Serenity – not just a Firefly spin off; it is the state of being calm, peaceful and untroubled.
The Serenity Mantra is a variant of the Srenity Prayer, but rather than asking for another entity to help you to navigate this, it brings the power of wisdom to yourself.
Here we break down why this is such a poweful idea.
Serenity Mantra:
* May I have the Patience, to Accept the things, I Cannot change – Be patient, all things change – Wait for new opportunities and use your strength wiseley – Acceptance is not approval
* May I have the Courage, to Change the thing, That I Can affect – Be Brave against the unknown – Progress feels good and inspires us – Review what we accepted, week new options and opportunities
* May I have the Wisdom, to tell the Difference, Between the Two – “Give me a lever long enough and a fulcrum on which to place it, and I shall move the world” – Archimedes – Work smarter, not harder – Are you applying effort to the right place?
We aren’t born knowing how to navigate this world, earn money or even get food. We need to learn how to do all of this. Learning takes a careful balance of neurotransmitters and thought strategies. Here we look at 12 ADHD Learning Hacks to help you optimise your learning. Not all ADHDers are the same, so while these are generically good for most ADHDers, you might find a step or two that isn’t ideal for you.
To optimise learning, we need balanced neurotransmitters, a positive mood, knowing what ‘good’ or ‘correct’ look like, a framework to grow our knowledge with and connecting our growing understanding to existing knowledge and understanding.
Neurotransmitters
We humans use a range of neurotransmitters to make our brain work well, learn a skill and then store that memory. When we say “balanced neurotransmitters”, we mean “not too much” and “not too little”, we are looking for a range of “good” in between them. Here we will go through some of the most important neurotransmitters. [Link to more about Neurotransmitters]
Dopamine
Dopamine is a key neurotransmitter that ADHDers struggle with. Dopamine helps us to be creative, connect ideas to other ideas and understand the deeper layers of nuance. Too much and our creativity drops, too little and our understanding of nuance and depth drops. We manufacture only so much Dopamine a day and our brains can use it poorly. Medication can often help with Dopamine delivery and retention in our important learning centres. You will often find that there is a time of day that you learn better, are more creative and more expressive. If you can, aim your study and learning for these times. Learning what it feels like when you run out of Dopamine is a key skill for knowing when to take a break – for most it feels like sudden fatigue, confusion and struggling to find the next thought.
Norepinephrine (Noradrenaline) helps us get things done, allows our mood to reflect the world in front of us, and identifies priorities. If your Norepinephrine is too high, it can cause paranoid thinking, aggression, mis-prioritisation (the wrong things seems important) and mis-hyperfocus (where you do one thing to the exclusion of all other things – but it is the wrong thing). If your Norepinephrine is too low, it can cause negative self talk, anxiety, angry thinking and interferes with task initiation and completion. Your body responds to low Norepinephrine by giving you social anxiety, fast anger response and tries to push you into Critical Mode.
Epinephrine (Adrenaline) plus moderate blood sugar is needed to store long term memories. If your Epinephrine is high, you’ll be triggered into Crisis Mode, and if it is low you’ll be pushed into Depression. Both of these take away from your ability to think clearly and make wise decisions.
When our Endorphins are medium to medium high we feel happy and our brain is receptive to new ideas, new connections and growth. If the Endorphins get too high, we can be too receptive and take in false ideas. If our Endorphins are low, we are likely to feel sad or bad and might find pain distracting. If our Endorphins get too low we can feel an absence of happiness, aka anhedonia.
Our Endorphin level is closely linked to having sufficient Dopamine, Norepinephrine and Epinephrine. If these go low, we often become (literally) un-happy. Even if these are at good levels, we need to be doing things we enjoy or thinking about good times to trigger this feeling.
Caffeine and Dopamine Foods (fat, sugar, carbohydrate, protein and salt) can help prompt your brain to make and release a bit more, but this does have limits – it is important to learn what it feels like when you have reached the limit of this helping. We also want to avoid too much sugar as that can interfere with long term memory storage. Also be aware that over use of caffeine and food can lead to other problems, so careful moderate use is key. Add in some nutritional other foods as thinking hard uses lots of nutritional resources.
Exercise that elevates both the heart rate and breathing rate for a sustained period of time, that is 10 minutes or more, can elevate Noradrenaline without necesarrily triggering just Adrenaline. This can help bring the energy back in to “doing” the task. This can be a brisk walk or light jog.
A warm shower or some stimming activities can bring in some extra endorphins to bring the happy back. Keep an eye on how much you are pushing through hate & anger – this is counter to positive feelings for learning. Time to refocus and reframe what you are doing. Stop pushing and find something that brings that fun feeling (but keeps your thinking clear) – such as a meditation on a fun memory or environment, feeling nice textures, playing that awesome 80’s mix tape or having a lovely conversation with someone. When the fun comes back, reframe what you are trying to learn / do so that it is empowering rather than awful, and go back and try again, but this time by adding fun features.
Brain Modes
Brain Modes is a short hand way of looking at what state we find ourselves in. We will briefly look at three of them.
In this state of mind, we feel comfortable, happy and want invest in doing things for a later time. We have the Dopamine to see connections and creative solutions, and sufficient Norepinephrine to put energy into initiating non-critical and non-urgent tasks.
This is an excellent learning state. Our solutions focus on Work Smarter rather Work Harder.
Critical Mode
In this state of mind, we think that there is an urgent and critical thing that needs to be done. This can be triggered by various urgencies (due date, friend coming over, expectations and judgement).
In this state we narrow our creativity, and focus on practical solutions. While creativity is narrowed, it isn’t gone, so we are able to logically and creatively add to solutions, but the emphasis is more on “doing” than “solving”.
This state of mind is quite familiar to ADHDers who hand things in at the last minute. It may be good, but it could have been better. It is important to acknowledge that “good enough” is often good enough, but it doesn’t feel good.
Sometimes people enter Hyper Focus with an urgent feel. This is where “only this task” exists and we can break lots of time limits. It often feels like “one more thing before I stop”.
Our solutions focus on Persistence Wins rather than Work Smarter.
Crisis Mode
In this state of mind, we need something done and we need it now. It can feel very pressured and we have no room to think things through, because this is a Crisis damnit.
Our creativity and learning are minimal. We decrease our solution space to Flight and Fight and there is little to no “think it through”. Dexterity is often down and we will frequently be physically clumsy.
Our solutions focus on Push Harder or Escape rather than Work Smarter.
Flow State
Sometimes we can enter into a state of mind where our enjoyment at learning and achieving triggers more neurotransmitter release. In this state of mind, we find that everything just flows and time can seem meaningless. This can lead to a very positive Hyper Focus with Creativity and Achievement being the central happy feel.
Hacking Learning
We need to acknowledge that ADHDers struggle to get sufficient Dopamine, which can lead to Brain Fog, and poor creativity. Often urgency is used to push us into a Critical Mode where we get the job done, but don’t necessarily learn that much from it. We can also use Anxiety and Anger to push ourselves harder, but this interferes with both Creative Solutions and closes our minds down to Simple Solutions.
What we want to do is to try to focus learning for when our brain has enough Dopamine to be thinking clearly, enough Norepinephrine and Epinephrine that we can get on with doing things and store long term memories. We want to use effective happiness to increase memory storing and if we can enter a Creative Mode or Flow State.
Euphoric feelings from cannabis and alcohol often interfere with memory storage, and learning critically needs memory storage and retrieval.
Here we have 12 learning Hacks that are geared towards ADHD Brains. Not all brains are the same, even amongst ADHDers, so some of these may not be optimal for you.
1 – Start on “Easy Mode”
What: Do things you know you can do, then add something that you want to learn.
How: Practice and refresh a bit of skill of something you have learned, then add new skills to that.
Why: By starting with something you know, your confidence will rise before trying something you are not good at, which helps buffer against a bit of failure and struggle.
Behind the Scenes: Success improves learning by promoting the reward neurotransmitter Dopamine and the happy neurotransmitter Endorphins. Failure, stress and anger raise Norepinephrine and Epinephrine, and if these rise too high, this will block learning.
2 – Focused Learning
What: Build skills sequentially, practice groups in parallel.
How: When you are learning, research about and experiment with one skill at a time. When you gain some confidence in that skill, add another skill, then another until you have a group of bundled skills.
Once you have a bundle of new skills, do something that uses most of those, practicing and consolidating them in parallel.
Start a new group of skills, adding one skill at a time, that are adjacent to the first bundled group. Now practice these in parallel.
If you are going well, add a third group.
If you can, practice all the skills together.
Why: When we can focus on one element, we can link it and explore it better. Greater understanding allows us to incorporate this into how we see the world, the area that we have learned in, and gives us maximum uses for the skill. Linking it to a bundle of skills allows our brain to store these in chunks, and memory chunks are easier to store and recall. Practicing the new knowledge and abilities in groups makes it more interesting, and more challenging, keeping our interest for longer.
Behind the Scenes: Building skills takes a combination of balanced Dopamine and Norepinephrine. Before boredom can set in, learning a new skill until we have a grouping of skills keeps things interesting. To consolidate that set, practicing them all together keeps us winning and rewarding, increasing Dopamine release (the reward “do this again” neurotransmitter) that we can bring in to our executive functions; and increasing the release of Endorphins (the happy neurotransmitter) that helps us store that memory better.
3 The Spacing Effect
What: Take breaks inversely proportional to the effort, aka the harder it is, the sooner you take a break
How: If this new skill is hard for you to learn, then it is going to use up more of your brain fuel. If you start to struggle to do the skill, or you notice you are making foolish rather than ignorant mistakes, stop pushing and take a break.
In your break time, do something very different to what you were doing. If it was a physically active skill, your break should be sedate; while if you were using lots of brain and little body, do some exercise.
If you haven’t been snacking during your learning, eat something.
Then, if you feel you can, get back to that skill.
Why: Learning new things takes lots of brain chemistry fuel. While all humans have limits to how much they can make per hour, ADHDers have a bigger limit. If you run out of brain fuel, you will start to lose skill instead of add new skills, and will risk becoming angry or fearful, which can block learning. Taking a break allows the fuel to regenerate so that you can do some more.
Behind the scenes: ADHDers have difficulties with accessing Dopamine in the areas of the brain that do the learning, and often have a secondary Norepinephrine issue, resulting in anxiety and or anger. If Adrenaline starts to get substituted in, to get things done, then learning stops and action begins. Instead of pushing yourself that hard, take a break and do something else to let the learning neurotransmitters regenerate.
4 Expert Frameworks
What: A framework is a way to connect what we are learning to things that we already know, and a learning framework is a method to quickly learn related skills to create groupings and bundles that support themself.
How: Before you re-invent the wheel, look up to see if someone has already created a learning framework that is compatible with you and what you are trying to learn. If so, use theirs. If you can’t find one that you can use, create one.
To create a framework, consider the core parts of the skill area that you are trying to learn and consider how that can affect other things. A method to do this is by creating an explosion chart.
Why: Memory stores and retrieves better in chunks than individual strands. Learning skills that work well together allows for them to support each other, creating a stronger and more robust skill, that can then be stored and retrieved in chunks.
Behind the scenes: It can be easy to lose focus on what we are trying to learn and what the end goal is. We can easily slip into a hyper-focus and or rabbit holes of interesting skills, and not learn and do what we had intended. A framework not only reinforces the things we just learned, not only improves how we learn them by optimising the sequences of skills, it also keeps us on track to learning what we set out to learn.
5 Fast Feedback Loop
What: Either check with an expert how you are going, or have a way to determine if what you are learning is correct and working
How: Good teachers are able to help you know that what you are learning is good and working. In the absence of a good teacher, try to learn in such a way that you can verify that what you are doing is improving and or accurate.
Why: ADHDers often lose patience with new things when rewards are distant. A quick reward loop keeps things fresh and focused. This is how computer games keep your attention, fast reward mechanisms. We can hijack this idea to help you learn new skills.
Additionally this helps you know that what you are learning is working, which improves skills fast.
Finding out that you are making a mistake early, and how to avoid that, quickly allows for improvement.
Perfect practice makes perfect learning.
Behind the scenes: ADHDers benefit from quick Dopamine from skills acquisition, and knowing that this is working and improving adds in some Endorphins. This then helps positive motivation, keeping Norepinephrine in the positive “we are doing things because this is fun” mood, instead of heading towards critical / crisis mode.
6 Airplane Mode
What: While learning, turn social off
How: Where you can, turn social media off and other aspects of trying to track what people are doing, saying and meaning; focus on the thing you are learning.
The two exceptions to this are parallel body doubling and tandem learning.
Parallel body doubling is where someone is around but not interacting with you in a social sense. They might prompt you to stay focused, check in on yourself or take a break. This should be someone that you are comfortable and feel safe with.
Tandem learning is where the two of you are trying to learn a skill, or you enjoy learning with them.
Why: Socialising takes up a lot of brain processing, which can distract you from learning. Often AuDHDers (Autism and ADHD) have brains that specialise in doing one thing very well, or two or more things poorly. Learning needs you to do one thing really well, so switch off the most distracting and resource hungry multitask – social.
You may learn better with music or television on in the background. Generally this works best if the music or television are very well known so that your brain can effectively ignore it. The more these have people interacting in them, the more it may switch your brain to social mode and out of learning mode.
Behind the scenes: We evolved to survive predators. Mostly non-human predators have been eliminated, leaving only human predators. Neurodivergent people (like ADHDers) have had to learn to navigate around neurotypical people and conventions that seem unnatural to them. This means that socialising is often prioritised over other things, such as learning. Socialising is a resource hog, leaving little resource for skills acquisition.
7 Positive Self Talk
What: Keep track of your self talk, refocus on positive reinforcement as needed
How: Not what your self talk is. ADHDers often have a fairly strong negative self talk track that is used to drive up “motivation”, which can help in getting things done, but often interferes with learning.
This isn’t the time to challenge the thoughts, just to redirect them with a counter talk track.
Self talk like “I can’t do this”, or “I’m no good” can be countered with “I haven’t mastered this yet, but I’m getting there” and “All expertise starts off terrible, so being no good at a thing is a good place to start”.
Why: ADHDers and AuDHDers often compensate for inadequate Dopamine and Norepinephrine by being very self critical. This toxic vehemence drives the person into Critical Mode, which allows things to get done in a more limited sense. While some learning can be done in this mode, it is poor compared to positive mind frame, and risks slipping into Crisis Mode. By re-routing the self talk to “I’m getting there” and “Of course I’m not good yet, I’m learning” we allow ourselves to acknowledge the reality of not being good yet, but also pushes us to see that we are progressing, keeping the brain more focused on Dopamine rewarding rather than Adrenaline Compensating.
8 Refresh Your Skills
What: Memory loves repetition, so refresh what you’ve learned.
How: After you have had a good learning session, take a nice long break from it, at least 2 hours, preferably 6. Go back and look over what you’ve learned, perhaps even doing some practice of it.
The following day, or after an afternoon nap, refresh and quickly practice again.
Why: We experience a great number of things every day. Before our brain puts what we have experienced into long term storage, it does an assessment trying to work out if it is important enough to store in detail, in brief, or just point to an already stored memory with a “mostly like this” message. We want to tell the brain “this is very important, please store it in detail”. Refreshing the skill later the same day and then the following morning is the optimal way for your brain to determine that this is an important thing to store well.
When we add links to many other ideas and skills, we create lots of ways to retrieve that memory. Part of your refresh should be considering how this can be used and what it is similar to.
Also check out Step 10, Have Fun.
Behind the scenes: Medium epinephrine (adrenaline) and medium blood sugar level are important in permanent memory storage. Refreshing the skills is less resource hungry than working the skill out in the first place, allowing more resources and focus to be on long term storage. The repetition informs the memory section that this is a priority, especially if that refresh follows a sleep.
9 Validate Progress
What: When you succeed, acknowledge that you did so. After a while, review how far you have come.
How: Celebrate when you get something right, or when something works.
Look back at your progress, over this learning session, over the last week, over the last year and so on. See how far you have come and celebrate that too.
When you celebrate, it can be a small internal positive feeling, a statement of “nailed it” or similar, or for the big end of learning session review, some bigger self reward.
If your review that you haven’t learned much, or you find that your success is eclipsed by failure, reconsider your learning framework. Something isn’t working here. Stop trying to learn this way and use a different method.
Why: We can often feel like we are not making any progress or that we are failing in what we are trying to do. If we only pay attention to the mistakes, we feel that things are terrible, which can hinder learning.
Quick celebrations trigger Reward Dopamine, which we explained earlier (5). It also reinforces that we are making positive progress, which counters confirmation bias that our negative self talk tries to convince us of (7).
If it does turn out that we aren’t making good progress, then we need a new framework. This validation has to be honest.
10 Have Fun
What: Enjoy the learning experience, bring in the fun even if that means bringing in the silly
How: If validating (9) and noting wins (5) isn’t enough to bring a positive mood, try being silly on your own, or with a study buddy (6). Being silly can be making up a funny repetitive song with the key elements, or drawing a silly memory aid, or using the key idea as a swear word etc. Sometimes putting on fun music can lift the mood, or reading and talking the idea out in an odd place can work.
Why: Having fun makes a positive learning experience and better, more flexible memories.
Behind the scenes: Eliciting fun releases Endorphins which promote Dopamine and positive Norepinephrine. This encourages understanding, experimenting and keeps us going. If we can, we may enter Flow Mode, long term self-sustained learning.
We can store fear memories or happy memories. Fear memories are specialised in staying alive in a crisis, and not much use otherwise. Happy memories are flexible and easy to retrieve. By having a positive fun mood as we learn, we make the learning a positive experience and that allows us to store this as a happy memory.
11 Teach Someone Else
What: Teach someone else how to do the thing you have just learned how to do
How: This can be teaching a study buddy, or a friend later on, or even a teddy bear. Rehearse how you would teach someone later on as a way to refresh the skill yourself.
Why: When you teach someone how to do a thing you have just learned, you reframe the concept and knowledge in your head into a system of learning for someone else, and effectively teach yourself at the same time. This also kicks in the Refreshing Your Skills (8) and gives you some positive feedback that you have learned the skill (5). If your framework is missing some key ideas, it highlights that problem too (4).
Behind the scenes: We may learn well in spirals, but we teach best linearly. Switching spiral layered learning into a linear explanation creates flexible understanding of the skill we are storing. By changing the focus from pulling the skill into our minds and body to teaching an external person, we give our brains a different way of understanding the knowledge and reinforce and consolidate that knowledge.
12 Self Empowerment
What: Acquiring skills is its own reward – there is no wasted knowledge
How: Knowledge brings power and choice. Learning is acquiring more knowledge and skill. Frame your learning towards increasing your choices, your options and your future.
A game you can use during a lesson is to look for the information or idea that you didn’t know before and speculate on how that can be useful. This can work even if you don’t like the class or teacher, because this is for you.
Why: We don’t always choose to start learning, sometimes we are pushed into it. When we do choose to learn, we may stumble on some failures and feel like a failure ourselves. This negative mind set interferes with learning and makes it even harder.
When we embrace the options that we can open up in our future, even if we can’t see it right now, then we can choose to learn. With choice comes self-empowerment, which brings in that positive mind frame we’ve been pushing for in the previous 11 Hacks.
Behind the scenes: PDA (Pathological Demand Avoidance) can kick in when we are told to do something, even learning. This triggers an epinephrine (adrenaline) response that generally turns towards anger and aggression, which can be quite self-damaging.
If we feel like we are struggling, we can also have an epinephrine (adrenaline) response that can become a general push back against a thing. This is a form of ODD (Oppositional Defiance Disorder). We feel that we can’t, so we make it impossible.
Pushing ourselves to learn through this can lead to actions with minimal memory of how, sabotaging our own learning process.
When we embrace that this is for ourselves and that we are going to gain from this, even if it is not in ideal circumstances, puts us on the path to embracing the learning. When we feel empowered by it, we switch the PDA and ODD off. When we follow these 12 Hacks, using small wins, frequent rewards, taking breaks as needed, and feeling good about what we learned, we overcome our ADHD learning impediments.
ADHDers can learn really well. Often, though, ADHDers don’t learn as they want to, they learn as their passion or random interests falls.
Even though these 12 ADHD Learning Hacks can help most ADHDers in most circumstances, they are not a substitute for appropriate medication as your brain needs it.
This guide is helping in Taming the Mess. Mess overwhelms when there seems to be far too much to do to get to clean and organised. Mess often happens when you are trying to keep more things than you have places to put things, which can happen when you down size your living space, have collected too many things or struggle to throw things out. Struggling to throw things out can lead to hoarding and squaller.
If you are struggling to just clean up a small mess, then this is not the guide you are looking for – what you are experiencing is likely Executive Dysfunction Task Avoidance. We’ll cover that elsewhere later.
This guide is to help you make some progress on the kind of mess that is pervasive and overwhelming due to how hard it is to create a system, primarily due to too many items in a finite space.
I would like to take a moment to be technical about the difference between collecting, hoarding and squallor. Reality TV shows have been using the term incorrectly compared to the medical industry.
Collecting
If there are a few things that you like to keep above and beyond the average person, and these are generally stored in an order with select items on display, then this is a collection. So long as you do not collect more than you have reasonable space to store them, where that reasonable space is defined by your income means (if you go in to debt to have them, it is no longer reasonable), then have fun – this may not be what other’s enjoy, but there is no medical or mental health issue here.
If your collection has exceed your ability to maintain, store, display and enjoy, then the collecting has become problematic. It can start to resemble an addiction, where you feel compelled to purchase items even though you can’t afford the financial cost, possible family cost, or the space to store them. When you find yourself sacrificing those other things to continue to collect those items, then it has hit addiction style levels.
Calling this an addiction is somewhat contested. Technically it isn’t a chemical addiction, but it has become a behavioural addiction – still a contested concept in medical health, but easily identifiable with people who struggle with it.
If this is something you are struggling with, seek help from a therapist who is versed in behavioural addictions.
Hoarding
If you aren’t collecting a limited set of specific things, and the collection has spilled over to most things or things that most others deem to be worthless, then you likely have crossed over from specific Colleting to Hoarding.
Unlike collecting, there seems to be little sentiment, special interest or resale purpose to the things that are kept. People who are aware of their growing mess will often justify what they are doing as keeping things so as not to spend money when they’ll need them later, or that things have sentimental value to them – except it is everything, or that they are going to make use of those items in a project they never get to, or that they’ll fix those items but never do.
Some people are not really aware that they keep bringing things home or fail to throw things out. There is no attempt to justify getting more things, there is just aquire.
Hoarding is often a biological brain condition. It can be a sign of neural damage (eg dementia or intelectual disabililty), it can be undiagnosed/ untreated ADHD, it may be a form of schizophrenia or it may be chronic fatigue syndrome / fibromyalgia. Some of these can be treated with medication.
Hoarding can also be a response to specific trauma around loss and powerlessness, generally poverty, captivity or war. This can be treated with both some calming medications and targetted therapy. Once managed, often the medication and therapy can stop and the condition won’t return.
Squallor
Squallor is what Reality TV tends to call hoarding. Squallor is where the hoarding has taken over so much that the person has tried to find impossible / unlikely places to store things. There is often an infestation of bugs, rodents and or fungi. There is often spoiled food. In these situations the person has a specific or general lack of insight and competency. It is almost always on the back of neural damage such as a degenerative neuron disease, brain damage and or intelectual disability. While these conditions were listed in Hoarding above, not all people who struggle with these conditions have crossed the threshold from Hoarding to Squallor.
A good indicator that this is squallor beyond the infestation and spoiled food is to compare the sleeping space and the person’s hygiene. In squallor the bed, shower and bath are being used to store things.
Generally there is no reasoning with someone who has squallor problems. They need formal care and a firm hand. Take photographs of the person’s house, infestations, bed and bathroom and take these to their doctor for a formal assessment. Sometimes you may need to get the psychiatric team or the aged assessment team from the local hospital. Having the local council condem the property is often a solid way to push through a relevant asssessment and diagnosis.
From Mess to Clean
Too Much Stuff
If we are not dealing with an insight problem, yet the problem is pervasive, then we can feel very overwhelmed in how to manage this. There just seems to be too much to do and no good place to start. The most common reason why a pervasive mess has occurred is too much stuff to put things away, so everything becomes too piled up and you get lost in what to get rid of.
Sometimes the reason for too much stuff is that you are having to temporarily down size and it is reasonable that you will return to a bigger place soon. In that case, boxes are your friend, and the items that you wish to keep can be put into boxes and stored in both a compact and vertical fashion – after the other things have been reduced.
Mental Health
Sometimes the problem is overhwelming and the decisions feel too hard because there is some underlying health problems. Pain and fatigue are going to need to be managed in chunks with suitable medication and support people. Mental health may need an better assessment. In my experience, that is most commonly undiagnosed or unmedicated ADHD – look at our ADHD section [Link] to learn about that condition – this is the Executive Dysfunction Task Overwhelm issue. Three other conditions of note are Anxiety disorders, PTSD for some specifically difficult items, and schizophrenia. It is wise to seek therapist help for these if they have not been suitably diagnosed and treated.
Skill Loss
Struggles in organisation can be due to not having learned any good strategy to sort goods, but can also be due to skill loss. Skill loss can be a result of brain damage, mental breakdown, adverse reaction to medication, ECT/TMS, burn out, and certain kinds of trauma. Skill loss is likely if you used to be able to do this and now you can’t.
The How – The 4 Piles Method
Our living spaces are generally built up of rooms. We are going to pick a room to start with, then divide that room up, then look at a strategy for how to evaluate the items.
Firstly pick a room. Any room will do, but if you want a guide for which room to start with, I suggest that you pick the room that you use the most, or the room closest to the door near the rubbish bin.
The Gentle Method
If the room is small, divide it up into 4 sections. Sometimes this is based on corners, or this is based on things like the bed/ the desk etc. If it is larger, add a bit between the corners and add a centre and now you have 9 sections.
Pick one. If not sure, the least cluttered bit by the door that is closest to a rubbish bin.
Look at the items in this section. We are going to make 4 piles by taking items out of the room from this section. These are the piles we are creating:
Pile 1 – To Be Thrown Out
This is for the items where you look at it and think “I don’t really want this, an opportunity/charity distributor wouldn’t even want it” – this goes in the trash.
Pile 2 – Strongly Sentimental and Unique
These are items with specific historic emotional value to you
You can only have 1 of any kind in this pile. When you have 2 highly sentimental items in the same category, pick one.
If it is artwork from a family member, will you display it?
If yes, keep here.
If no, take a digital photo of it for remembrance and throw it out.
If you are keeping it is on behalf of them, give it to them if they are adults, or you can keep it if they are children.
If the adults don’t want them, throw it out.
Pile 3 – Gifts
When you look at this item, you think to yourself “I know who I will give this to”
if you can’t feasibly give it to them within 2 weeks, is it really for them?
if they don’t want it, gift it to the opportunity shop
this pile includes the opportunity donation, but it has to be something that the opportunity charity store is likely to want, and you have to get it to them within 2 weeks (or a reasonable time limit)
Pile 4: Mine All Mine
If it isn’t rubbish, not sentimental or something we are rehoming, then perhaps we are keeping it.
is the item still in use (at least 3 months of reasonable use in the last 12 months)? If yes, belongs in this pile.
If no, are you going to actually use it in the next 2 months? If yes, belongs in this pile.
if no, is it worth more than 4 loaves of bread? If yes, belongs in this pile.
otherwise move it to one of the other piles.
if it is still in this pile, you’ll need to start thinking about where is “away”. Sort like items with like items.
Once half the room is reduced, create “away” places for what remains. This might mean better storage, vertical boxes (if temporary) or some other cleaver now achievable method. There are plenty of smart methods to store things that are searchable, but be careful not to spend much money on them, or aquire extra goods that don’t actually fit or fix the storage problem.
The Brutal Method Move everything out of your room until it is empty.
Put back the most important things (necessary furniture).
For what is left in the big pile of “used to be in this room”, sort the items based on the above 4 Piles Rules described above, starting from “clearly rubbish”, and moving towards down to “Mine All Mine”.
Help is Good
It is good to have a body double and second opinion. This person should be a positive influence in your life who will respect your opinion of “throw out” or “keep”, but is willing to challenge you on “keep”, such that their challenge fits the 4 Piles rules. Challenge does’t mean override, it means ask and respect your choice. If you aren’t throwing out or gifting enough items though, perhaps you should listen to them a bit more.
We can become emotionally fatigues making these choices. Try not to take on too much in one go. In the gentle version, do a section, then check on your emotional capacity before starting a new section. If you think you have what it takes, go the Brutal Method for fast results.
Schedule when you are going to take the items to the Opportunity/ Charity donation location, and when you are going to see the people you are gifting items to, or when people are going to come and get the items you are offering them.
While online “come and get a thing” are great ideas, if the complexity of doing this is yet another barrier, then don’t do this. Let it go – Opportunity or Charity shops are fantastic for this, or just throw it out if they don’t want it. Them not wanting items is a good indicator that the item actually has no real value to anyone and has become rubbish.
If this doesn’t work, look at what I said about other reasons (beyond no skill or lost skill) why this is hard for people, the mental health side of things.
Sort that out first by talking to your GP and get a Therapist, or if you have one, talk to your Therapist. Medication may be needed or a new diagnosis if they haven’t factored in the things that you are specifically struggling on.
Lastly, this is a generic guide that you’ve found online. Being generic, it likelly won’t fit all of what you are looking for, or may be completely wrong for you.
You can contact us and talk about it, or talk to your GP, therapist or support worker.
Can we normalise NOT confusing someone’s FREE time with their AVAILABILITY…???
We need:
This isn’t the full list of “free”.
Us Time
Recover time
Recharge time
Getting bored to increase creativity time
Hobby time
Casual social time
Parallel task time
Special interest time
And none of that should be confused for “available”. Yes, they can be paused while an urgent thing is attended to…
… but be careful whose “urgent” that is.
Is it actually objectively urgent, is it emotionally actually urgent for them, or is it labelled as urgent so that their whim is rated as more important than your need?
Because “free” time is a need.
How long has your’s been on hold for?
Original picture from @AlexJaySinger from Music is Life
Unlike many psychological and psychiatric diagnoses, Postnatal Depression actually defines itself quite. Postnatal literally describes the time after giving birth, and depression is a symptom where a person feels down, sad, numb, incapable, questions the self, has little to no energy, and may feel suicidal and or contemplate self harm. This term is reserved for the one who gave birth to the child.
This temporary condition can start to show signs in the third trimester and can continue up to the child’s second birthday.
In the absence of a history of any significant depression (including a teen goth or emo phase), then this is most commonly caused by hormone disruption. While the level of oestrogen in people experiencing postnatal depression is around the same as those who are not, it was found that oestrogen supplementation improved depression symptoms in many of the people experiencing this symptom with little relapse over an extended period of time. While oestrogen supplementation is generally an effective first strategy, individuals should work closely with their treating professional as not all bodies are the same, for example thyroid hormones can also be disrupted and can sometimes be a secondary cause and so on.
If there is a history of mental health and or thyroid problems, then often the cause for postnatal depression is that the person has ceased their medication while pregnant and breastfeeding. Frequently this is not a wise or necessary decision. Few mental health and thyroid medications have been shown to actually cause foetal or newborn problems (breast feeding). While there have been some correlation with “later mental health problems” for the newborn, this has been mostly falsely attributing the pathology of mental health issues with the medication to treat an underlying long term hereditary condition. Correlation does not mean causation.
While most mental health medications are safe, many health professionals are unwilling to guarantee that there is no risk. It is important to do a risk analysis – the additional risk of the pregnant or breastfeeding person becoming distressed and potentially other symptoms will likely have a much worse consequence for the foetus and newborn than the medication that mitigates this. The medications that we know are not safe to take are clearly labelled as such, while the other medications are generally listed as “may be a risk” because no one wants to promise it is safe and be proven wrong. The reason I suggest 10+ year old medications is that unsafe medications would be apparent by now and added to that “don’t take it if pregnant/breastfeeding” list.
Another major factor in postnatal depression is undiagnosed or barely managed mental health conditions. This can include ADHD, Autism, anxiety, depression and several others. You may have had this managed before pregnancy, but with the hormonal and routine change, that management strategy can no longer cope, and it is now time to consider diagnosis and medication. Your child is going to stick around for about 2 decades and the first 8 years are going to be very disrupted – this is the new normal. Oestrogen hormone supplementation can help a few anxiety, depression, ADHD people, so is a good first step and indicator that you should be looking more seriously at these conditions, or SSRI medication may be more appropriate.
The last two factors to consider are around lifestyle. These can co-occur with the above causes, and should not be ignored.
The more mundane factor is that you have just had your entire life turned upside down, especially if this is your first child. Adjusting to being on call 24/7 is hard. The Geneva Convention for War explicitly states that Sleep Deprivation is a no no, and yet our new born babies require us to be sleep deprived for months, sometimes years. Tasks that used to take 1 day to complete will now take 8 days to complete and we can feel like we are failing on every front. We often fall for the Naturalistic Fallacy, that only the old ways are best which denies us modern solutions; or the Natural Mother Fallacy, that we will somehow just instinctively know how to parent our kid without lessons or help; or the Uber Parent Fallacy, that we can somehow maintain a job, a child, our house chores and social life.
Everything takes longer, everything requires more preparation, and everything takes extra supplies. The change in your appearance and status can be quite a blow to your self esteem. People can be more interested in seeing your child than you, and you can begin to feel like a slave to the kid. This is not uncommon and can be an indicator of some of the above biological causes. Medication and therapy can help re-adjust this.
The more concerning factor is that your partner may not be a good person. A common tactic of certain controlling and abusive types is to tie their victim down with a dependency to enhance the belief that they can’t leave. A child is a perfect mechanism for this kind of lie. When clients come to see me with postnatal depression and they’ve known the father for less than 2 years, I check for red flag signs of abuse. This can be complicated by the perceptions of the person with postnatal depression being skewed by the above discussed biological causes, so the therapist needs to be mindful of that and look at methods to test and detect potential domestic violence that are independent of the clients reports. It is a delicate thing to check as we do not want to have vulnerable parents disbelieved and leave them at risk, nor do we want to give too much credence to potentially distorted perceptions and malign the good character of the father.
While these are the top 5 causes of postnatal depression, this is not a complete list. If you are struggling with your mood, energy, confidence, or have odd ideas such as hurting yourself or giving up, – alk to your partner (if safe to do so), doctor, obstetrician and child nurse. If any of these people ignore your concerns, move on to a new specialist until they hear you out and do some actual checks.
Ask your GP to see a therapist (while Hospital Therapists are okay for a quick chat, they aren’t generally good for ongoing care, so generally see an external consistent therapist).
Maintaining Mental Health if frequently about resource management. Do I have enough neurotransmitter to do this task? Do I have enough bravery to overcome my anxiety to do that? Do I have enough attention to focus on this? Can I put enough towards remembering the details of this course, without having to pull the necessary ability away from relationships?
Spoon theory is a good way to look at this. The cost of tasks is simplified to spoons. We get a certain amount each day, depending on how well we slept, whether we took our medication and have we eaten enough suitable food.
We spend spoons to do tasks, both starting them and completing them. Not all tasks are created equal. Getting out of bed is quite cheap for most people, but it is darn expensive if you are depressed and or have back pain. Some tasks replenish your spoons back, such as eating, but you needed enough to make the food in the first place. How often have you stood at the fridge door looking for something to eat, but you only see ingredients?
Some spoons are specialised. When you run out of social spoons, you may be able to use other spoons at a ruinous rate, with the result that you get very tired very quickly. Sometimes it is worth the cost, but sometimes you really should just leave. You may have the spoons to be Arts and Crafty, but have run out of social spoons, so can’t People or make decisions right now.
We can look at tasks that are commonly expensive and work out ways to make them cheaper. – If a problem with social is that auditory processing differences means lots of energy is used to compensate for noisy environments, ask for the gathering to be held in a quieter place, or bring noise cancelling headphones to help filter out some noise – We can gang a few similar tasks together so that the startup cost only needs to be paid once and only the doing task cost is needed – We can pre-choose some things, so that the default option is both simple and cheap, and only chose differently if you have spare energy and desire to do so
Often ADHDers release spoons in block amounts. If a task isn’t complex enough, or important enough, no spoons are released for that. A solution for ADHDers can be to add complexity to some tasks (multi-tasking, music/tv in the background, adding a personal challenge) so that the big block of spoons you release all get used up, instead of wasted. Urgency can trick your brain into releasing a block of spoons, but over use of this can leave you exhausted without much being done. There are many more ADHD hacks than this.
It can seem frustrating to put effort into streamlining some processes as you don’t see the benefits of that streamlining immediately. When you next do that task, you’ll find that it’s easier and you have extra spoons for other things. This can require financial set up, or logistical set up, or sorting and categorising. Maintenance of this efficiency can be hard when we are exhausted, because we ran out of spoons.
Learning to keep an eye on your spoon level and start to shut the task down before you get that empty. This is a form of enteroception that many people with mental health struggles also struggle with.
We can over streamline and fall into perfectionism. This can lead to endlessly trying to ease our anxiety by doing some kind of improvement that never pays off, because you are fixing the wrong thing.
It can take time for spoons to regenerate. We need to eat regularly, sleep and give ourselves some down time. Down time can look like switching off or doing a fun and different activity. You’ll know it is regenerative as when you finish that bit, you feel more able to do other things.
This is just a quick snapshot. If you want some help beyond this, perhaps contact us for an appointment.
It is an important skill. We need to be able to express our reasonable needs and have them taken seriously.
Seriously from and for ourselves.
Seriously from our “family”.
Seriously from our “friends”.
Seriously from our government.
Seriously from services.
Too often, though, we feel that we can’t Speak Up. We fear that we are too…. something. Even when we are sure we are being reasonable when we speak up, we are told that we are too…. something.
Even when we don’t silence ourselves, it is far too easy to be told to be silent, by being told we are asking or demanding too much.
While most people don’t need medicine regularly, the vast majority of us have benefitted from medication at some time or other. Sometimes the medicine doesn’t seem to do what we expect it to do, and that might be due to genetics affecting the way that we metabolise those medicines. Mast medications rely on particular enzymes connected to Cytochrome P450 to be metabolised. Having a variation in the genes that control the expression of these enzymes can mean that a medication that would normally address the medical issue they have been prescribed for may either not work at all, or be metabolised faster than is helpful. Fortunately, in Australia, this can be checked by your pathologist following a referral from your GP.
Most people don’t need to do this. If your specific traits fit a diagnosis and the medication prescribed for you to treat and or manage that diagnosis is working as expected, then either that medication doesn’t require these enzymes, or your enzyme expression is within the expected type and quantity to metabolise the medication.
By MorgueFile : see [1], CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=1570359
There are two major enzymes that I want to bring to your attention: CYP2D6 and CYP2C19. The kinds of medications that are affected by CYP2D6 include many antidepressants (SSRI, TriCyclic/ some SNRIs), neuroleptics, some antiarrhythmics, lipophilic β-adrenoceptor blockers and opioids {Molecular Genetics of CYp2D6 [Link]}{Wiki CYP2D6 [Link]}. The kinds of medications that are affected by CYP2C19 are antidepressants (as above), benzodiazepines, proton pump inhibitors and antiepileptic drugs, while the CYP2C19 enzyme also affects the metabolism and management of cholesterol, steroids (including sex hormones) and other lipids {Wiki CYP2C19 [Link]}.
Two important caveats before you rush out to get that gene test.
Firstly, some medications and foods can hinder CYP2D6 and CYP2C19, effectively reducing the metabolism of the medication that need these enzymes. Generally your medical professional should know that these two medicines shouldn’t be prescribed at the same time (without the intention to have one slow down the metabolism of the other) {Clinical Pharmacogenetics Implementation Consortium Guideline [Link]}, or to warn you not to consume a food that can adversely affect metabolism. Sometimes health professionals don’t know all of the medications you are taking (scripted, “alternative medicine” or not scripted), didn’t do their due diligence and check to ensure that the combined medications were not adversely affecting each other (contraindication means something else), or forgot to warn you about inhibitory foods. Substances to be mindful of include strong citrus, cannabis, St John’s Wort, ginseng and milk thistle as these can all inhibit these enzymes {Food, drink and substances affecting CYP450 [Link]}.
Secondly, for a medication to work, the diagnosis has to be correct (I’m simplifying here). Prescribing an SSRI (Select Serotonin Reuptake Inhibitor) for the depression symptom caused by certain serotonin problems can be highly effective, but not terribly helpful for people who experience depression due to unmedicated ADHD {ADHD Primer [Link]}, financial hardship or low iron. Sometimes we need to look at the root cause for the symptom we are experiencing rather than assuming there is a gene driven enzyme variance.
While I have highlighted CYP2D6 and CYP2C19 in particular as they most affect the people that see me for therapy, it is important to be aware that there are 4 other P450 enzymes that may be relevant to you: CYP1A2, CYP 2C9, CYP2E1 and CYP3AF. While all of these can be found in the liver as part of the metabolic process, CYP3A4, CYP2D6 and CYP3A4 can be found your gut wall (intestinal tract) {Role of cytochrome P450 in drug interactions [Link]}.
We evolved these enzymes to assist catalyse various important body chemistry processes. I couldn’t find any specific symptoms of gene variation on their own, just literature regarding how this affects the metabolism of medication. Modern medications have mostly unwittingly capitalised on these enzymes to metabolise medicines mostly via your liver, and in some cases in your brain {Meta-analysis Probability Estimates Worldwide Variation [Link]}.
Both the CYP2D6 and CYP2C19 enzymes are part of the cytochrome P450 system. The genes that control your expression of these enzymes can be variant in two major ways. You can have gene deletion, where you don’t have the gene to create that enzyme in the first place, or you can have polymorphism, where you have multiple copies of the gene. Polymorphism can lead to variant versions of the enzyme, some of which can significantly impact your medication metabolism {Genetic polymorphism of CYP2C19 [Link]}. Generally, most populations have between 2 to 6% chance of variance in these genes, however it must be noted that some ethnic genotypes have higher likelihood of having variations in specific directions (deletion or polymorphism) {Cyp2D6 Overview: Allele and Phenotype Frequencies [Link]}{Meta-analysis Probability estimates worldwide variation [Link]}. Separately to that, Neurodivergent people have a moderately higher statistical likelihood than their ethnic genotype of having variation in these genes {CYP450 2D6 and 2C19 genotypes in ADHD [Link]}.
If you have found that a range of the medication types discussed here are not very effective, it is a good idea to talk to your GP or Psychiatrist about the reasonable possibility that you have a P450 CYP2D6 / CYP2C19 gene anomaly and discuss whether getting a pathological gene screen for this is suitable {GP Australia, Pharmacogenomics in general practice: The time has come [Link]}. With the confirmation that your genetic expression of these enzymes is varied, your prescribing professional can factor how that can affect potential medications. Conversely, knowing that this is not affecting you can allow further investigations into whether some other factor is interfering with your medication or whether your diagnosis needs to be re-explored.
When our bodies have all of the right biochemicals and our brains have the right neurotransmitter levels, we are a wonder of nature. Unlike other animals, we take in not only our surroundings, but also anticipate the future, guess at areas beyond our senses and make wise decisions that improve our lives. When our bodies biochemistry and neurotransmitters are out, we will often compensate with adrenaline. When the adrenaline runs out, we uses strong emotions to force our body to create new resources to keep going, which outside of a genuine emergency can be a problem.
The STOP Skill
The STOP Skill helps us to not take actions that we will later regret.
S – Slow down; the feeling of urgency in the absence of direct threat are an illusion
T – Take stock; food you take your medication, are you hungry, are you pushing too hard, do you need to sleep, do you need to change the ambient stimulation (more stimulation or less), do you need some caffeine / nicotine? Once you’ve identified what is good for your biology, do it.
O – Orientation; Now that you know the emotions are an illusion, and you have looked at the biological needs to address your neurotransmitters, what do you need to actually do now, biasing against the illusory emotions? What is presently important? Do you need to get back to that assignment, finish the project, take a bit of time out, negotiate for a few minutes, do some vigorous exercise etc. Ruminating isn’t part of the deal, if you really want to explore those thoughts, write down a brief paragraph note and talk to your therapist/bestie later about it.
P – Proceed Intentionally; It is easy to feel like you just *have* to do something that makes little objective sense. Ideally you have a Wellness Plan for this situation, follow those steps. If not, safely address the biological need, take a moment to recover your senses, then continue on with what you should have been doing if reasonable, or make a new plan when you’ve got your thinking back.
Wellness Plan: If you have a Wellness Plan [Link], build the smart decisions into it.
When I was born, it was clear that I had certain…. attributs. As such, part of the identity that placed on my birth certificate was “male”. My presentation certainly matches “male” and so most people assume that I am male. I’ve never got a test to check to see if my biological chromosomes or base hormone levels match this assumption. This is the trio of criteria that the Olympics has formed to define “female” and “male”.
Even though I’ve never been formally diagnosed “male”, I can use this as part of my identity. Heck, trying to encourage people not to use male pronouns for me is harder work than I generally have the patience for. When we do not have direct scientific medical information on a person, we often look at behaviours. When I look at how “men” are supposed to behave, I don’t find much of me in that description.
I frequently feel like an imposter for being given this identity label. Somehow I am failing to live up to the pedestal (or down to) I’ve been placed upon, and it feels like somehow that is my fault.
Identity is an interesting thing. Part of it is how you see your self; that is, how you identify you to other people. Part of it is how your friends and loved family see you; that is, how they identify you to others. Part of it is how general society sees you; and thus how you are described by them. While most people have all three being approximately the same, all of these can be quite different to each other. For some, a valuable part of their identity is how their enemies see them.
I could legitimately identify myself as a cat, helicopter, or alien. If no one else agrees with my self identity, then I will be the only one who uses that description of myself. While it is possible that others might call me ‘that person who thinks they are a[n] _____’, this isn’t the same as them agreeing with how I see myself, it is just a recognition that I do and they don’t. It wouldn’t feel validating. The difference between who I see myself as and who others see me as can be jarring.
Imagine that one day you wake up and everyone you meet calls you by a different name, and now treats you as a member of some minority group that you don’t think you belong to. For example on this fresh new day, the people I come across are now calling me Stacey, and treating me like I am visually impaired. Some young fella is asking me if I need help crossing the road, since clearly I’m blind. “Um, well actually, my name is Joshua and I can see perfectly fine, thank you – I don’t even want to cross the road, and if I did I can manage on my own quite fine”, I’d tell them. The helpful young man trying to take my elbow laughs and responds “of course you are… now let me help you cross the street ma’am”. It would feel very weird and I’d wonder what the heck has happened. After the third or fourth seemingly random run in with people calling me Stacey and being overly helpful due to my visual impairment, it would get quite concerning.
While this seems quite farcical, and it would be reasonable to question my sanity should I truly have this experience, it wouldn’t take long for this difference between how I see myself and how everyone is treating me to start eroding my confidence about who I actually am and what that means.
Just take a moment to try to imagine that.
This highlights why identity is more than just how you identify yourself. It is how others identify you and how they treat you because of that identity that they perceive. That unease at the difference in this imagined scenario is a glimpse into Identity Dysphoria.
Dysphoria has its etymological roots in the Greek words for “hard” [dys] and “to carry” [pherein], and is best understood in English as the phrase “hard to bear”, or “a painful burden”. In modern times, it is understood to mean being in a “state of unease” or a generalized “dissatisfaction with life”. In Mental Health, it can be coupled with a specific descriptors such as – ‘gender’, that is, a feeling of unease about the state of your gender; or
– ‘body’, that is, a feeling of unease about the state of your body.
Dysphoria highlights how you feel in reaction to either the difference in how you think you are when compared to how you perceive yourself to be; or how you feel in reaction to the difference in how you self identify and how others identify you. I call myself Joshua, and on this weird day, people call me Stacey. After a while of being called Stacey, I might start dressing differently to either emphasise that I am NOT Stacey, or I might dress to go along with it. This schizm in identity will push me to change something to try to rectify the feelings of dissatisfaction.
I would like to introduce you to the concept of Neurotype Dysphoria, or NeuroDysphoria. That is, a feeling of unease in your neurological type, your Neurotype.
Neurotype is a part of the language around Neurodiversity, the recognition that all humans have brains, but they aren’t all the same brain-type; much like all humans have blood, but aren’t the same blood type. The most common Neurotype (brain type) is called Neurotypical, and those who are not Neurotypical are Neurodivergent (neurologically divergent from the biggest group, aka the typical or common group). There are many different Neurodiverse groups.
Sometimes people’s differences from the typical are clearly noticeable, and assumptions can be made that are likely fairly accurate. However, sometimes a person’s divergence is subtle to observation, or hidden under camouflage. We call this camouflage masking.
There is a very strong biologically driven social conformity drive which is call “peer group pressure”. It isn’t the explicit pressure from the group to conform to them, it is the subconscious desire to be welcomed and included that pushes us to change the way we behave and present so that we fit in, even if that goes against our instinctive nature. We blend, disguising our difference, sometimes even from ourselves. Given enough people calling me Stacey, I might start to dress like a how people expect Stacey to dress, and start to act more like how people expect Stacey to act. I might also rebel and go the other way. Either way, I’m no longer dressing and acting like what feels genuine to me.
When we feel dysmorphic we may not know why, or even that it is a consequence of identity schizm. We can often identify that we feel alone and isolated, that we struggle to be around other people, that we are anxious or depressed, and that life is a struggle. We get so used to struggling that we think that is normal and it isn’t until our struggle escalates to breaking that we can even admit that there is a problem. We fear appearing weak, so we fall back on denial and bargaining.
But what is that root problem?
If you don’t show clear signs in the publicly acceptable way that you are Neurodivergent in the ways attributed to a recognisable group, people will just tell you to conform better. In the denial of how ill at ease we feel, we might break down. We will likely be called histrionic, dramatic or needy. We may be mislabeled as schizophrenic (which is a thing, but quite different, and it is a Neurotype [or probably 3]) or bipolar or crazy.
Many people have a perfectly reasonable reaction to this invisible and unreasonable situation. Without that hard to see and understand context, the reasonable reaction (anger, avoidance, breaking rules, refusing to comply, anxiety, feelings of lost identity, confusion etc) seem unreasonable. This commonly leads to these feelings being medically recognised as borderline personality disorder (BPD*), which in my experience is most commonly undiagnosed ADHD and or Autism (and sometimes actual Bipolar Affective Disorder).
* BPD is also known by emotionally unstable personality disorder (EUPD), or mislabeled as complex post traumatic stress disorder (cPTSD). On a brief side note, actual cPTSD is a complex other diagnosis, and much like Schizophrenia is misattributed and thus often misunderstood. That’s beyond the scope of this write up though.
Back to the point.
Certain neurotypes are frequently diagnosed as a medical condition due to a common need for medication and or support, such as Autism and ADHD. Medical condition are diagnosed on how the condition makes you suffer. After all, a medical intervention isn’t needed if you seem to be doing fine. We shouldn’t blame the medical system for this, that is the nature of how they triage resources – they identify what the harm is and what to do about it. For people who are in need of resources, especially medical and social support, it is good that such an assessment can be done and resources are then hopefully made available. These resources for Autism are generally classified from Level 1 (you need some help) to Level 3 (you need constant help). There is no Level 0 (you are Autistic, but don’t need any help), because you don’t diagnose people with a medical condition that don’t need help.
Many people who have Autistic neurology are not be disabled, disordered, impaired or dysregulated. Having no discernible harm or medically significant enough difficulty due to their neurology does not make the person’s brain typical. An Autistic Person who has overcome problems due their Autistic Traits, or learned to navigate the exclusive society successfully has not somehow change their brain neurology to being typical either. Trying to get a formal medical diagnosis to be considered Autistic is both expensive and in this kind of case, very hard.
The dysphoria comes in around identity. How you see yourself, how you are seen by others, how you are behaving and how you feel you should behave – all at odds with each other.
While aspects of identity can be a medical phenomena, such as ancestral DNA, melatonin levels in our skin, height, sex, intelligence and so on, these aren’t medical conditions. We can use these identity labels without having to get that medical confirmation. These are often quite visible and obvious though, so perhaps that is fair enough. I have not been formal diagnosed as being “kind”, and yet that is often a part of how people identify me, and I am quite comfortable with identifying myself that way too. This is a “not obvious” and “not outwardly physical” attribute that was not formally, medically, diagnosed.
An Autistic brain is different to the typical, and sometimes that difference can be disabling, disordered, and the persons experience of the world might be impaired. But that isn’t required for the person to be Autistic. Yet to earn the label of Autism Spectrum Disorder, a person has to who their “impairment”, “disorder” and “disability”. As has been shown, you can have an Autistic Brain and not have these medical problems.
And it costs to get assessed. Wow does it cost (in Australia).
This makes getting a medical confirmation of being classified in the identity group of “Autistic” expensive. I don’t have to pay to be classified as “male”, or “average heighted”, “kind”, or “white enough”. I don’t have to pay to be able to identify myself as a nerd.
I shouldn’t have to pay to be identified as Neurodivergent, and I shouldn’t have to suffer to have the medical system agree that my brain works differently to the typical.
Getting a diagnosis for Autism, ADHD and other Neurotypes is a privilege that I would not want to deny to anyone who can benefit from that diagnosis, subsequent support and external confirmation of identity.
We should also not willingly join the gate keeping that the medical system has accidentally created, or the government has used to shape its policies. We should not exclude a person from their Neurotype just because they either don’t have the privilege to get an assessment, or “fail” to meet the medical criteria for a medical condition that needs help. A formal diagnosis to recognise that you are the kind of weird that fits in to your neurotype isn’t required.
While the medical and government recognition system is broken, and we do have to use it to help those who need that support; we need to be careful not to use their language for ourselves, or wear their labelling system when we aren’t interacting with them. These are tools to access a broken system, the tool and the system is not us. We must respect the people who do need to use that system and do need to go through that process.
We need to be us, not the convenient labels and criteria they defined for us.
We must embrace our identity and be proud of ourselves. We need to be welcoming of our NeuroSiblings and support our NeuroCousins.
Diagnosis is a privilege not all of us have access to, and we don’t require the government or medical system to acknowledge that we are who we are, if we give our NeuroSiblings and NeuroCousins that welcome and recognition.
