century of handedness research: Myths, truths; fictions, facts; backwards, but mostly forwards. Brain and neuroscience advances , 3 , 2398212818820513. https://doi.org/10.1177/2398212818820513 Rucklidge J. J. (2010). Gender differences in attention-deficit/hyperactivity disorder. The Psychiatric clinics of North America , 33 (2), 357–373. https://doi.org/10.1016/j.psc.2010.01.006 Russell J, Franklin B, Piff A, Allen S, Barkley E. Number of ADHD Patients Rising, Especially Among Women. Epic Research. https://epicresearch.org/articles/number-of-adhd-patients-rising-especially-among-women . Accessed on May 23, 2024.
- How to Find the Right Therapist: A Guide to Choosing Your Therapeutic Match
Written by Dr Sara Tookey As a psychologist who has been both therapist and client, I understand firsthand how challenging it can be to find the right therapist - even for someone who works in the field! While the process can feel daunting, with some guidance and key factors to consider, it can be a manageable and ultimately rewarding experience. This article presents a comprehensive guide to help you navigate your search for right therapeutic match for you. Start With Self-Reflection Before beginning your search, taking time for self-reflection is crucial. This preliminary step helps you clarify your needs and expectations, making your search more focused and effective. Consider: What specific issues bring you to therapy? (e.g. anxiety, depression, trauma, relationships). Beyond broad categories like anxiety or depression, try to identify particular patterns, situations, or concerns that impact your life. What are your therapy goals? Are you seeking short-term solutions for specific problems, or are you interested in deeper, long-term personal growth and understanding? What therapy style might suit you best? (structured vs. open-ended, directive vs. non-directive) Some people prefer structured approaches with concrete tools and homework, while others benefit from more exploratory, open-ended conversations. What aspects of your identity and experience are important to you? Consider how your cultural background, gender identity, sexual orientation, neurodiversity, or other key aspects of your identity shape your experience and needs. What would you like your therapist to understand or share with you? Look for Value Alignment Finding a therapist whose values align with yours is about more than just personal preference – it's fundamental to building trust and creating an environment where you can be fully authentic. A therapist's explicit stance on various issues can significantly impact the therapeutic relationship: Social Justice and Cultural Understanding: A therapist with strong cultural competency understands how societal factors, systemic inequalities, and cultural background influence mental health. They should appreciate the unique challenges faced by different communities and understand how these factors impact therapeutic goals. Identity-Affirming Approaches: Many people benefit from working with therapists who explicitly affirm various aspects of identity and experience. This might include being LGBTQIA+ affirming , neurodiversity-affirming , culturally responsive, or understanding of specific religious or spiritual beliefs. Trauma-Informed Approach : A trauma-informed therapist understands how past experiences can impact current functioning and appreciates the need for safety, choice, and control in therapy. They recognise that trauma responses are normal adaptations to abnormal situations and work at a pace that feels comfortable for you. This approach emphasises physical and emotional safety, transparency, and collaboration in the therapeutic relationship. Relationship Styles : Some therapists specialise in working with diverse relationship structures and styles, including being poly-friendly, kink-allied, or sex-positive. Having a therapist who understands and validates your relationship choices can be crucial for open and honest therapeutic work. Treatment Philosophy: Consider whether you want someone who takes a more traditional medical approach to mental health or someone who views psychological challenges through a social, political, or holistic lens. Some therapists focus on symptom reduction, while others emphasise personal growth and/ self-actualisation. Life Experience: You might prefer a therapist who has specific lived experience or expertise with certain life situations, such as: Chronic illness or disability Immigration or cross-cultural experiences Military service Addiction recovery Parenting or family dynamics Career transitions Grief and loss When exploring potential therapists, don't hesitate to ask about their stance on issues that matter to you. A skilled therapist will be open about their approach to these areas and honest about their limitations. Remember, it's not about finding someone who agrees with everything you believe, but rather someone who can create a safe, understanding space for you to explore your experiences and challenges. Understanding Different Therapeutic Approaches Different therapeutic approaches can serve different needs, and understanding these differences can help you make an informed choice. See some examples below: Cognitive Behavioural Therapy (CBT) : Best suited for those seeking practical tools to address specific thoughts and behaviours. CBT is particularly effective for anxiety, depression, and other mood disorders where identifying and changing thought patterns can lead to improved well-being. Acceptance and Commitment Therapy (ACT) : Combines mindfulness strategies with behavioural change techniques. Well-suited for those wanting to live more fully according to their values while developing psychological flexibility. Psychodynamic Therapy : This approach explores how past experiences and relationships influence current patterns. It's particularly helpful for those interested in deep self-understanding and addressing long-standing emotional patterns. Compassion Focused Therapy (CFT) : An approach that combines evolutionary psychology and neuroscience to help develop self-compassion. Particularly effective for those struggling with shame, self-criticism, and trauma-related difficulties. EMDR Therapy : A specialised approach primarily used for processing trauma and distressing life experiences. Particularly helpful for PTSD, phobias, and anxiety disorders where specific memories or experiences trigger distress. Existential Therapy: Focuses on exploring life's fundamental questions about meaning, purpose, and human existence. This approach is particularly valuable for those grappling with major life transitions, identity questions, or existential concerns about death, freedom, and responsibility. Internal Family Systems (IFS) : Views the mind as containing many sub-personalities or "parts." Effective for complex trauma, relationship issues, and those interested in understanding different aspects of themselves. Systemic Relationships Therapy : Considers problems within the context of relationships and broader systems. Valuable for couples, families, and those wanting to understand how their relationships and social systems influence their well-being. Many therapists use an integrative approach, combining elements from different modalities. However, in evidence-based therapy, approaches should be chosen systematically based on research evidence and clinical expertise, guided by a clear understanding of your specific needs - not selected randomly or based solely on therapist preference. When considering a therapist who describes their work as integrative, don't hesitate to ask how they select their approaches and what evidence supports their methods for your specific concerns. Visit our therapeutic services page to learn more about different therapeutic approaches . Consider Practical Factors The logistics of therapy can significantly impact your ability to engage consistently and meaningfully in the process. Consider these key factors: Location and Format: Decide whether in-person or online therapy better suits your needs. Online therapy offers flexibility and accessibility, while in-person sessions might provide a more contained therapeutic space. Consider your comfort level with technology and your need for physical presence in the therapeutic relationship. Schedule and Frequency: Think about what timing works best for your mental energy and lifestyle. Consider whether you need regular weekly sessions, bi-weekly meetings, or a more flexible arrangement. Some therapists offer evening or weekend appointments for those with traditional work schedules. Financial Investment: Understand the full financial picture, including: Session fees and payment methods Insurance coverage and reimbursement options Sliding scale availability Cancellation policies Additional costs (like between-session support or report writing) Accessibility Needs: Consider any specific requirements you have, such as: Physical accessibility of the office space Language preferences Technology requirements for online sessions Accommodations for hearing, vision, or sensory needs Verify Credentials and Experience Ensuring your therapist has appropriate qualifications is crucial for your safety and the effectiveness of therapy: Professional Registration: Verify that they're registered with appropriate professional bodies in your region. Different titles (psychologist, counsellor, psychotherapist) have different training requirements and scopes of practice. learn more about mental health professional titles HERE Specialised Training: Look for additional certifications or training in areas relevant to your needs, such as trauma work, specific therapeutic modalities, or particular population groups. Experience Level: Consider whether you prefer an experienced practitioner or someone newer to the field. Both can be effective, but they might offer different perspectives and approaches. Use Available Resources to Find the Right Therapist: Make use of multiple channels to find potential therapists: Professional Directories: Websites like Psychology Today, GoodTherapy, International Therapists Directory, offer searchable databases with detailed therapist profiles, making it easier to find someone who matches your criteria. Community Resources: Local mental health organisations, community centres, or healthcare providers often maintain lists of trusted therapists and can provide recommendations based on your specific needs. Personal Networks: While recommendations from friends or family can be helpful, remember that therapeutic fit is highly individual. What works for someone else may not work for you. Free Initial Consultations: Take advantage of discovery calls or brief consultations to get a sense of different therapists' styles and approaches before committing. Trust Your Instincts During Initial Contact The first few interactions with a potential therapist can tell you a lot about whether they're the right fit: Communication Style: Notice how they respond to your questions. Are they clear, professional, and timely in their communications? Do they explain things in a way you can understand? Initial Comfort Level: Pay attention to how you feel during your first conversation. While some nervousness is normal, you should feel generally comfortable and respected. Collaborative Approach: The therapist should be open to questions about their approach and willing to discuss how they might help with your specific concerns. Starting the Therapeutic Journey Once you've chosen a therapist, remember: Building Trust Takes Time: While you should feel basically comfortable from the start, developing a deep therapeutic relationship takes time. Give yourself and your therapist time to develop rapport. Regular Check-ins: Good therapy includes periodic reviews of your progress and the therapeutic relationship. Your therapist should be open to discussing what's working and what isn't. Flexibility to Change: If after several sessions you feel the fit isn't right, it's perfectly acceptable to discuss this with your therapist or seek someone new. Finding the right therapist is an investment in your wellbeing. While it may take time to find the perfect match, the effort is worth it for the potential positive impact on your mental health journey. The Role of Ongoing Assessment As your therapy progresses: Regularly evaluate whether your needs are being met Discuss any concerns openly with your therapist Be honest about what's working and what isn't Consider whether your goals have changed Conclusion Finding the right therapist is an investment in your mental health and well-being. While the process might take time and effort, the potential benefits of a good therapeutic match make it worthwhile. Remember that you have the right to be selective and to change therapists if needed - your mental health journey is personal, and finding the right support is crucial for your growth and healing. Ready to Start Your Search? At True North Psychology, we understand that finding the right therapist can feel overwhelming. We know how crucial this match is for your therapeutic journey. Our team of diverse, specialised therapists offers compassionate, evidence-based care aligned with your unique needs and values. Some of our specialisms include: supporting adults with ADHD, trauma recovery, relationship challenges, and those seeking identity-affirming therapy. True North Psychology offers two FREE ways to find your perfect therapeutic match: Book free discovery calls with our therapists Discuss what brings you to therapy Ask questions Get a sense of the therapeutic fit Use our matching service Complete our brief online form Receive personalised recommendations Get matched with the right therapist for your needs Take the first step today: BOOK A FREE DISCOVERY CALL → COMPLETE OUR CONFIDENTIAL THERAPIST MATCHING FORM → Our FREE therapist matching form is designed to help you connect with the most suitable psychologist for your needs. How it works: Click on the Therapy Matching Form link above Complete the form now or later Get personalised therapist recommendations within 2 working days Book your initial consultation with your matched therapist Learn more about our services: www.truenorth-psychology.com Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. References Barkham, M., Moller, N. P., & Pybis, J. (2017). How should we evaluate research on counselling and the treatment of depression? A case study on how the National Institute for Health and Care Excellence's draft 2018 guideline for depression considered what counts as best evidence. Counselling and Psychotherapy Research, 17(4), 253-268. https://doi.org/10.1002/capr.12141 Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (2010). The heart and soul of change: Delivering what works in therapy (2nd ed.). American Psychological Association. https://doi.org/10.1037/12075-000 Norcross, J. C., & Wampold, B. E. (2019). Relationships and responsiveness in the psychological treatment of trauma: The tragedy of the APA Clinical Practice Guideline. Psychotherapy, 56(3), 391–399. https://doi.org/10.1037/pst0000228 Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303-315. https://doi.org/10.1037/pst0000193 Swift, J. K., Callahan, J. L., Cooper, M., & Parkin, S. R. (2018). The impact of accommodating client preference in psychotherapy: A meta‐analysis. Journal of Clinical Psychology, 74(11), 1924-1937. https://doi.org/10.1002/jclp.22680 Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge. https://doi.org/10.4324/9780203582015 For reliable online resources about finding a therapist, visit: British Association for Counselling and Psychotherapy (BACP): https://www.bacp.co.uk British Psychological Society (BPS): https://www.bps.org.uk Health and Care Professions Council (HCPC): https://www.hcpc-uk.org Note: These references reflect current research in psychotherapy effectiveness and therapeutic relationships. For the most up-to-date guidelines and research, please consult recent publications and professional bodies.
- LGBTQIA+ and Neurodivergent: Shining a Light on Intersectionality and Mental Health
Written by Dr Sara Tookey As we celebrate Pride Month, it's crucial to recognise and understand the unique experiences of individuals at the intersection of LGBTQIA+ identities and neurodivergence. This article explores the growing body of research revealing a significant overlap between neurodivergent conditions like autism and ADHD and diverse gender identities and sexual orientations. We'll delve into recent studies that highlight the higher prevalence of LGBTQIA+ identities among neurodivergent individuals, examine potential reasons for this correlation, and discuss the specific challenges faced by this community in accessing appropriate healthcare and support. By shedding light on this important intersection, we aim to promote greater understanding, acceptance, and targeted support for LGBTQIA+ neurodivergent people. Contents: What is Pride? Mental Health Challenges for the LGBTQIA+ Community The Impact of Neurodivergence Celebrating Neurodivergent LGBTQ+ Voices Supporting LGBTQIA+ Neurodivergent Mental Health Conclusion Resources & Groups for Neurodivergent LGBTQIA+ People Subscribe to our newsletter to keep up to date on the latest news, events, resources Book an initial consultation What is Pride? June is Pride Month — a time to unite and celebrate the rich identities and experiences within the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, pansexual, and others) community. Pride Month commemorates the Stonewall riots , which occurred in June 1969 in the United States. These significant protests marked a turning point in the fight for gay rights, impacting not just America but the world. Pride is a celebration where people come together in love and friendship to highlight the progress made in LGBTQIA+ rights and acknowledge the ongoing struggles. It stands for acceptance, equality, honouring the contributions of LGBTQIA+ people, educating others about LGBTQIA+ history and raising awareness of issues affecting the community. Pride also serves as a reminder of the harmful effects of homophobia, both past and present, and emphasises being proud of who you are. Defining Terms: Sex, Gender and Sexuality. Click the arrow to learn about how we use the terms sex, gender and sexuality in this article. Firstly, it's important to understand that sex, gender, and sexuality exist on spectrums and can be co mplex, personal subjects. Sex refers to our anatomy, chromosomes, and primary/secondary sex characteristics. Gender identity is our innermost understanding of self, while gender expression is how we outwardly communicate gender. Sexual orientation describes who we are romantically/sexually attracted to. These components do not always align in a binary "male/female" or "masculine/feminine" way. There are non-binary genders, sexualities like asexual or pansexual, and intersex identities that fall outside societal norms and are included in the LGBTQIA+ acronym. For those with marginalised identities, there can be erasure and invisibility. Those with identities society deems "normative" may not have actively examined how they define their own gender and sexuality. If these concepts are new, please approach with openness - don't make assumptions about how someone identifies. It's best to respectfully ask if someone chooses to share their identity with you. While Pride is a joyous occasion, Pride also raises awareness about the unique mental health challenges that LGBTQIA+ individuals often face. Studies show that LGBTQIA+ people are more than twice as likely to experience mental health conditions like anxiety and depression compared to their heterosexual peers ( 1 ). This month, we want to highlight the important intersection of being LGBTQIA+ and neurodivergent, and outline how we can better support the mental wellbeing of these communities. Mental Health Challenges for the LGBTQIA+ Community For LGBTQIA+ people, experiences of discrimination, stigma, social isolation and lack of access to supportive services can significantly impact mental health . Negative coming out experiences, rejection from family and friends, and internalising societal prejudices like homophobia and transphobia take a major toll. The transgender community, in particular, faces extremely long wait times to access gender-affirming care, compounding issues like gender dysphoria. Research shows transgender people are at heightened risk of developing long-term mental illness ( 2 ). The Impact of Neurodivergence Recent years have seen an increase in research examining the connections between neurodivergence and identifying as LGBTQIA+. A growing number of queer adults who did not receive neurodivergent diagnoses in childhood are now being identified and gaining information about neurodivergent conditions later in life. However, even with this newfound awareness, neurodivergence remains widely misunderstood and lacks sufficient representation within LGBTQIA+ communities. Defining Terms: Neurodivergence. Click the arrow to learn more. The term "neurodivergence" encompasses a wide array of variations in how people process information, communicate socially, focus their attention, learn, and experience other neurological functions. Neurodivergent conditions include Attention Deficit Hyperactivity Disorder ( ADHD ), Autism Spectrum Disorder ( ASD ), dyslexia, and others. While these are classified as disorders or conditions, neurodivergence itself is not something requiring a "cure" or "fix" - it is simply one facet of an individual's identity and way of being in the world. At the same time, a formal diagnosis can provide access to supportive tools and resources that enable neurodivergent people to better navigate a world that was not built with them in mind. Recent studies have revealed a strong correlation between neurodivergence and increased likelihood of identifying as LGBTQIA+. This includes a greater sexuality and gender variance neurodivergent people. Researchers theorize that this may be because neurodivergent individuals are more inclined to question gender and sexual norms ( 3 ). A 2014 study reported that gender variance was found to be 7.59 times more common in participants with ASD and 6.64 times more often in participants with ADHD ( 4 ), with more recent studies confirming this increasing representation of gender variance amongst neurodivergent individuals ( 5 ; 6 ). It has been reported that 70% of autistic individuals identify as non-heterosexual ( 7 ). Another study of autistic women reported only 8% as exclusively heterosexual ( 8 ). Research from Cambridge University found that autistic people were 8 times more likely to identify as asexual or "other" sexuality compared to non-autistic peers ( 9 ). Findings suggested that autistic males were 3.5 times more likely to identify as bisexual compared to non-autistic males, while autistic females were three times more likely to identify as homosexual than non-autistic females. Autistic females were also more likely to be sexually active, identify as asexual, bisexual, and "other" sexuality, and less likely to identify as heterosexual compared to autistic males ( 9 ). An exploratory study found that 61% of ADHD participants reported a non-heterosexual sexual orientation ( 10 ). More research is needed to understand this intersection and learn how best to support these individuals. Despite this elevated representation, LGBTQIA+ neurodivergent people face unique barriers accessing diagnosis and support due to assumptions they don't understand their genders/sexuality and are more often misdiagnosed or dismissed by healthcare providers ( 3 ; 11 ). Cisgender women and AFAB (assigned female at birth) individuals are chronically under-diagnosed for neurodivergent conditions like autism and ADHD, as diagnostic criteria may not account for how these conditions present in those socialised as girls. For example, researchers from University College London, Bargiela, Mandy and Steward (2016) , suggested in their research that while some autistic girls can be “shy”, many can have close friends as well as an interest in making friends ( 12 ). Due to the many layers of barriers, the practice of self-diagnosis is generally considered an acceptable route for many to understand themselves better and access helpful tools and resources. Celebrating Neurodivergent LGBTQ+ Voices Despite the obstacles, more neurodivergent LGBTQIA+ creators and advocates are raising awareness and sharing their stories through mainstream channels. Comedians like Hannah Gadsby and Josh Thomas , whose shows feature queer neurodivergent characters, have shared their own autism diagnoses. Photographer Nora Nord highlights misinformation about ADHD and the stereotypical focus on men. Online communities like The Autisticats , run by LGBTQIA+ autistic youth, are also providing resources and sharing personal stories. Supporting LGBTQIA+ Neurodivergent Mental Health If you are LGBTQIA+ and/or neurodivergent and struggling with your mental health, there is support available: Practice self-care through exercise, sleep, nutrition Find an LGBTQIA+ community group . Get support by talking to a therapist who specialises in LGBTQIA+ and neurodivergent-affirming care. Know your legal rights in accessing accommodations . Employers and allies also play a crucial role by: Creating clear anti-discrimination policies and practices . Providing training to increase understanding of LGBTQIA+ and neurodivergent identities. Offer LGBTQIA+ employee resource groups. Use inclusive language like sharing pronouns . Listen, amplify queer and neurodivergent voices, and take time to educate yourself as an ally. Conclusion As we celebrate Pride this June, it's vital that we create more spaces where LGBTQIA+ individuals feel safe, seen, and supported in all aspects of their identities - including neurodivergence. Through continued dialogue, compassion, and community-building, we can destigmatise mental health and ensure resources are available for those navigating this intersection. At our practice, we are committed to providing LGBTQIA+ and neurodivergent-affirming care. Our services are also available to those who may not identify under the LGBTQIA+ umbrella. All are welcome. Think You Might Be A High-Functioning ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. WANT TO LEARN MORE? Resources & Groups for Neurodivergent LGBTQIA+ People Please note that True North Psychology is not affiliated with any of the organisations listed below: A Guide for Queer Folks Who Just Learned They Have ADHD Resources For Trans People On The Spectrum Asperger/Autism Network – Online Coaching and Groups for LGBTQIA+ People Queer ADHD - Queer centered ADHD coaching Queerly Autistic: Blog exploring the intersection of being queer and autistic Autistic Women & Non-Binary Network Choice support (UK) Atypiqueers community (London, UK) ADD itude - Neuroqueer (Online) STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! Subscribe to our newsletter to keep up to date on the latest news, events, resources and features from True North Psychology THINK YOU MIGHT BE ADHD? At TNP we specialise in High-Functioning ADHD and other non-typical presentations of ADHD. Book a Screening Call with us today to see if you'd be a good fit for our compassionate ADHD assessment approach! Learn more about our compassionate and individualised approach to Adult ADHD assessment and Book Your 15-minute, no obligations Screening Call Today ! NEED THERAPEUTIC SUPPORT? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology our clinicians provide a LGBTQIA+ and neurodiversity-affirming approach to therapy. We listen to neurodivergent and LGBTQIA+ voices and providing appropriate accommodations and approaches to support our clients and staff. Book a FREE 30-minute Therapy Discovery Call with one of our neurodivergent-affirming Psychologists Today. Get Started & Book your Therapy Discovery Call References Gmelin, J. H., De Vries, Y. A., Baams, L., Aguilar-Gaxiola, S., Alonso, J., Borges, G., Bunting, B., Cardoso, G., Florescu, S., Gureje, O., Karam, E. G., Kawakami, N., Lee, S., Mneimneh, Z., Navarro-Mateu, F., Posada-Villa, J., Rapsey, C., Slade, T., Stagnaro, J. C., Torres, Y., … WHO World Mental Health Survey collaborators (2022). Increased risks for mental disorders among LGB individuals: cross-national evidence from the World Mental Health Surveys. Social psychiatry and psychiatric epidemiology , 57 (11), 2319–2332. https://doi.org/10.1007/s00127-022-02320-z Watkinson, R. E., Linfield, A., Tielemans, J., Francetic, I., & Munford, L. (2024). Gender-related self-reported mental health inequalities in primary care in England: a cross-sectional analysis using the GP Patient Survey. The Lancet. Public health , 9 (2), e100–e108. https://doi.org/10.1016/S2468-2667(23)00301-8 Bouzy, J., Brunelle, J., Cohen, D., & Condat, A. (2023). Transidentities and autism spectrum disorder: A systematic review. Psychiatry research , 323 , 115176. https://doi.org/10.1016/j.psychres.2023.115176 Strang, J.F., Kenworthy, L., Dominska, A. et al. Increased Gender Variance in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder. Arch Sex Behav 43 , 1525–1533 (2014). https://doi.org/10.1007/s10508-014-0285-3 Strang, J. F., van der Miesen, A. I. R., Fischbach, A. L., Wolff, M., Harris, M. C., & Klomp, S. E. (2023). Common Intersection of Autism and Gender Diversity in Youth: Clinical Perspectives and Practices. Child and adolescent psychiatric clinics of North America , 32 (4), 747–760. https://doi.org/10.1016/j.chc.2023.06.001 Gratton, F. V., Strang, J. F., Song, M., Cooper, K., Kallitsounaki, A., Lai, M. C., Lawson, W., van der Miesen, A. I. R., & Wimms, H. E. (2023). The Intersection of Autism and Transgender and Nonbinary Identities: Community and Academic Dialogue on Research and Advocacy. Autism in adulthood : challenges and management , 5 (2), 112–124. https://doi.org/10.1089/aut.2023.0042 Strang, J. F., Powers, M. D., Knauss, M., Sibarium, E., Leibowitz, S. F., Kenworthy, L., Sadikova, E., Wyss, S., Willing, L., Caplan, R., Pervez, N., Nowak, J., Gohari, D., Gomez-Lobo, V., Call, D., & Anthony, L. G. (2018). "They Thought It Was an Obsession": Trajectories and Perspectives of Autistic Transgender and Gender-Diverse Adolescents. Journal of autism and developmental disorders , 48 (12), 4039–4055. https://doi.org/10.1007/s10803-018-3723-6 Bush, H. H., Williams, L. W., & Mendes, E. (2021). Brief Report: Asexuality and Young Women on the Autism Spectrum. Journal of autism and developmental disorders , 51 (2), 725–733. https://doi.org/10.1007/s10803-020-04565-6 Weir, E., Allison, C., & Baron-Cohen, S. (2021). The sexual health, orientation, and activity of autistic adolescents and adults. Autism Research, 14(11), 2342–2354. https://doi.org/10.1002/aur.2604 Abé, C., Rahman, Q., Långström, N., Rydén, E., Ingvar, M., & Landén, M. (2018). Cortical brain structure and sexual orientation in adult females with bipolar disorder or attention deficit hyperactivity disorder. Brain and behavior, 8(7), e00998. https://doi.org/10.1002/brb3.998 Hillier, A., Gallop, N., Mendes, E., Tellez, D., Buckingham, A., Nizami, A., & OToole, D. (2019). LGBTQ + and autism spectrum disorder: Experiences and challenges. International Journal of Transgender Health, 21(1), 98–110. https://doi.org/10.1080/15532739.2019.1594484 Bargiela, S., Steward, R., & Mandy, W. (2016). The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. Journal of autism and developmental disorders, 46(10), 3281–3294. https://doi.org/10.1007/s10803-016-2872-8 Other links referenced in article: ADDitude: ADHD and Queerness: Living in the Neuroqueer Intersection Neuroqueer individuals, those who are both neurodivergent and queer, experience challenges with ableism and homophobia that are unique to the intersection they inhabit — here, ADDitude readers share their experiences and stories. Dattaro, Laura. “Gender and Sexuality in Autism, Explained: Spectrum: Autism Research News.” Spectrum , 18 Sept. 2020, www.spectrumnews.org/news/gender-and-sexuality-in-autism-explained . NHS Dorset: Neurodiversity as LGBTQ+ community LGBT Foundation: https://lgbt.foundation/how-we-can-help-you/mental-health Gregory, A. & Adams, R. (2021). Almost half of all young non-binary adults... The Guardian. Thomas, T (2024): Review of gender services has major implications for mental health services… The Guardian Stonewall: https://www.stonewall.org.uk/about-us/news/coming-out-and-neurodiversity [5] Brain Charity: https://www.brainchairtylancashire.org.uk/2022/06/08/lgbtqia-and-neurodiversity/ Self-Diagnosed Autistic Community: https://selfdiagnosis.org/resources.shtml Queerly Autistic Eclectic: https://queerlyautisticeclectic.com/ ACAS (Disability Rights): https://www.acas.org.uk/disability-at-work Human Rights Campaign: https://www.hrc.org/resources/workplace-policies Mind UK: Supportive tips for everyday living. LGBTQIA+ mental health. mypronouns.org : https://www.mypronouns.org/ True North Psychology Blog (2024): Is Adult ADHD the Latest Trend? True North Psychology Blog (2024): Celebrating Neurodiversity: Understanding the Autism Spectrum The Full Spectrum: What's is like to be gay and autistic? Cleveland Clinic: AFAB and AMAB: What the Sex You’re Assigned at Birth Means for Your Health Netflix- Douglas, Hannah Gadsby show Josh Thomas website Photographer Nora Nord website The Autisticats , run by LGBTQIA+ autistic youth, are also providing resources and sharing personal stories. Disability at work (UK): accessing accommodations All content provided on our website is for educational purposes only and should not be a substitute for professional advice from a medical or mental health professional. Think You Might Be An ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists.
- 12 Most Damaging Myths About Adult ADHD: Facts About ADHD in Adulthood
Written by Dr Sara Tookey As an ADHD person and psychologist specialising in adult Attention-Deficit/Hyperactivity Disorder (ADHD), I've encountered numerous misconceptions about ADHD as a condition or set of traits. These myths can be particularly detrimental to adults who may not align with the stereotypical ADHD image, leading to delayed diagnoses, self-doubt, and unnecessary struggles. At True North Psychology, we advocate for a neurodiversity-affirming perspective that acknowledges both the challenges and strengths associated with ADHD. Let's explore and debunk some prevalent ADHD myths, understanding their impact on individuals and society. Myth #1: ADHD is Always a Disorder and a Deficiency While ADHD is categorised as a disorder in diagnostic manuals, viewing it solely through this lens can be restrictive. Neurodiversity theory sees ADHD and other conditions, like Autism and dyslexia as natural variations in brain structure and function, not inherently dysfunctional ( Sonuga-Barke and Thapar, 2021 ). In fact, some experts argue that the term "Attention Deficit Hyperactivity Disorder" itself is misleading and potentially harmful. Dr. Edward Hallowell and Dr. John Ratey, both leading experts in ADHD, propose that a more accurate term would be "Variable Attention Stimulus Trait" (VAST). They argue that individuals with ADHD don't have a deficit of attention, but rather an abundance of it. The challenge lies in controlling and directing that attention ( Hallowell & Ratey, 2024 ). This shift in perspective is crucial for adults with ADHD. Many professionals argue that ADHD is not a deficit of attention, but a problem with ‘regulating attention’ and that it is just a matter of time before the diagnostic criteria and definition of ADHD catches up. Understanding ADHD as a difference rather than a deficit can help to support the building of self-esteem and coping strategies for adults with ADHD. For many “ high-functioning adults ”, ADHD traits can also be great strengths (to learn more about these and other strengths read our blog on high-functioning ADHD HERE) . These can include: Creativity and innovation Hyperfocus Cognitive flexibility Resilience The neurodiversity approach emphasises that challenges often arise from a mismatch between the individual and their environment, rather than from inherent deficits ( Sonuga-Barke and Thapar, 2021 ). For example in working spaces where staff are made to work in open-plan offices people with ADHD may find it challenging to focus due to increased distractions. Noise cancelling headphones or having dedicated individual working spaces may help to support ADHD staff to regulate their attention and focus on tasks. Myth #2: Intelligent People Can Overcome ADHD Alone Cognitive ability and ADHD are distinct attributes. Many highly intelligent and successful people, including historical figures like Alexander Graham Bell, Leonardo da Vinci, Thomas Edison, Albert Einstein, John F. Kennedy, John Lennon, and Wolfgang Amadeus Mozart likely had ADHD. Their high intelligence may have helped them to compensate and mask their symptoms from many, often resulting in delayed diagnosis and support, and potential for burnout later in life . Research shows that ADHD affects individuals across all intelligence levels, and having a high IQ does not shield someone from the challenges of ADHD. High-IQ adults with ADHD often experience significant cognitive difficulties, such as impaired working memory and processing speed, similar to those with average IQs. These individuals may excel in areas requiring divergent thinking—creative, out-of-the-box approaches—but struggle with tasks that demand accuracy, logic, and speed. Despite their talents, they frequently face functional impairments, poorer quality of life, and higher rates of comorbid conditions like depression, OCD and generalised anxiety ( Antshel et al., 2010 ). High-IQ adults with ADHD also grapple with a unique set of emotional challenges. Many internalise their intellect as a core part of their identity, leading to an intense fear of failure. This can result in perfectionism, chronic self-monitoring, and a relentless drive to appear competent in all areas of their lives. However, this often comes at a high emotional cost, leaving them burdened, exhausted, and isolated ( read more about ADHD burnout from our previous article). They may feel compelled to hide their struggles, fearing that revealing their difficulties would expose them as frauds. Ultimately, intelligence does not negate the impact of ADHD; it simply complicates the path to diagnosis and effective management ( Littman, 2022 ). Myth #3: Everyone is a Little ADHD in Today's World This myth suggests that ADHD is a modern phenomenon caused by our fast-paced, technology-driven society. However, this view overlooks the long history and biological basis of ADHD. ADHD has been recognised in medical literature for over a century, albeit under different names. In 1798 a Scottish physician, Dr Alexander Crichton first described a condition he named it “the Fidgets”, based on behavioural observations that align with today’s ADHD criteria (read more about the history in our blog article addressing the adult ADHD “trend” ). This early recognition underscores that ADHD is not a product of the modern world but a longstanding neurodevelopmental condition. While our current environment may exacerbate ADHD symptoms or make them more noticeable, it doesn't cause the underlying neurological differences. However, it's important to note that modern society, with its relentless time pressures, constant digital communications, and ever-increasing work expectations, can be particularly challenging for individuals with ADHD. This fast-paced environment may exacerbate the risk of burnout and perpetuate a cycle of stress, especially for high-achieving individuals with ADHD who strive to meet high standards, often without appropriate accommodations for their neurodivergent traits. The interplay between ADHD and our current societal structure is a complex issue that merits further exploration. ADHD has a strong genetic component, as evidenced by research highlighting its neurobiological roots ( Faraone & Larsson, 2019 ). For high-achieving adults with ADHD, this myth can be particularly frustrating. It may lead to dismissive attitudes like “we’re all ADHD these days" or suggestions to simply "unplug" more often. While managing technology use and reducing overstimulation can be helpful strategies, they alone won't address the core challenges of ADHD. Recognising the long history and biological basis of ADHD can help to validate the experiences of those with the condition and emphasises the importance of comprehensive, evidence-based management and support. Myth #4: ADHD Only Affects Hyperactive Children The notion of ADHD as a childhood condition characterised by hyperactivity is outdated. While ADHD has long been viewed as a disorder of childhood, research shows that up to 90% of children with ADHD continue to experience symptoms into adulthood ( Sibley et al., 2022 ). Estimates vary, but research suggests around 4-5% of adults in the US and UK have ADHD. The true prevalence may be considerably higher. Many adults learn they have ADHD after one of their children is diagnosed, or when they seek help for a co-occurring problem like anxiety or depression. Some couples identify undiagnosed ADHD as the key factor in their marital issues ( Kahveci Öncü et al., 2022 - more on this in a future article). Many adults, particularly women or those with primarily inattentive ADHD, don't fit the hyperactive stereotype. For high-functioning adults, ADHD often manifests in less visible but still very impactful ways: Challenges with prioritisation and time management Procrastination followed by intense periods of hyperfocus Emotional intensity and heightened sensitivity to rejection Overthinking and decision paralysis Difficulty "quieting" an active mind Understanding these adult presentations is crucial for accurate diagnosis and support. Understanding that ADHD affects people beyond childhood—and in ways that go beyond hyperactivity—helps ensure that those identifying with the ADHD experience receive the appropriate care and access to supportive resources. Myth #5: ADHD is the Same for Everyone This myth suggests that ADHD manifests uniformly in all individuals, leading to misconceptions about diagnosis and treatment. In reality, ADHD is a highly heterogeneous condition, with symptoms and challenges varying significantly from person to person. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognises three distinct presentations of ADHD: Predominantly Inattentive : Characterised by difficulties with focus, organisation, and following through on tasks. Predominantly Hyperactive-Impulsive : Marked by excessive energy, restlessness, and impulsive behaviour. Combined Type : Involves a mix of inattentive and hyperactive-impulsive symptoms. However, even within these categories, individual experiences can differ greatly ( Sonuga-Barke and Thapar, 2021 ). For high-achieving adults, ADHD might manifest in unique ways that don't align with stereotypical symptoms. Some may excel in high-pressure situations but struggle with routine tasks, while others might focus intensely in their area of expertise but find everyday responsibilities overwhelming. Additionally, ADHD often co-occurs with other neurodivergent conditions such as dyslexia, autism, or anxiety, with studies showing that more than 50% of individuals with ADHD have at least one other co-occurring condition ( Katzman et al., 2017 ). This further diversifies its presentation and complicates diagnosis and treatment. Understanding the diverse nature of ADHD is crucial for proper diagnosis and effective treatment. It underscores the need for personalised approaches to ADHD management, rather than one-size-fits-all solutions. For high-achieving adults, recognizing this diversity can validate their unique experiences and challenges, even if they don't fit the "typical" ADHD profile. Myth #6: ADHD is Not a Legitimate Medical Condition Despite overwhelming scientific evidence, there persists a misconception that ADHD is not a genuine medical disorder. This myth can be particularly harmful, as it undermines the experiences of those living with ADHD and can hinder access to necessary support and treatment. Neuroimaging studies have consistently shown structural and functional differences in the brains of individuals with ADHD compared to those without the condition ( Yu et al., 2022 ). These differences include alterations in key neurotransmitters such as dopamine, norepinephrine, and glutamate, which are crucial for attention, motivation, and impulse control. Genetic research further supports ADHD's biological basis. Studies of identical twins show a high concordance rate for ADHD, indicating a substantial genetic component - such that individuals with a family history of ADHD are 4 to 6 times more likely to have the condition, and nearly half of children with ADHD have at least one parent with ADHD ( Uchida et al., 2021). Despite this robust scientific foundation, individuals with ADHD often face unfair judgement and labelling. They frequently encounter challenges such as: Lack of appropriate accommodations in educational and workplace settings Delayed diagnosis, especially in adults or those who don't fit the stereotypical ADHD profile Scepticism from others questioning the validity of ADHD as a real condition This scepticism can lead to delayed treatment, inadequate support, and unnecessary suffering. Recognising ADHD as a legitimate neuro-developmental condition is important for ensuring that individuals receive timely diagnosis, appropriate accommodations, and effective treatment. Dispelling this myth fosters a more understanding and supportive environment for those living with ADHD. Myth #7: ADHD is an Excuse for Laziness One of the most damaging myths about ADHD is the belief that individuals with the condition are simply unmotivated or lazy. In reality, many adults with ADHD are incredibly driven, often pushing themselves to the point of exhaustion in an effort to overcome their challenges. ADHD is a neurological condition, not a matter of willpower or discipline. The ADHD brain exhibits differences in dopamine functioning, making it difficult to initiate and sustain focus on non-stimulating tasks, regardless of the individual’s intentions or work ethic ( Volkow et al., 2009 ). Even simple tasks like sorting mail or answering emails can be daunting because they require significantly more mental energy for someone with ADHD. This isn't laziness; it’s a genuine neurological challenge. This misconception fails to recognise the neurobiological basis of ADHD. It's not a matter of simply trying harder or having more discipline. ADHD involves differences in brain structure and functioning, particularly in areas responsible for executive functions like attention regulation, impulse control, and working memory ( Faraone & Larsson, 2019 ). For high-achieving adults with ADHD, this myth can be especially harmful. Many have spent years pushing themselves to extremes, believing that more willpower could help them overcome their struggles. This often leads to cycles of burnout and self-reproach. Recognising ADHD as a legitimate neurobiological condition is essential to moving past this harmful misconception and providing proper support for those affected. Myth #8: Adults with ADHD Are Unable to Succeed in Academic, Professional or High-Achieving Careers Contrary to this myth, many adults with ADHD excel in their careers, particularly when they find roles that align with their strengths and passions. The cognitive style associated with ADHD often fosters innovative thinking, creative problem-solving, and intense focus on projects of interest—traits highly valued in numerous professions ( White & Shah, 2011 ). High-achieving adults with ADHD often thrive in dynamic, fast-paced environments where their ability to think on their feet and juggle multiple tasks and high-stress environments sets them apart. From entrepreneurs and artists to emergency physicians and journalists, individuals with ADHD have made significant contributions across a wide range of industries. However, success in the professional realm doesn't mean that ADHD's challenges disappear. Many high-functioning adults with ADHD may excel at work but struggle with personal relationships, self-care, or other aspects of life. Recognizing the broad impact of ADHD is crucial for providing comprehensive support and effective management strategies. This myth oversimplifies the diverse experiences of those with ADHD, ignoring both their potential for success and the unique challenges they face. SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. Myth #9: Medication is the Only Effective Treatment for Adult ADHD While medication can be an effective tool for managing ADHD symptoms, it is not the only approach, and it isn’t suitable for everyone. A comprehensive treatment plan for adult ADHD often includes a combination of strategies beyond medication. Effective alternatives include psychotherapy tailored for ADHD, mindfulness practices, executive function coaching, lifestyle changes, environmental adjustments, community support groups, and assistive technologies ( Knouse et al., 2008 ). Each individual's treatment should be personalised to address their unique needs and preferences. Myth #10: People with ADHD Can't Focus on Anything This myth misunderstands how attention functions in individuals with ADHD. Rather than an inability to focus, ADHD involves difficulty regulating attention. People with ADHD often experience periods of intense hyperfocus on tasks they find interesting or challenging ( Ashinoff & Abu-Akel, 2021 ). While this can lead to exceptional productivity and creativity, it also makes it difficult to shift attention to less stimulating but necessary tasks. As our understanding of ADHD evolves, the term "deficit" may be updated to "dysregulation" to more accurately reflect these experiences. Myth #11: ADHD is Caused by Inadequate Parenting The belief that ADHD is caused by poor parenting is a damaging misconception. Scientific evidence clearly shows that ADHD is rooted in neurobiology, not parenting styles. While a structured environment can support individuals with ADHD, it does not cause or cure the condition. Parents often feel unnecessary guilt, believing they could have prevented their child's ADHD through better discipline or control. However, attempts to “control” ADHD behaviours through constant discipline can often exacerbate the difficulties. This misunderstanding can lead to undue stress and societal judgement of the child and the parents, as ADHD-related behaviours like impulsivity or restlessness are mistakenly viewed as signs of poor upbringing. ADHD is a complex neuro-developmental condition that often requires professional intervention. Psychotherapy, medication (when appropriate), and other evidence-based treatments are often necessary components of effective ADHD management. These interventions go beyond what even the most skilled parenting can provide alone. Recognising ADHD as a neurological difference, rather than a reflection of parenting failures, is essential for reducing parental guilt and focusing on effective support strategies. This understanding fosters acceptance and helps implement the right support systems for individuals with ADHD and their families. Myth #12: People with ADHD Can't Be Mindful or Meditate This myth assumes that the restlessness and inattention associated with ADHD make mindfulness practices impossible or ineffective for those with the condition. In fact, research shows that mindfulness and meditation can be particularly beneficial for people with ADHD, helping to improve attention, reduce impulsivity, and enhance emotional regulation ( Mitchell et al., 2015 ). Although traditional sitting meditation may be challenging for those with ADHD, many alternative mindfulness practices can be adapted to suit their needs. These might include: walking meditation brief mindfulness exercises yoga and mindful movement guided visualisations and modified meditations for ADHD Each of these methods can help individuals with ADHD incorporate mindfulness into their daily routine in a way that aligns with their unique cognitive style. For high-achieving adults with ADHD, finding the right mindfulness approach can be a valuable tool for managing stress and improving focus. It's important to explore various techniques and select those that fit best with personal preferences and lifestyle. While mindfulness can be an effective part of ADHD management, it is not a substitute for comprehensive treatment. Integrating mindfulness with other evidence-based interventions can provide a holistic approach to managing ADHD. Conclusion & Summary: Many common beliefs about adult ADHD are based on outdated or oversimplified understandings of this dynamic neurotype. By challenging these myths with current research and clinical insights, we can promote a more accurate, empathetic and effective approach to supporting ADHD in adults. Recap of the Key Points: ADHD is a neurological difference with both challenges and strengths, not simply a disorder or disability. ADHD can affect individuals of all intelligence levels, including highly intelligent and successful people. Adult ADHD can manifest differently from childhood ADHD and can impact various aspects of executive functioning ADHD is rooted in neurobiological differences, not laziness or lack of willpower. Many adults with ADHD succeed professionally, often excelling in dynamic environments. Effective ADHD management often involves a multi-faceted approach beyond medication alone. ADHD affects attention regulation, which can include periods of intense focus (hyper-focus) as well as distractibility. Understanding these realities about ADHD can be the first step toward developing effective strategies for managing the challenges and leveraging strengths. It's important for individuals who suspect they may have ADHD to seek support, information to develop deeper self-understanding and/ a diagnostic assessment. Resources are available for those looking to learn more about adult ADHD or seek support. Organisations like CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) offer valuable information and resources. At True North Psychology, we're committed to providing neurodiversity-affirming care and support for adults with ADHD traits (including self-identified or self-diagnosed ADHD - also valid). If you're seeking more information or professional support, we encourage you to explore the resources available in your community or enquire about our online assessment and support service. We're here to guide you on that journey of self-discovery and empowerment. Think You Might Be ADHD? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. WANT TO LEARN MORE? Below are recommended resources and supportive communities exploring Adult ADHD. ADHD Books : ADHD an A-Z: Figuring it Out Step by Step by Leanne Maskell ADHD 2.0 by Edward M. Hallowell, M.D. and John J. Ratey , M.D. Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood by Edward M. Hallowell, M.D. and John J. Ratey, M.D. It's Not A Bloody Trend: Understanding Life as an ADHD Adult by Kat Brown Scattered Minds: The Origins and Healing of Attention Deficit Disorder by Dr Gabor Mate The ADHD Effect on Marriage by Melissa Orlov Understand, Survive and Thrive - Midlife ADHD Diagnosis by Emma Mahony Your Brain’s Not Broken: Strategies for Navigating Your Emotions and Life with ADHD - by Tamara Rosier The Year I Met My Brain: A travel companion for adults who have just found out they have ADHD - by Matilda Boseley How to ADHD: An Insider's Guide to Working with Your Brain (Not Against It) - Jessica McCabe Women with Attention Deficit Disorder: Embrace Your Differences and Transform Your Life - by Sari Solden The Mindfulness Prescription for Adult ADHD: An 8-Step Program for Strengthening Attention, Managing Emotions, and Achieving Your Goals - by Lidia Zylowska Order from Chaos by Jaclyn Paul Books about Neurodiversity Different, Not Less: A Neurodivergent's Guide to Embracing Your True Self and Finding Your Happily Ever After - by Chloe Hayden Divergent Mind: Thriving in a World That Wasn’t Designed For You - by Jenara Nerenberg How Not to Fit In: An Unapologetic Guide to Navigating Autism and ADHD - by Jess Joy and Charlotte Mia UNMASKED: The Ultimate Guide to ADHD, Autism and Neurodivergence - by Ellie Middleton The Neurodivergent Friendly Workbook of DBT (Dialectical Behaviour Therapy) Skills - by Sonny Jane Wise The Pocket Guide to Neurodiversity by Daniel Aherne The Power of Different: The Link Between Disorder and Genius - by Gail Saltz Websites with free resources on adult ADHD: ADDitude - https://www.additudemag.com/ TotallyADD - https://totallyadd.world/ CHADD - https://chadd.org/ ADHD U K - www.adhduk.co.uk ADDA - https://add.org/grow/adhd-library/ Podcasts: ADHD As Females ADHD Experts ADHD Rewired Podcast Taking Control: The ADHD Podcast The ADHD Adults Podcast The ADHD Women's Wellbeing Podcast Online Forums/Groups: Reddit's ADHD Community (r/ADHD) - https://www.reddit.com/r/ADHD/ ADDitude Forums - https://www.additudemag.com/forums/ CHADD Online Support Groups - https://chadd.org/attending-a-meeting/ TotallyADD Forums - https://totallyadd.world/forums/ ADDA - https://add.org/grow/adhd-library/ Social Media: Facebook ADHD Groups (ADHD Adults, Adult ADHD Support Group, etc.) Instagram ADHD Hashtags (#ADHD, #ADHDAdults, #ADHDLife, etc.) STAY CONNECTED Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! SUBSCRIBE to learn more about adult ADHD, get tips on managing and thriving with ADHD, and keep up to date with our service announcements and events. THINK YOU MIGHT BE ADHD? At TNP we specialise in High-Functioning ADHD and other non-typical presentations of ADHD. Book a Screening Call with us today to see if you'd be a good fit for our compassionate ADHD assessment approach! Learn more about our compassionate and individualised approach to Adult ADHD assessment and Book Your 15-minute, no obligations Screening Call Today ! NEED THERAPEUTIC SUPPORT? TNP logo - © True North Psychology Ltd. 2024 At True North Psychology we provide a neurodiversity-affirming and inclusive approach to therapy - listening to neurodivergent voices and providing appropriate accommodations and approaches to supportive our clients and staff. 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Frontiers in psychiatry , 13 , 1070142. https://doi.org/10.3389/fpsyt.2022.1070142 In text links: ADHD Foundation: Neurodiversity concept: is it helpful for clinicians and scientists? https://www.adhdfoundation.org.uk/wp-content/uploads/2022/03/The-neurodiversity-concept-is-it-helpful-for-clinicians-and-scientists.pdf True North Psychology: 'The Hidden Struggle: When High-Functioning ADHD in Adulthood Leads to Burnout and Breakthrough'. By Dr Sara Tookey (2024) https://www.truenorth-psychology.com/post/hidden-struggle-of-high-functioning-adhd-in-adulthood True North Psychology: "Is Adult ADHD the Latest Trend?" By Dr Sara Tookey https://www.truenorth-psychology.com/post/is-adult-adhd-the-latest-trend Diagnostic and Statistical Manual of Mental Disorders (DSM-5) https://www.psychiatry.org/psychiatrists/practice/dsm Think You Might Be A High-Functioning ADHDer? Enquire about an assessment or neurodivergent-affirming therapy with our specialist psychologists and psychotherapists.