Neurodiversity: Like biodiversity; for brains.
Neurotype: your brain style. This could be Neurotypical, Autistic, ADHD, Dyslexic, OCD, and more.
Neurotypical: a term used to describe individuals with the most common neurological style.
Neurodivergent: a term used to describe individuals whose neurological development and function differs from that of the majority. I.e. Autistic individuals and ADHDers.
Allistic: a term used to describe people who are not Autistic.
Neurodiversity-affirming: accepting and supporting the view that the human brain is naturally diverse, and that individual differences in brain style are the result of variations in human evolution, as opposed to ‘disorders’ that 'need to be cured.’
Neurodiversity-informed: being educated and knowledgeable about the presentations, experiences and needs associated with a variety of brain styles, and not just the most common one.
Neurodiversity is central to everything we do at our practice. Why? Because your neurotype impacts important things like:
Likelihood of Mental Health Conditions:
How probable it is for you to experience a mental health condition.
Comorbidity of Mental Health Conditions:
Likelihood of experiencing multiple mental health conditions simultaneously.
Susceptibility to Specific Mental Health Conditions:
The type of mental health conditions you are most vulnerable to.
Response to Evidence-Based Treatment:
How much benefit you are likely to derive from typical, evidence-based treatment.
Tailoring Approaches for Real Benefit:
What approaches we need to take to give you real benefit.
Most research and information on mental health conditions, diagnostic criteria and treatment protocols have been based on one type of brain only: the typical brain.
New studies have found that people with ADHD and Autistic neurotypes have had the highest needs in mental health settings all this time, and yet, have gained the least benefit from them [4].
We care about that, big time.
More specifically, we care about the links that are being found between neurodivergence, eating disorders and trauma.
Autistic traits have been linked (pretty intensely) with all three: Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder [11].
It is estimated that 23% of people who are being treated for Anorexia Nervosa in hospital settings, are Autistic, whether they know it or not [24]. Autistic women's eating disorder symptoms are reported to last longer and start younger [4]. That is a big deal when we consider the fact that Autistic people with eating disorders report the least positive outcomes from 'gold standard' treatments, like good old CBT [4].
ADHD traits have also been linked to eating disorders. A 2017 study on 1165 adults with eating disorders found that 35% of those with Bulimia Nervosa scored above clinical cut-offs when screened for ADHD. The same was found for:
37% of people with Anorexia Nervosa (binging/purging subtype),
26% of people with Eating Disorder Not Otherwise Specified,
31% of people with Binge Eating Disorder, and
18% of people with Anorexia Nervosa (restricting subtype) [20].
Autistic traits have an especially high correlation with restrictive eating disorders. ADHD traits have an especially high correlation with binge-purge eating disorders. Yet, both are linked with all eating disorders, more than the neurotypical population.
Somewhere between a third and half of all Autistic people also qualify as ADHDer's [18].
Studies have found that the lifetime prevalence of PTSD is significantly higher among ADHDer's, compared with neurotypical people [2].
On one hand, research is finding that neurodivergent people are more likely to have traumatic experiences in the first place.
In one study, 72% of self-identified Autistic people reported that they had experienced sexual or physical assault, and 44% of the sample met full diagnostic criteria for PTSD [14].
Being a minority has something to do with it. The Autistic cis women and gender minorities in that same study reported a significantly higher number of traumas and were significantly more likely than cis men to experience sexual trauma and meet the criteria for PTSD [14].
Unique Triggers and Events in Neurodivergent Individuals:
On the other hand, research is suggesting that neurodivergent people experience triggers and events in such a way that makes them even more traumatic.
One study looked at this and found that, while some neurodivergent people reported traditional traumas (e.g. maltreatment) and forms of social marginalization, others reported traumas related to their environment clashing with their neurodivergent needs (e.g. sensory trauma). All described sources of trauma in interviews that would not be captured by standardized measures [15].
In another study, more than half of the neurodivergent group reported traumatic events that were not recognized as traumatic by the DSM 5, and yet, 40% of these people still met criteria for a PTSD diagnosis [19].
High Rates of Trauma, Mental Health Diagnoses, and Suicide in Autistics and ADHDer's:
Overall, both Autistics and ADHDer's have been found to have significantly higher rates of trauma, mental health diagnoses, and suicide [3, 5, 8].
Clinical Importance of Subthreshold PTSD in Eating Disorders:
When it comes to eating disorders, partial or subthreshold PTSD has consistently been found to be of clinical importance [1, 7, 21].
There may be a functional association between the two, where eating disorder behaviors serve as a way to block and avoid traumatic triggers and memories.
A study that looked into this found evidence to support it. Specifically, thought-suppression, hyperarousal, distressing thoughts and moods, and purging were all revealed as key players in the eating disorder-PTSD link [16].
Understanding the Link:
When researchers have tried to understand how this link works, the following have stood out:
Self-criticism
Low self-worth
Guilt
Shame
Depression
Anxiety
Emotion dysregulation
Anger
Impulsivity/compulsivity [13].
Mediators Between Childhood Trauma and Eating Disorders:
Beyond that, childhood trauma has been linked to eating disorders through the following mediators [22]:
Pathological dissociation
Difficulty with emotion-regulation
Body dissatisfaction
Negative affect/depression
Anxiety
General distress
Self-criticism
Alexithymia
Unfortunately, many of these are also common experiences among neurodivergent people.
Overlap Between Neurodivergence and LGBTQIA+ Community:
To touch on one, final, layer of complexity, there is a known overlap between neurodivergence and members of the LGBTQIA+ community [10, 23].
That's cool. Except for the fact that LGBTQIA+ adults and adolescents experience a greater incidence of trauma, eating disorders, and disordered eating behaviors than their heterosexual and cisgender counterparts. Gay, bisexual, and transgender people of all ages are at increased risk for eating disorders and disordered eating behaviors [6, 17].
Multiply Neurodivergent and Intersectionality:
Neurodivergent people are often multiply neurodivergent. They are part of a minority and are often part of other minorities at the same time. When they have a mental health condition, it is rarely the only one they have, and the severity levels are often higher than expected. They have a higher-than-expected prevalence of trauma and eating disorders, and tend to respond much less favorably to traditional treatment approaches.
Commitment to Neurodiversity Affirming Model at Treat Yourself Well Sydney:
If you have never heard of the neurodiversity affirming model, here's a rundown:
It is the opposite of ableism
It puts neurodivergent voices on top
It is acceptance and strengths based
It is trauma-informed
It supports disability rights, body freedom, racial justice, and of course, neurodiversity.
That's what we follow, and that's what we will continue to follow. For good reason.
To learn more or to enquire about our Neurodivergence support, contact us at: info@treatyourselfwell.com.au, or give us a call on (02) 9555 4810.
