Welcome back to the REJECTION PROTECTION CLUB: a monthly blog that will take a broad but focused look at issues which arise from high-functioning neurodivergence as well as considering novel ideas about a modern reconstruction of mental health and how we look at it. No matter whether you have been diagnosed with a specific condition or just feel that things work slightly differently for you, the RPC has a goal of both further destigmatizing our perceptions of mental health and also learning how to actually see differences in our lives.
REJECTION PROTECTION CLUB CHAPTER 2
“THE ILLUSION OF FIT”
THE INTERPLAY OF SCIENCE AND NEURODIVERGENCE
When it comes to understanding the science behind psychological mechanisms, we must first go through a few caveats around science and mental health that may not be obviously evident.
First, it is paramount to look at where we are in mental health and radically accept we are far, far behind in our research and application as compared to where we are in physical medicine or philosophy, and therefore comparing to other areas of study may hold an unfair or invalid transposition. This is obviously not to degrade or disqualify what we do know about neurology and psychology from a scientific level, but rather to emphasize that while natural, many comparisons that we make between mental health and these topics are ripe for harmful and/or misleading misinterpretation.
Secondarily, there is the concept of cognitive dissonance– we are unfortunately not always the best at seeing ourselves clearly, and unlike something like high blood pressure, there is no way to tangibly confirm whether something is happening when it comes to internal cognitive and emotional phenomena. When we observe something such as a raised public awareness around people overblowing conditions and misdiagnosing themselves, we seem to be quick to want to “see the receipts” of measurable confirmation which, at least to some degree, creates more doubt and ambivalence around mental health and its legitimacy. Ultimately, neurodivergence is largely connected with an inability to regulate emotions– that unfortunately means that we have a harder time communicating what is wrong, and are quick to assume it must be us failing rather than an actual scientific difference in our brains.
And finally, there is also the unique challenge of the ever-changing perspectives on mental health. Whether it just be the actual nomenclature– there are dozens of DSM conditions which have been renamed or altered multiple times in just the last few decades– or the understanding/definition of symptomatic presentation clusters, it is important to understand that very unlike the necessary rigidity and uniformity of treatment in modern western medicine, mental health must actually somehow allow for the opposite and understand that treatment must be holistic and individualized due to the complexity of human emotion and cognition.
HELPFUL POINTS FOR UNDERSTANDING NUANCES
I will start with a list of nuances and misconceptions that I feel can represent most of the challenges that I and those I have worked with see most commonly when the idea of neurodivergence becomes intersected with science.
The single most frequent misdiagnosis sequence I have seen (in addition to statistical suggestions that it is indeed the most misdiagnosed condition in the DSM) goes like this: client tells a mental health practitioner that they have mood issues where they have daily or hourly swings between extreme emotions, never able to regulate. The practitioner diagnoses bipolar disorder. This very harmful and swift assumption situation has happened to virtually all of my ADHD clients as well as myself, and is an unfortunately perfect example of where, even at a professional level, we can see how vulnerable relying on a few key symptoms to identify a person’s entire functioning patterns is to sending a person the wrong direction, and possibly regressing them from getting adequate services due to mistrust or disagreement with what a professional has told them.
Why does this happen so frequently? Well, bipolar disorder is most well known for its mood swings! But crucially has a very distinct qualification of one feeling the same extreme emotion constantly, for weeks, and then experiencing the swing to the other side for a prolonged period. This is almost comically a COMPLETELY opposing interpretation of what the person who is struggling to regulate emotions on a day-to-day basis said, never knowing how they may wake up the next day is directly contradicting to someone who has prolonged periods of a sustained emotion, even if both are correctly described as a mood swing.
Since ADHD is foremost seen as an inattentive disorder, PTSD is foremost seen as an anxiety response disorder, and ASD is foremost seen as a social functioning disorder, we overlook the fact that someone experiencing this emotional pattern is actually extremely likely to fall into one of those three categories, because for many, dysregulation of mood is actually the foremost barrier which then leads to inattention, social struggles, and/or anxiety responses. There is no hard test or measure on an abstract definition of “emotional dysregulation”, and therefore a non-holistic and sweeping judgment assessment of the situation seems to be an extremely common action based on the fact that I unfortunately hear negative interaction accounts like this every week.
We can see a similar parallel in medical terms– a sore throat may be indicative of a myriad of different root causes. But what differs here is not only that many mental symptoms are permanent, but while a sore throat is likely to eventually be cured with minimal damage from incorrect diagnostics that may occur, a misinterpretation of mental health symptoms could be as dire and harmful as if a doctor prescribed chemotherapy for a sore throat.
In connection to recent trends which see the phenomenon of younger generations “diagnosing themselves with everything”, “for attention”, or similar– while we will continue to expand on this in future discussion, we must first acknowledge that someone who is struggling to connect through typical social measures… is going to do so in… atypical social measures. And while we all certainly know the definition of “atypical”, we also are ripe to overlook that we also have more “acceptable” and “unacceptable” ways to be atypical. If someone has a speech impediment, that is seen as rude to be impatient or criticize them because the person only has so much control over how they are communicating. The truth is, this same concept is valid in far more scenarios than we probably realize. This can come out in MANY different ways, and without an overt and socially prominent definition of neurodivergence, you may not realize the possibility that someone who is speaking in an emotional, loud, and nonlinear way is not actually “freaking out” or “dramatic”, but rather neurodivergent and not recognizing where they may be discrepant to the norm. Someone who is “being a dick for no reason” at least has the reason of not knowing how to emote appropriately in social settings.
A clear example here comes from my summers spent at camp for kids with autism– I can’t tell you how many times– I mean seriously, hundreds of times a WEEK– that I was given a self-report from campers that they were “about to die”, “need to go to the hospital”, or “hate everything at camp and will die if they don’t go to the hospital”. With diligence to what may actually be an emergency, one working in this position must be quick to realize that these statements are not likely to be reporting valid truths they fully believed, but rather the quickest and easiest communication response to an emotion that felt too large for a person who lacks a conventional way to do so that is deemed “socially appropriate”. Nobody ever died nor even went to the hospital, and sometimes that same person would tell me they loved camp minutes after re-regulating.
While it is in no way wrong or even unwarranted to assume danger from the outsider perspective in this scenario, it is unfortunately common to be perceived on the neurodivergent side of misinterpreted communication as the equivalent of someone responding to another person having a lisp by explaining that “no, you actually pronounce the ‘S’ sound like this!” as if that person was the first in history to enlighten the other on a very basic skill in a way that could very easily be perceived as offensive or condescending.
So to go back to the issues of people acting socially inappropriately around misdiagnosis– yes, it needs to be clear that this can become extremely problematic and as is hopefully obvious, diagnostics are best left to the people which are most trained and experienced with them. What is ACTUALLY important about this behavior is to recognize that not everyone who is trying to reach out about something going on with their mental health is going to have the expected social or communication skills to be able to do so appropriately. In fact, these individuals are even more vulnerable to taking a misunderstood or socially inappropriate measure to do so. Until we have a foolproof system which can see distinct mental conditions as easily as we can see a broken bone in an x-ray… we must understand that most behaviors which appear to be maladaptive or atypical around this issue probably require some form of mental health intervention– even if the accurate condition is the farthest possible from the one an individual is assuming they may have.
It is very important to first indicate that I don’t believe I can fully verbally describe the following conundrum, so hopefully these examples will do justice. But when it comes to many neurodivergence symptoms, it is extremely common for me to hear that they are either perceived as overly extreme or totally invalidated. The following may seem unconnected at first, but imagine yourself in the following scenarios:
You have to take your semester final for a class. The classroom is 105 degrees and completely insulated, making it muggy and your clothes are sticking to you.
You go for a run, but you brush against something leaving your house that makes your leg really itchy for the duration of it.
You’re learning about a new topic that is very dense. One part sticks out to you that catches your attention and seems most interesting, and you focus on this part without realizing you will have to know the others to fully comprehend.
You just sat down for a movie you really want to see starting, but realize you have to pee. You choose to keep watching the movie because you don’t want to miss anything, but end up thinking about how badly you have to pee for 20 minutes before missing part of it anyways
None of these situations are actually going to fully barricade you from completing the intended goal, all of these situations involve some variable which is a little more annoying than what we would consider a “fly in the ointment” situation, but still, none of these scenarios warrant the activity being completely stopped. In all of these situations, we would likely explain the emotional experience as something like “[this variable] was making it worse than usual, that kind of ruined a little, but ultimately I got through it.” In most cases, others would probably agree and validate that due to the presence of annoying variable, they validate your perspective that this would downgrade the experience.
To live with neurodivergence (and any other unseen disability for that matter) is in some ways like permanently experiencing something similar to these examples yet feeling responsible to complete tasks as if there was no limitation. If someone is living with unaddressed neurodivergence symptoms, the validation part is often nonexistent or even rejected by themselves or others. Even reading these examples, many who are trying to sympathize may either assume that life with this as a constant is either a neverending hell without accounting that we have also lived our entire lives with this as a norm, or on the opposite, assuming that there is ZERO exhaustive toll after years and years of having to manage. The truth is, I would assume that every living human has some small nuisances that they will have to manage, and just the concept that we all have to brush our teeth every day of our lives to avoid major problems is extremely overwhelming when framed this way. This is again not an argument that the mere existence of these unseen issues are special or uncommon problems– just that certain neurodivergent problems are less discussed and misinterpreted as such.
What intersects to make this situation harder for neurodiverse individuals is stigma, and again to compare to the medical field, we don’t actually have much judgment around certain accommodations people make for themselves. If someone has very dry skin, they use a lot more lotion than others and probably don’t think twice about it. If someone has a balky knee, they may wear a compression sleeve, and probably wouldn’t be asked to do activities which this injury makes more difficult for them. If someone has a visual impairment, they will need some accommodation to help them see. Now turn this into “if someone has ADHD, they would benefit in quality of life overall from working less hours and being given more creativity” or “if someone has sensory issues, they should be exempt from certain things which are overwhelming to them”.
I’m not sure about you, but in my experience the first three are most typically seen as “good, healthy, accommodating” moves by society, while the latter two… are far more likely to be seen as “enabling my lazy ass to slack off” and “giving snowflakes special privileges”. Which leads nicely to…
The single most disheartening thing I have heard consistently as a therapist has been not just the lack of accommodation, but the frequency that attacking, invalidating, or skeptical responses are given in response to a high-functioning neurodivergent person asking for accommodations. While I am ultimately realistic and do not necessarily fault those who do not understand what is actually required, I also fear that without improvement in greater public awareness around the concept, the issue will never resolve.
We go back to the issues that are seen in the (thankfully) extinct diagnosis of “Gifted twice exceptional”-- there is a permeating view in society that if someone is intelligent, can present with politeness, and/or follows rules properly, they are “just fine”, and should be seen as not only someone without problems, but perhaps even with additional pressure from being “so smart and destined for success! Everyone has something! Could be worse!” For a long time, and still today to much degree, the concept of having any mental health label is a very discouraged, threatening, damning, and undesired fate because that would make us “crazy”, or at least make others think so.
The combination of these two factors is one of the most common reasons that someone experiencing the discomfort that the very focus of this writing is centered around would not recognize that their issues may be coming from an unseen root. Particularly with ADHD and autism, potentially the single most common comment I have ever heard as a therapist may be “I nor nobody around me realized because I got good grades/didn’t cause trouble/was “a good kid”/kept it all internal”. After all, I was not diagnosed until 19 despite showing many clearcut signs… they were just not seen as “bad”. Essentially, any chance of someone asking for accommodations in a world that not only doesn’t see their barriers but may ridicule them for asking… is probably not one to bet on.
All this together, and it is crystal clear to see why it is so difficult to accommodate, or even ask to accommodate these disabilities as compared to say, asking for an inhaler during an asthma attack. Some accommodations may be set up poorly– i’ve seen ADHD accommodations which solely include extended test time in a quiet room, and while that is accommodating for some, many ADHD individuals might actually be discrepantly fast test takers who need to listen to music to focus. If a person feels supported, they may ask for a modification that works for them– not the easiest ask for populations that struggle with initiation AND feel chronically burdensome– and even still that is at heightened risk to be met with either denial of their condition being real, unfriendly teasing, or similar invalidations, further pushing the person away from actually getting accommodations, and probably creating additional negative feelings as well.
HELPFUL SCIENTIFIC POINTS ON NEURODIVERGENCE
You may be wondering– how does this guy not recognize how flawed this argument is without any actual science? Well, rest somewhat assured– I have simply held out. Now, we go back to the initial and paramount point that we are not too far in our advances of this concept and state that I really cannot give a fully sound and scientifically correct definition of “neurodivergence”, and in fact doing so may make things more controversial.
But here is what we do know scientifically about the three neurodiverse conditions which will be most heavily discussed in this series. I limit myself to these as I feel most educated around them, but the general idea of having some semblance of explanation with no hard answer applies to any form of neurodivergence. And as must unfortunately be reiterated ad nauseum, reminder that we are only so far on full understanding, and therefore as a built-in barrier, important to recognize we cannot confirm this as we can confirm something like a broken bone.
ADHD: ADHD is largely believed to be a genetic disorder, with the only exceptions being linked to natal issues. ADHD CANNOT, under ANY circumstance, be developed from environmental factors (though trauma responsive symptoms may look identical). Any and every person with ADHD was born this way, and will always have this condition. In regards to the parts of the brain responsible for emotional regulation and executive functioning, the actual neuroarchitecture of an ADHD brain is completely different from that of a non-ADHD brain. It is strongly believed that misappropriation of dopamine due to this differing structure is the actual neurotransmitter responsible for creating atypical patterns.
AUTISM SPECTRUM DISORDER: ASD is also largely believed to be a genetic disorder, with the only exceptions being linked to prenatal exposures to certain chemicals. ASD CANNOT, under ANY circumstance, be developed from environmental factors (though trauma responsive symptoms may look identical). Any and every person on the autism spectrum was born this way, and will always have this condition. Differences in an autistic brain are still being discovered, but we can confirm that the central nervous system and connectability between the two hemispheres of the brain are completely different from a non-ASD brain. Possibly important, but if just an intriguing fact, autistic brains are also scientifically proven to be physically larger than neurotypical ones. Those with diagnoses of autism have also shown a significant correlation to both gastrointestinal and autoimmune diseases, with some hypothesizing if this connection could be more influential than the CNS one. In some ways, autism could be seen as the “furthest” neurodiverse condition from neurotypical– as far as we can tell, virtually every one of the 11 cortical regions in an autistic brain are seen as discrepant from a neurotypical one.
TRAUMATIC RESPONSES: trauma-derived issues are NOT seen as having a genetic root, with caveat to the concept of historical trauma which suggests trauma of ancestors could be passed down to future generations, but rather are rooted in environmental influences changing the structure of the brain. The trauma response is a very natural and important one, but when we are kicked into a fear-driven response of fight or flight, we are also compromising cognitive and emotional functioning to attain this overdrive, and usually without clear recognition of doing so. You can think about this similarly to someone who lifts a car from an adrenaline rush, but crushes one of their vertebrae as a result. While this is entirely effective if we need to run from an animal in a one-off situation, it is not hard to see where individuals who spend a lot of their mental time in this response, particularly in childhood, begin to suffer longer term neural consequences from this imbalance. An additional response from the brain is what we call dissociation, which creates a scenario where the brain begins to code memories and associations in a much different way– again, not too difficult to see how this can start to affect memory, cognition, and emotional patterns when seeing it as the brain metaphorically scribbling some illegible words right in the middle of a crucial written instruction.
So while neurodivergent brains born with developmental disorders are quite literally ‘designed’ as different structures than neurotypical ones, neurodivergent brains that are trauma-derived are better seen as neurotypical brains that faced environments so extreme that the impact has shaped the brain into one that must now be seen differently. The best way I have come to explain the nuance, as trauma response can look exactly like ADHD/ASD: a developmental disorder was born a circle, trauma-response was born a square that was sanded down to now look like a circle.
And because life is cruel, obviously individuals can be born with a developmental disorder which is reshaped by a trauma response as well.
IncongRuencies BETWEEN SCIENCE AND MENTAL HEALTH
It’s no surprise that the brain is infinitely complex, and therefore our understanding of what we can see or even what we should be looking at in the form of scientific evidence is extremely difficult to make many, if any, objective statements about. Even for something that is tangible like nonverbal individuals– we are quick to overlook that we are going to know LESS about someone who cannot communicate, and are prone to jump to the conclusion that someone who cannot communicate in a common way must therefore have no desire, ability, or reason to communicate, and determine the inability to talk as the core, defining condition. While in most cases this is not intended as malevolent and far more due to the issues within our systemic understanding of mental health, I cannot tell you how many times I have heard a metaphorical equivalent in mental health to someone asking about an amputee, “this person lost their arm? How are they going to avoid being rude when people want to shake hands?”
Now truly, I truly do understand why someone would be skeptical about many, many aspects of mental health based on the schema and frameworks which we understand medicine in general– it, to some degree, contrasts both logic and rationality to just take people’s internal accounts as fact if we don’t relate to the experiences they have had. But this is also why rationalization and intellectualization are considered defense mechanisms. The idea that we can misunderstand ourselves has no hard, tangible counter– I can feel feverish and be 100% proven wrong when my temperature is 98.6– is also certainly at risk. But altogether, we must understand that there can be truths to these concerns while also understanding we are making an ‘apples to oranges’ comparison.
EXAMPLE 1: DIABETES TO ADHD
If someone has diabetes… they certainly know from internal body sensations and irregular body reactions. They go to a doctor, and report that they are not feeling well in one way or another. Our modern understanding of medicine allows the doctor to see that the body is either not producing enough insulin or misappropriating insulin. This is something we can scientifically connect to what we call diabetes, a patterned condition that we have seen throughout time. We luckily have enough understanding of insulin regulation that we can utilize what we call an insulin pump, and this can, on a scientifically based, numeric system, maintain blood sugar levels so that the individual can live with a quality of life closer to the average thanks to the accommodation.
If someone has ADHD… they certainly know from internal body sensations and irregular body reactions. They go to a doctor, and report that they are not feeling well, in one way or another. Our modern understanding of psychology does NOT easily allow the doctor to see that the body is misappropriating dopamine, even though this is something we can scientifically connect to what we call ADHD, a pattern that holds some controversy, but can be retroactively hypothesized to explain many ‘strange crazy behaviors’ seen throughout time. ADHD shows symptomatic presentation which might overlap with depression, anxiety, autism, bipolar, personality disorders, and many more conditions, and additionally any of those might also be present to any degree of severity. We do NOT have enough understanding of the science around dopamine regulation to have an equivalent to the insulin pump, instead we have a chemical which is loaded with controversy and is deemed “risky” to administer because historically, we have seen people that get far different reactions than those who actually need it to abuse the chemical. To call amphetamines “speed” is quite ironic when considering it regulates and therefore calms those who have ADHD, yet we are currently seeing a massive restriction on them.
At risk of being morbid, you may be thinking– but in one case the person dies, and in another they just deal with mental struggle. I can go as far as to say that this makes sense for why science first found a way to adequately manage diabetes, but I also offer the perception of how looking at the hard, ultimate negative that is death and how that may create a blind around considering quality of life. There are many studies showing the most proactive action towards prevention of ADHD individuals developing substance use disorders is to learn how to manage this dopamine imbalance in younger ages, yet the stigma of this preventative measure as enabling ADHD kids to become substance users later in life reigns supreme. There is very clear scientific evidence that certain brains have different reactions to something such as amphetamines, but that does not take precedence over the perception that ‘Speed’ is a dangerous street drug, even though peanuts can be lethal to some yet I eat them every day.
In some cases… we cannot make these comparisons because the social stigmas and perceptions around treatment genuinely change the entire experience, and mental health treatment includes a heightened risk around the impact of judgment, guilt, or worse emotions that interfere with the actual process of feeling better. To reiterate in a painfully comical way, one of the most common symptoms of many forms of neurodivergence is… internalized guilt, shame, and self-blame.
EXAMPLE 2: DIAGNOSIS, PROGNOSIS, AND TREATMENT
Shame is killer, but in other situations, what we think makes sense does not actually reflect the true breakdown of what happened, even if it certainly appears that way to society.
You break your femur. You’ll certainly know, the pain will do its evolutionary job informing you how this new damage is not going to work out well in letting you live your life until it gets corrected. We not only live in a natural world we adapted to and an artificial one based around our anatomy as bipedal homo sapiens, but we also see that even in the most primitive parts of the animal kingdom, this kind of injury is extremely grave. We go to the doctor and he gives us a DIAGNOSIS of a broken leg. This is correct, we can see it visually, and we have hundreds of years of examples of people getting into the exact same situation, at least physically. Thanks to this information, you’ll be given a PROGNOSIS and TREATMENT PLAN – we can safely assume you’d like your leg to work how it used to, so we say that if you put it in a cast and do physical therapy, in 4-6 months, you should expect to be HEALED to the point where you were initially, more or less feeling the same as before it happened. This is all very effective for a physical health issue… but consider how the same terms get applied to autism:
You recognize at 26 that you are on the autism spectrum. You likely have suffered from symptoms in one way or another throughout your life, but were very unlikely to connect those symptoms to autism, given the most predominant examples of the condition were shown at extremes and perhaps seen as a completely different presentation from what you’ve experienced. To call it how it is, and truly without judgment, the majority of people that do not clearly identify with the condition are certainly going to have hesitation around seeing themselves having autism– for a myriad of reasons– and will instead just assume that their sensory issues or rigidity or confusion in social situations as things that are either their fault for never learning, comparatively not important in relation to people with far more extreme symptoms, or similar dismissive measures. They may just not even connect these things as issues. There is no way to tangibly prove this parallel to seeing a bone fracture, and perhaps most detrimentally, the concepts of PROGNOSIS and TREATMENT to HEALING are now very vulnerable to being seen the same way as a femur break: fixing it.
UNLIKE a physical injury, our neurotype was NOT something that can be healed to return to “normal”, but should rather be viewed similarly to someone who was born with three legs. While it logically and rationally is going to achieve the goal of getting a two legged human into a society designed for two legged humans, you can see clearly in this example where cutting one of them off is not likely to improve this individual’s quality of life. We actually would be much better off helping them figure out what works best for them as a three legged person.
Perhaps looking at the NON-physical components of breaking a leg is actually the better way to see the similarities between the two– while we know the physical, biological prognosis can be safely and effectively used to measure our progress, what if breaking my leg now makes me terrified of physical activity? What if the stagnation of not being able to move has left me in a depressive episode? What if breaking my leg leads to losing my job? We can see here how the concept of diagnosis-prognosis-completion of treatment is actually a lot less cut and dried than how we may perceive it in general, and this is why, though understandably mixed up, it is a dangerous albeit easy transposition for us to make when looking at mental health treatment.
In some cases… we cannot make these comparisons because they are, structurally, not very comparable. This is an area where I feel the risk of seeing conditions from a rigid, DSM-driven perspective becomes most potentially harmful– it makes sense and is safe to rule out the feet if the bicep is the problem, but if we were flipping the comparison to correctly look at physical injury in terms of mental health, it is critical to realize that a bicep tear might have affected OR been caused by the feet, the appetite, and the liver enzyme breakdown as well. The confusion from this angle is clear to see.
EXAMPLE 3: THE PRINCIPLE OF FIT
A third consideration on why trying to compare medical to mental health issues becomes problematic is just simply what is most commonly described by the analogy that “if you expect a fish to climb a tree, it will spend its entire life believing it is a failure”. When it comes to something such as a neurotype, the complexity of what makes it “work/not work” or “manageable/problematic” is ultimately just based on the environment that each neurotype finds themselves in. While a morbid but valid consideration to a ‘survival of the fittest’, ‘adapt or die’ reality is worthy of mention, a counter would be that our environments are ultimately artificial in modern society, and therefore this would be the equivalent of arguing that a fish should not survive in trees without acknowledging that the failure to thrive is solely due to an unnatural existence in this environment and lack of opportunity to be in water, where it was designed to be.
The evolutionary hypothesis on ADHD is a great example– if you are assuming these neurotypes exist for evolutionary reasoning, it makes common ADHD symptoms such as having excess energy and hyperfocus, responding well in crisis, feeling more productive at night, and quicker baseline emotional responses a lot more valuable if we were still living in our original hunter-gatherer environment. Especially in tandem with neurotypical minds as a social species!
And furthermore, the behaviors which are seen as truly optimal for succeeding in the modern world may not even be correct! Let’s veer for a second and look at the traits of a cult leader– it is not the true empathy, connection, and trustworthiness of someone that creates the psychological conditions where people will begin to follow and wholly trust someone with their life path, it is actually the charisma, conviction, and ability to manipulate which gets them into the situation. As I and many, many high-functioning neurodiverse individuals can attest, the fact that one is smart and clever and well behaved as a child was definitely pitched to us as the ticket to a utopian existence. The reality after 30 years is that along with the many positives that I do appreciate, nobody ever told me that my heightened awareness and understanding would also lead to far more suffering due to awareness, existential dread, or crushing expectations around traits which, unfortunately, do NOT directly connect to success. They connect rather to anxiety, depression, restlessness, and similar unenjoyable results.
In some cases… We cannot make these comparisons because the variables of any situation are always fluid, and while we are evolutionarily designed for the natural earth around us, nature did design brains and did NOT design artificial parts of society.
A COMPROMISE TO BOTH SIDES
I think I’ve done an adequate job of conveying how confusing, contrasting, and self-crossing this very dense nuance of how we perceive mental health is. How about some proactive takes!
INTERDISCIPLINARY EDUCATION AND COLLABORATION
Look, man. As a licensed therapist, rule NUMBER ONE is the therapist must rule out a medical or physical condition. Why a medical doctor does not have the same responsibility to account for, or even required to have awareness of, mental conditions is beyond me. A LOT of improvement could be gained if we truly focused on bettering interdisciplinary (meaning holistic assessment looking through the lens of many fields of study) collaboration.
ACCEPTING THE MENTAL HEALTH FIELD MORE LIKE THE TECH FIELD
Another way we can look at mental health with a more open view that allows for more plasticity is to look at it more like we look at technology– it is a joy to me to explain just how awesome the most primitive and basic apps were on the iPhone when I was 14 in comparison to the full on console-level video games that a 14 year old can play on an iPhone now (they are astonished that anyone would spend money on an app that just gives you an image of a lighter). There was a point when the beeper was considered breaking technology– and that point was only 25 years ago. In 2009, the idea of an “internet meme” was niche to teenagers on the internet– they are now basically an entire medium of conversation for all ages. The list goes on and on, but at the end of the day is it really that strange to accept that our perception of mental health might advance as drastically as VCR becoming VR in just 40 years?
SEEING HOW PHYSICAL HEALTH HAS TAKEN THE SAME TRAJECTORY
And even if we did just keep our comparison to physical medicine– it is objectively true that to take a 1924 approach to medicine in 2024 is likely to make a person worse off, even though you would technically still be considered to be ‘following scientific evidence’. And in the opposite– I can certainly imagine there were many who were skeptical about the effectiveness of vaccines or antibiotics when they first were discovered just simply due to the fact that they couldn’t see it, so why would they believe it?
PLEASE PLEASE PLEASE PLEASE PLEASE…
JUST BELIEVE PEOPLE!
And finally… PLEASE… understand that it is a scientific fact that validation is the most surefire and expedited way to re-regulation.
Take the case of someone experiencing psychosis due to schizophrenia, it is VALIDATING the perceptions that person is having are real to them which will lead to THEIR internal recognition that they are in fact experiencing delusions, but invalidating the experience tends to create more exacerbation, dysregulation and resistance on the end of the person having the delusion.
IT IS VERY CLEARLY COUNTERINTUITIVE… but if anyone is reporting mental discomfort that seems problematic to them, regardless of how misdirected or illogical it may be perceived… the fastest and healthiest way to discover the actual root begins with letting the person try to explain without risk of judgment or correction.
CHAPTER 2 IN REVIEW
So I suppose that’s how you explain something scientifically when the science part is largely defined by what is NOT known.
What can be said, as is easily accepted as true and factual in the cases of something like dreaming or favorite food preference or why one singing voice is beautiful and another is legitimately inducing negative feelings, is that not everything CAN be proved through tangible measure! While we may never get to a point where someone can look and see on a screen where serotonin levels need to be adjusted, we can absolutely begin to accept mental health as a concept far more permeating than just a classifiable set of symptoms and see where the benefits of loosening our perspectives could result in a large positive change. On the opposing side… a more holistic and accepting perception would (ironically) REDUCE the issues caused by overdiagnosing or overclinicalizing specific mental health conditions, as the problem lies far more in the misinterpretation of everything that a diagnosis can encompass than the fact that we have organized common symptom clusters into specific labels. If the issue is in worry around mismanagement of medication, that is ALREADY happening due to the misunderstanding of treatment, and the situation could actually improve by taking a more open-minded stance about our misunderstanding of the medications and who needs them.
While we may never get to a point in this lifetime where mental health is adequately and fully understood, it is still promising to see how science has advanced and embraced mental health.
After all, the ultimate goal of science IS… just to continue to observe, study, question, and progress how the world works around us.
WHAT’S COOKING FOR NEXT MONTH
THE REJECTION PROTECTION CLUB CHAPTER 3: “INTENTION DEFICIT DISORDER”
For the next section, we will begin to discuss some of the lesser known and further problematic aspects of neurodivergence, which include ancillary issues such as rejection sensitivity dysphoria, secondary symptoms, and internalized self doubt that truly can create far more discomfort than what is usually seen as the “disability” pieces within neurodivergence.
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