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By Sara-Louise Ackrill, Co-founder, Start Differently
One of the hardest things to resolve for people in therapy is what belonged to their parents and caregivers and what they would have chosen to bring into their adult lives, if they had consciously thought about it.
Ideally, when we were young people, we would have tackled this as part of our individuating from our families of origin and gone out into the world clear on what we wanted for ourselves, what we believed in and knowing about what does us good and what does us harm. But all the way through our lives, we are to a degree enmeshed with what we grew up with, and this often involves carrying opinions on
• who gets to have a mental health or neurodiversity label
• Who gets to use the word disabled
• whether meds should be part of the picture
• and how often we should be interacting with medical professionals.
If you grew up in a family that wouldn't contemplate taking a paracetamol for a headache, then you are likely still that person now, many years later. And sometimes cultural values come into this too. We don't tend to realise how malleable we were as young people and while we are dependent on parents and caregivers, we are beholden to their thinking on a huge range of topics.
If your parent doesn't believe in neurodiversity, then you won't be seeing a doctor any time soon. You may also believe you are lazy or stupid or have constant family tensions as your unfathomable behaviour looks like the cause of yet another ruckus. If your parents and their parents didn't do meds, then you can struggle with ADHD all you like but you won't be getting meds and there will be repeated messages about trying harder and resilience and questions about why you are underperforming.
If your family aren't into labels, you may or may not have a diagnosis but you might never find out you are 'wired differently' and be kept in the dark about having a markedly different brain activity to most of the population and left to wonder why you're so 'weird' 'mad' 'bad' or 'crazy'.
I've worked as a psychological therapist now for 13 years, and I have rarely met a young person who was anti-labels, anti-diagnosis, or anti meds. What I have seen are a lot of young people being told they are fine and need to try harder. Or to just get some strategies. Or to not use their labels as an excuse. And this is something I can empathise with; the world is hard and parents want children who are going to weather the storm, especially in preparation for the time they are no longer around.
I am not a parent myself but I realise that labels can be weaponised by everyone and we are all susceptible to being asked to do things that we don't want to do at times. In those moments, any excuse might feel like a good excuse. But the reality is that for the odd occasion where a young person might hide behind a label or use it obstructively, there are far more young people well on their way to developing mental health problems through not having their neurodiversity ‘seen’.
It is not unusual to see people who are 16-30 who are considering taking their own life because they feel trapped, confused, angry and frustrated. They can't get their school or uni work done. Their parents don't want to hear the reasons. The young person feels terrible they are letting their parents down and they cannot fathom what is wrong with them that they cannot get that assignment or the revision done. Young people tend to use social media and although it gets a bad rep, it is a source of great understanding and relatability when it comes to neurodivergent young people.
Rejection Sensitive Dysphoria1, justice sensitivity, having a literal take on the world, spoon theory2, co-morbidity with physical health conditions, complex trauma3, self-advocacy, having relationships… these are all elements of being neurodivergent that we would never know about if we waited for doctors, schools or social workers to tell us about them. Thank goodness for freely available, entertaining and validating resources on platforms like TikTok and Instagram. But too often, this is the young person's only source of feeling like they are a part of normality and then they get told they are having too much screen time and should go out more. Online, young people find their tribes wherever they might be in the world, and in a way that is nigh on impossible in real life. You cannot walk down the High Street on a weeknight and ask people if they are neurodivergent or live with anxiety or OCD. But online you can filter people quickly and find groups and hang outs and get chatting immediately about things that in real life, you might not divulge to another person over the course of a 20 year friendship! (Obviously there is good and bad in that). In the 'in person' world, it's very easy to be isolated, scared and trapped when you’re neurodivergent, let alone also young and vulnerable simply through being the age you are.
Conclusion
My message is that I would like parents and carers to be more open minded when it comes to labels, medication and doctors, and to get out of their young person's way. It is rare, nowadays, that a young person doesn't just accept they are neurodivergent. That they don't see a label as offering clarity. They rarely want to use anything as an excuse or to get them off the hook. If anything, in my experience, young people need to learn how to make life easier for themselves, and to beat themselves up a lot less.
Young people are not usually terrified of meds or stigma. They are likely to know that 1 in 5 people is neurodivergent, and they might even refer to it as a superpower.
I am not fond of the superpower narrative because neurodiversity does bring strengths, but only in the sense that we have to learn to master it first. Like giving someone a violin — that doesn't make them a great player, it just gives them an opportunity to learn to play.
Learning to master neurodiversity takes a lot of practice and affirmative support, the right information and an environment where people feel safe to be themselves. But most of all it requires people to feel psychologically safe with the people caring for them. The same people who are often, without meaning to, keeping a lid on the young person’s potential by passing on outdated beliefs, assumptions and anxieties that were never theirs to deal with in the first place.
References:
[1] Rejection Sensitive Dysphoria is explained here Rejection Sensitive Dysphoria (RSD): ADHD and Emotional Dysregulation
[2] Spoon theory is a system people with long-term health conditions use to describe how they spend energy. The Spoon Theory written by Christine Miserandino
[3] Pete Walker defines complex trauma as ‘the cumulative psychological impact of prolonged childhood abuse or neglect, resulting in Complex PTSD (CPTSD) with lasting emotional, cognitive, and relational effects’. Suggested books are You’re Not Broken: Break free from trauma and reclaim your life: Woodhouse, Dr Sarah and Waking the Tiger: Healing Trauma: The Innate Capacity to Transform Overwhelming Experiences: Levine Ph.D., Peter A., Frederick, Ann although there are many good ones nowadays
Sara-Louise Ackrill is a therapist, author, consultant and speaker working in neurodiversity and her clients are based all over the world. She is the London-based co-Founder of Start Differently, a non-profit working to get neurodivergent people into employment, self-employment and entrepreneurship.
