Understanding Intrusive Thoughts: What They Are and How to Handle Them

Have you ever had a strange, upsetting thought pop into your head out of nowhere? Maybe it was about something you’d never actually do, or something that made you feel worried or ashamed. These are called intrusive thoughts, and they’re something almost everyone experiences at some point.

Let’s explore what intrusive thoughts are, why they happen, and how you can deal with them.

What Are Intrusive Thoughts?

Intrusive thoughts are unwanted thoughts, images, or urges that suddenly show up in your mind. They can feel uncomfortable or even scary. Some examples include:

• Worrying about accidentally hurting someone (“What if I trip and hurt a friend?”),

• Thoughts about doing something inappropriate (“What if I yell something rude in class?”),

• Fears of germs or getting sick (“What if touching this makes me sick?”),

• Worries about being bad or breaking rules (“What if I did something wrong and didn’t know it?”),

• Feeling like things must be perfect or orderly (“I need to line up my books exactly right.”).

These thoughts can feel upsetting because they often go against what you believe or care about. For example, if you care deeply about your family, having a thought about hurting them can feel really confusing or scary. But here’s the truth: having an intrusive thought doesn’t mean you’ll act on it or that it’s true.

Why Do Intrusive Thoughts Happen?

Intrusive thoughts happen to everyone. Our brains are always coming up with new ideas, some of which don’t make sense or feel good. But certain things can make these thoughts stick around longer or feel more intense, like:

• Stress or Anxiety: When you’re stressed, your brain might focus more on negative or scary thoughts.

• Trying Too Hard to Ignore Them: When you try to push a thought away, it can make it pop back up even stronger. (Ever tried not thinking about a pink elephant? It’s hard!)

• Mental Health Conditions: Some people who have conditions like OCD, PTSD, or anxiety disorders might notice intrusive thoughts more often.

• Neurodivergence: ADHD, autism, and other neurodivergent traits might make someone more susceptible to more frequent intrusive thoughts or find them harder to let go. This is because our brains often process information in unique and sensitive ways.

The important thing to remember is this: thoughts are just thoughts. They don’t control your actions, and they don’t define who you are.

How to Handle Intrusive Thoughts

Even though you can’t stop intrusive thoughts from showing up, you can change how you respond to them. Here are some tips:

1. Name the Thought When a thought pops up, say to yourself: “This is an intrusive thought. It’s not me, and it’s not important.” Giving it a label helps you see it for what it is—just a thought.

2. Don’t Fight It The more you try to push the thought away, the more it sticks. Instead, imagine the thought like a cloud in the sky or a leaf floating down a river. Let it pass by without grabbing onto it.

3. Remember Your Values If the thought feels upsetting, remind yourself: “This bothers me because it goes against what I care about. That’s proof that it’s not who I am.”

4. Practice Mindfulness Mindfulness means focusing on the present moment without judgment. If a thought pops up, notice it, but don’t give it too much attention. Focus instead on your breathing or what’s happening around you.

5. Challenge the Thought If the thought feels like it’s saying something true about you, remind yourself: “Just because I think it doesn’t mean it’s true.” Thoughts aren’t facts, and they don’t predict the future.

6. Talk to Someone If intrusive thoughts are really upsetting or won’t go away, talking to a therapist can help. Therapies like Cognitive Behavioral Therapy (CBT) or Exposure and Response Prevention (ERP) are great for learning how to manage these thoughts.

Intrusive Thoughts Are Normal

It’s easy to feel alone or scared when intrusive thoughts show up, but here’s the truth: you are not alone. Almost everyone has strange or uncomfortable thoughts sometimes. The key is to recognize them as just thoughts and not let them control how you feel or act.

For people who are neurodivergent, it’s especially important to understand that your brain might hold onto these thoughts a little longer. But you also have strengths—like creativity and resilience—that can help you manage them.

You don’t have to face intrusive thoughts alone. There are tools, strategies, and people who can support you. You’ve got this!

When Trauma Meets Neurodivergence: The Impact on Autism and ADHD

When an individual with autism and ADHD also has a history of trauma and/or childhood abuse, the presentation of both neurodevelopmental conditions can be significantly impacted and may even become more complex. Trauma can exacerbate symptoms of autism and ADHD, leading to more pronounced difficulties with executive functioning, emotional regulation, and social interaction. Here's how these conditions might present in such an individual:

1. Heightened Emotional Dysregulation

• ADHD: Individuals with ADHD already struggle with emotional regulation, often experiencing intense emotions and difficulty controlling impulses. A history of abuse can further heighten this dysregulation, leading to mood swings, heightened irritability, or emotional outbursts (Matson & Goldin, 2013).

• Autism: Autistic individuals may also face challenges with emotional regulation, especially when overwhelmed by sensory input or changes in routine. Trauma can exacerbate these challenges, increasing the likelihood of meltdowns or shutdowns when triggered by stressful or unfamiliar situations (Hull et al., 2020).

2. Increased Hypervigilance and Anxiety

• ADHD: Trauma can heighten ADHD symptoms, especially hyperactivity and inattention, due to increased hypervigilance. Individuals may become overly alert to potential dangers, which can worsen focus and increase impulsivity as their mind frequently shifts between perceived threats and distractions (Bremner, 2006). This can make it difficult to complete tasks or concentrate on long-term goals.

• Autism: Many autistic individuals already experience anxiety due to sensory sensitivities and difficulties with social interactions. A history of abuse can lead to a state of chronic anxiety or hypervigilance, where the person becomes overly focused on protecting themselves from perceived harm. This may make it even harder to navigate social situations or adapt to changes in their environment (Ozsivadjian et al., 2012).

3. Social Difficulties Intensified by Trust Issues

• ADHD: People with ADHD often struggle with impulsivity in social interactions, such as interrupting conversations or missing social cues. Trauma can compound these issues by leading to mistrust or avoidance of social situations, as the person may fear being harmed or taken advantage of again (Craig et al., 2016).

• Autism: Autistic individuals may already experience difficulty interpreting social cues and forming relationships. A history of childhood abuse can lead to a profound fear of rejection, abandonment, or mistreatment, making social interactions even more challenging. This may cause withdrawal from social situations or an increased reliance on repetitive behaviors and routines as coping mechanisms (Rumball, 2019).

4. Executive Function Challenges Intensified by Trauma

• ADHD: Executive function deficits, such as difficulties with organization, time management, and working memory, are core features of ADHD. Trauma can exacerbate these issues, leading to further disorganization and forgetfulness, as the brain becomes preoccupied with managing emotional distress (Teicher & Samson, 2016).

• Autism: Autistic individuals often struggle with executive function, particularly with planning, flexibility, and prioritizing tasks. Trauma may intensify these challenges, as the person might become more rigid in their routines or avoid tasks that feel overwhelming, further impairing daily functioning (Craig et al., 2016).

5. Sensory Sensitivities and Overload

• Autism: Many autistic individuals experience heightened sensory sensitivities, which can be worsened by trauma. Sounds, lights, or textures that were previously tolerable may become overwhelming, causing sensory overload. Abuse may also lead to specific triggers related to past traumatic experiences, making certain environments unbearable (Rumball, 2019).

• ADHD: While sensory issues are not a primary feature of ADHD, some individuals do experience sensory sensitivities. Trauma may amplify these sensitivities, contributing to irritability or restlessness when exposed to overwhelming stimuli.

6. Difficulty with Trust and Authority Figures

Individuals with a history of childhood abuse may have difficulty trusting others, particularly authority figures such as teachers, employers, or therapists. This can complicate relationships and reduce their willingness to seek help or engage in therapeutic interventions, further isolating them from support systems (van der Kolk, 2014).

Conclusion

The combination of autism, ADHD, and a history of childhood abuse can lead to significant challenges in emotional regulation, executive function, and social interaction. Trauma can amplify existing symptoms and create additional barriers to coping, making it crucial to approach treatment with a trauma-informed lens. Interventions should be individualized to help these individuals manage the overlapping effects of neurodevelopmental conditions and trauma, focusing on emotional regulation, cognitive flexibility, and building trust in supportive relationships.

References:

• Matson, J. L., & Goldin, R. L. (2013). Comorbidity of autism spectrum disorders and ADHD: Implications for assessment and intervention. Research in Developmental Disabilities, 34(9), 2351-2356.

• Hull, L., Mandy, W., & Petrides, K. V. (2020). Behavioral and cognitive differences in autism spectrum condition as a function of sex and gender. Autism, 24(2), 347-359.

• Bremner, J. D. (2006). Traumatic stress: Effects on the brain. Dialogues in Clinical Neuroscience, 8(4), 445-461.

• Ozsivadjian, A., Knott, F., & Magiati, I. (2012). Parent and child perspectives on the nature of anxiety in children and young people with autism spectrum disorders: A focus group study. Autism, 16(2), 107-121.

• Craig, F., Margari, F., Legrottaglie, A. R., Palumbi, R., de Giambattista, C., & Margari, L. (2016). A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment, 12, 1191-1202.

• Rumball, F. (2019). Autism and trauma: The impact of childhood abuse. Journal of Autism and Developmental Disorders, 49(10), 4034-4043.

• Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry, 57(3), 241-266.

• van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.

What Are ACE Scores and Why Do They Matter for Neurodivergent Adults?

As a therapist, I often work with individuals who have experienced various forms of trauma. One helpful tool to understand the long-term effects of early adversity is the Adverse Childhood Experiences (ACE) score. This score assesses the impact of negative experiences during childhood, helping predict how these experiences might influence a person's physical and mental health. ACE scores can be particularly relevant for autistic and ADHD adults, whose neurodevelopmental traits may interact uniquely with trauma.

What Are ACEs?

Adverse Childhood Experiences (ACEs) refer to potentially traumatic events before age 18. These include:

• Abuse (physical, emotional, or sexual)

• Neglect (physical or emotional)

• Household dysfunction, such as exposure to substance abuse, domestic violence, mental illness, or parental incarceration

The original ACE study by the CDC and Kaiser Permanente found that the more ACEs a person experiences, the higher their risk of negative health outcomes later in life, such as mental health disorders, chronic diseases, and even early mortality (Felitti et al., 1998).

How ACE Scores Work

An ACE score is calculated by counting the number of categories of adverse experiences a person faced during childhood, with a range from 0 to 10. For example, a person who experienced emotional neglect and parental substance abuse would have an ACE score of 2. Higher scores are linked to more significant risks for long-term issues such as heart disease, depression, or substance use disorders (CDC, 2019).

Trauma and Neurodivergence: A Complex Intersection

For autistic and ADHD adults, the impact of ACEs can be particularly intense. Neurodivergent individuals are often more vulnerable to trauma because of factors such as social isolation, bullying, or misunderstanding from others. Autistic individuals, for example, may be more sensitive to changes in their environment or face challenges in social situations, heightening their risk of emotional trauma (Kerns et al., 2015). Similarly, ADHD individuals may experience criticism for their impulsive behavior or inattentiveness, increasing their exposure to emotionally painful experiences (Craig et al., 2016).

Unique Gendered Experiences

Gender presentation can further complicate the relationship between neurodivergence and ACEs. Girls and AFAB (assigned female at birth) individuals with ADHD and autism may be underdiagnosed, leading to feelings of being misunderstood or unsupported during formative years. Girls with ADHD are more likely to internalize symptoms, which can manifest as anxiety or depression, both of which are exacerbated by trauma. In contrast, boys or AMAB (assigned male at birth) individuals may face more externalizing symptoms, such as impulsive or disruptive behavior, increasing the likelihood of being labeled "troublemakers" and experiencing harsher discipline, which can be traumatic in itself (Hull et al., 2020).

The Impact of ACEs on Neurodivergent Adults

While ACE scores are predictive of health outcomes for the general population, neurodivergent adults face unique challenges. Trauma may amplify existing difficulties, especially around emotional regulation, executive functioning, and social communication. For example:

• Heightened Anxiety and Hypervigilance: Many autistic individuals experience high levels of anxiety, which trauma can worsen. Hypervigilance, a common trauma response, is often intensified in autistic adults due to sensory sensitivities (Ozsivadjian et al., 2012).

• Emotional Dysregulation: ADHD is associated with emotional dysregulation, and trauma can further complicate the ability to manage emotions. Individuals with both ADHD and high ACE scores may struggle with anger, frustration, and sadness, affecting personal and professional relationships (Craig et al., 2016).

• Compounded Executive Functioning Challenges: Trauma can worsen executive dysfunction, such as difficulties with organization, time management, and decision-making, which are already present in autism and ADHD (Teicher & Samson, 2016).

Trauma-Informed Care for Autistic and ADHD Adults

For neurodivergent individuals, it’s essential that care providers understand the intersection between trauma and neurodevelopmental differences. Trauma-informed care helps clinicians tailor treatment to address both the impact of childhood adversity and the specific challenges associated with autism and ADHD. By fostering resilience and offering personalized strategies, therapy can support individuals in managing symptoms and improving their quality of life.

Conclusion

ACE scores provide valuable insights into the long-term effects of childhood trauma, especially for autistic and ADHD adults. Understanding this intersection helps clinicians offer effective, compassionate care that addresses both trauma and neurodevelopmental challenges.

Citations:

• Felitti, V. J., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258.

• Centers for Disease Control and Prevention (CDC). (2019). Adverse Childhood Experiences (ACEs). Retrieved from https://www.cdc.gov/violenceprevention/aces/index.html

• Kerns, C. M., et al. (2015). Anxiety in autism spectrum disorder: Clinical and research perspectives. Neuropsychiatry, 5(1), 147-155.

• Craig, F., et al. (2016). A review of executive function deficits in autism spectrum disorder and ADHD. Neuropsychiatric Disease and Treatment, 12, 1191-1202.

• Hull, L., Mandy, W., & Petrides, K. V. (2020). Behavioral and cognitive differences in autism spectrum condition as a function of sex and gender. Autism, 24(2), 347-359.

• Ozsivadjian, A., Knott, F., & Magiati, I. (2012). Parent and child perspectives on the nature of anxiety in children and young people with autism spectrum disorders: A focus group study. Autism, 16(2), 107-121.

• Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry, 57(3), 241-266.

How Trauma Affects Executive Function: Understanding the Connection for Neurodivergent Adults

Executive function is a set of cognitive processes that allow us to manage time, focus attention, regulate emotions, and plan and execute tasks. When trauma enters the picture—whether from childhood experiences, chronic stress, or life-threatening events—these critical functions can become compromised. This is especially relevant for autistic adults and individuals with ADHD, as both conditions already involve executive functioning difficulties, which trauma can significantly exacerbate.

The Impact of Trauma on Key Executive Functions

1. Emotional Regulation and Impulse Control
   Trauma disrupts the brain's ability to regulate emotions, leading to heightened responses such as irritability, anxiety, and impulsive actions. This is due to alterations in the amygdala and prefrontal cortex, regions of the brain critical for managing emotional responses (van der Kolk, 2014). For individuals with ADHD or autism, this may result in more frequent emotional outbursts or difficulty calming down after stressful situations.

2. Working Memory and Focus
   Trauma can impair working memory, which is crucial for holding and using information in real time. Research shows that people who have experienced trauma often struggle to focus on tasks or retain information, especially under stress (Bremner, 2006). Autistic adults and those with ADHD may already experience working memory deficits, and trauma only intensifies these challenges, making it harder to stay on task or remember important details.

3. Cognitive Flexibility and Adaptability
   Trauma affects cognitive flexibility, the ability to shift between different tasks or adapt to new information. For autistic individuals, who may already prefer routine and predictability, trauma can exacerbate difficulties with change, causing heightened stress or even meltdowns in unfamiliar situations. Similarly, individuals with ADHD may find it harder to transition between tasks or adjust when plans change.

4. Hypervigilance and Executive Function
   Trauma often leads to hypervigilance, a constant state of alertness where the brain is scanning for threats. This impacts executive function by diverting attention from tasks to the environment, making it hard to focus on work, school, or social interactions (DePrince et al., 2009). Hypervigilance can leave individuals mentally and emotionally exhausted, further limiting their ability to engage in goal-directed behaviors.

5. Decision-Making and Problem-Solving
   Trauma survivors often struggle with decision-making and problem-solving due to their brain being "stuck" in survival mode. Autistic individuals and those with ADHD, who already face challenges in these areas, may find that trauma makes it harder to weigh options or solve problems, as their executive functioning is further compromised (Teicher & Samson, 2016).

The Combined Effects of Trauma, ADHD, and Autism

For those living with autism or ADHD, trauma can make the already difficult task of managing daily life even more overwhelming. Both ADHD and autism involve deficits in executive functioning, such as organizing, focusing, and regulating emotions. When trauma is added, these issues are intensified. For example, an individual with ADHD may find it impossible to stick to a routine due to impulsivity, while trauma-induced hypervigilance makes focusing on a task even more challenging.

In autistic adults, trauma might exacerbate sensory sensitivities or increase rigidity in routines, as unexpected changes become even more stressful. This interplay can lead to a sense of being "stuck" in survival mode, with heightened anxiety and a reduced ability to cope with daily challenges.

Strategies for Managing Trauma and Executive Dysfunction

• Trauma-Informed Cognitive Behavioral Therapy (CBT): This approach helps individuals recognize and manage how trauma impacts their thoughts and behaviors. CBT can improve emotional regulation, helping people better manage impulsivity and stress.

• Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation can help reduce hypervigilance and improve focus by calming the brain’s stress response.

• Assistive Tools: Time-management apps, visual schedules, and reminders can support working memory and organizational skills, making day-to-day tasks more manageable.

• Sensory Modifications: Creating a sensory-friendly environment can help autistic individuals manage trauma-related stress by reducing sensory overload, while tools like weighted blankets or noise-canceling headphones can offer comfort.

Conclusion

Trauma can deeply affect executive functioning, especially for autistic adults and individuals with ADHD who are already navigating challenges related to attention, flexibility, and emotional regulation. Understanding how trauma interacts with executive dysfunction is crucial for offering effective support. With the right strategies, individuals can better manage their cognitive challenges, reduce the impact of trauma, and regain control over their daily lives.

References:

• Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry, 57(3), 241-266.

• van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.

• DePrince, A. P., Weinzierl, K. M., & Combs, M. D. (2009). Executive function performance and trauma exposure in a community sample of children. Child Abuse & Neglect, 33(6), 353-361.

• Bremner, J. D. (2006). Traumatic stress: Effects on the brain. Dialogues in Clinical Neuroscience, 8(4), 445-461.

Questions for the Mental Health Community

FYI - one does not “treat autism”

Neurotypes are more operating systems than flaws/bugs to be fixed.

This feels critical to the continued conversation.

Below I will share several discussion questions that have been hot topics in several therapist circles I frequent.

Treatment plans/service plans with autistic clients may focus on the symptoms that manifest as a result of being autistic in a neurotypical focused world, such as managing anxiety symptoms, sensory overwhelm symptoms, social difficulties from inconsistent or inauthentic social cues from others, etc. but the focus (when being affirming) is on improving health, not on “becoming less autistic”.

I’ve received a few messages regarding fear of speaking up about this due to the acceptance of interventions that are commonly included in ABA (applied behavioral analysis) treatment protocols.

Autistic people don’t need to become less autistic.

We may need to learn that we need to gain some linguistic and interaction focused scripts in order to exist in the world, but … that’s not about “treating autism”, it’s about gaining skills to navigate social situations with others who are different from us.

In the same way that others need to gain skills to interact with our brains’ operating systems.

Research links that back this up … escape me at the moment but I welcome anyone who has the spoons to share below.

I will share my favorite giant resource list from a therapist in Florida for those looking to learn more about autism and share resources with clients : https://therapyforpetpeople.com/neurodivergence-acceptance

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What is Executive Function and Dysfunction? A Lighthearted Look at the Experience of Autistic and ADHD Adults

Ah, executive function: the mysterious brain process that helps us organize our thoughts, stay focused, and generally not be walking chaos. For most people, executive function is like having a personal assistant who keeps everything in check. But for autistic adults and those with ADHD, that personal assistant may take frequent, unannounced vacations, leaving them in charge of planning and organizing life’s to-dos on their own. Spoiler alert: things can get messy.

So, what exactly is executive function, and how does it go rogue in autistic and ADHD brains? Let’s dive into the fun and dysfunction of it all.

Executive Function 101

In a perfect world, executive function is the brain's “manager” that handles all your daily operations. It includes:

• Working Memory: This is the ability to hold and manipulate information in mind over short periods. It allows you to remember a phone number long enough to dial it or to follow multi-step instructions without losing track.

  • Remembering where you left your keys while also deciding what to make for dinner. (Spoiler: those keys are long gone.)

• Cognitive Flexibility (Flexible Thinking): This skill enables you to adjust to new situations, shift your thinking, and see things from different perspectives. It's what allows you to switch between tasks or adapt when plans change unexpectedly.

  • Being able to roll with the punches when your perfect plan doesn’t go as expected. (Like when your favorite show releases another season right when you’re about to start being productive.)

• Inhibitory Control (Self-Control): This involves controlling impulses and resisting distractions. It's the mental brake that prevents you from acting on every thought or urge, helping you stay focused and behave appropriately in various contexts.

  • Suppressing the impulse to check your phone every 10 seconds or buy that life-sized replica of Baby Yoda.

But when executive dysfunction comes into play—especially for autistic adults and those with ADHD—these processes can feel like a comedy of errors.

Executive Dysfunction: When the Command Center Misfires

Executive dysfunction occurs when these cognitive processes are impaired, leading to difficulties in managing thoughts, emotions, and actions. For autistic adults and those with ADHD, executive dysfunction can manifest in several ways:

• Organization and Planning Issues: Struggling to keep track of belongings, manage time effectively, or plan ahead for tasks and responsibilities.

• Difficulty with Starting and Completing Tasks: Procrastination or trouble initiating tasks, even ones that are important or of interest, and difficulty following through to completion.

• Problems with Focus and Attention: Being easily distracted by external stimuli or internal thoughts, leading to challenges in maintaining attention during tasks or conversations.

• Impulsive Behavior: Acting without considering the consequences, interrupting others, or making hasty decisions.

• Emotional Regulation Challenges: Difficulty managing emotions, leading to heightened responses like frustration, anger, or anxiety over seemingly minor issues.

Executive Dysfunction in ADHD: The “What Was I Doing Again?” Loop

Adults with ADHD often live in a world of constant distractions, impulsivity, and forgotten tasks. As Barkley (2015) humorously describes, the ADHD brain often struggles to prioritize—which is why laundry day can turn into a spontaneous quest to deep-clean the fridge. Focus can be elusive, and time management? Well, that’s more of a vague concept than an actual skill. If you’ve ever had an hour-long work meeting turn into 45 minutes of mentally planning a vacation, you know what we’re talking about.

In addition to squirrel brain moments, impulsivity in ADHD means blurting out a random idea in the middle of a serious conversation or suddenly deciding that reorganizing the bookshelf is way more important than answering emails.

In adults with ADHD, executive dysfunction often appears as:

• Inattention and Distractibility: Challenges with working memory and inhibitory control can make it hard to focus on tasks, especially those that are less engaging.

• Hyperactivity and Impulsivity: Excess energy and difficulty controlling impulses can result in restlessness, interrupting others, or engaging in risky behaviors.

• Time Management Difficulties: Problems estimating how long tasks will take or prioritizing tasks can lead to procrastination and missed deadlines.

Executive Dysfunction in Autism: The “Wait, I Didn’t Plan for This” Struggle

Autistic adults experience executive dysfunction differently, often manifesting in cognitive rigidity (Ozonoff et al., 2016). If you’ve ever seen someone stick to a routine like it’s their life’s mission, that’s because change can be pretty distressing. Planning and flexibility aren’t just tricky—they can be downright overwhelming.

And let’s not forget that many autistic people hyperfocus on certain interests. Hyperfocus can be amazing for diving deep into a hobby but less so when you realize you’ve spent five hours learning everything about 17th-century shipbuilding and forgot to eat lunch.

For autistic individuals, executive dysfunction may contribute to:

• Routine Dependence: A strong preference for routines and difficulty adapting to changes can be linked to challenges with cognitive flexibility.

• Detail-Focused Processing: While often excellent at noticing details, autistic people might struggle with seeing the bigger picture, affecting planning and organization.

• Emotional Overload: Difficulties with inhibitory control can make it harder to regulate emotions, leading to sensory overload or meltdowns in overwhelming situations.

When ADHD and Autism Team Up: Double Trouble

Now, imagine both conditions together. You might find yourself caught in a never-ending loop of hyperfocus, while also struggling to keep up with the chaos that surrounds you. Planning can become extra tough because both the impulsivity of ADHD and the rigidity of autism are in full force. (Think of it as a never-ending fight between spontaneity and the need for order.)

How to Tame Executive Dysfunction (Sort Of)

Managing executive dysfunction doesn’t require a brain overhaul—just a few strategies to get that personal assistant back on track:

• Cognitive Behavioral Therapy (CBT): This is like giving your brain a toolkit to manage impulsivity and break tasks into bite-sized pieces. Suddenly, checking things off your to-do list feels achievable.

• Assistive technology: Using phone reminders, timers, and calendars can help keep things on track. Who knew that a digital reminder to drink water could be life-changing?

• Environmental modifications: Create a predictable routine that helps you feel grounded. Even a sticky-note army can be a step toward keeping the chaos under control.

Conclusion

Executive function can be like trying to herd cats for autistic adults and those with ADHD. The brain’s “manager” often goes off duty, leaving behind a trail of disorganized thoughts and impulsive decisions. But with the right strategies—and maybe a few sticky notes—executive dysfunction can become a little more manageable. After all, life is more about finding a balance between spontaneity and structure, even if that means occasionally losing your keys.

References:

• Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Press.

• Ozonoff, S., Goodlin-Jones, B. L., & Solomon, M. (2016). Evidence-based assessment of autism spectrum disorder in children and adolescents. The Guilford Press.

• Craig, F., Margari, F., Legrottaglie, A. R., Palumbi, R., de Giambattista, C., & Margari, L. (2016). A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment, 12, 1191–1202.

The Benefits of Writing and Journaling After a Late Diagnosis of Autism and ADHD

Receiving a late diagnosis of autism or ADHD can be a profound experience, filled with emotions ranging from relief to grief, as it often reshapes how individuals see their past and present. Journaling and writing can play a significant role in processing these feelings, providing a way to navigate the complexities of understanding oneself through a new lens. For many, writing becomes a therapeutic tool that helps to externalize thoughts, process emotions, and better manage daily life.

1. Emotional Processing and Self-Acceptance

A late diagnosis of autism or ADHD often brings about a reevaluation of one’s identity. Many people reflect on missed opportunities, misunderstood behaviors, or periods of self-criticism. Journaling provides a safe space to explore these feelings without judgment. By writing down their thoughts, individuals can begin to make sense of their experiences, understanding how neurodivergence may have shaped their lives.

Research suggests that expressive writing can be a powerful tool for managing difficult emotions and reducing stress. Pennebaker's studies on expressive writing show that writing about emotional experiences can lead to better mental health and reduced stress levels (Pennebaker & Beall, 1986). For neurodivergent adults, journaling can become a pathway to self-acceptance, helping them come to terms with their diagnosis and the unique ways their brains work.

2. Organizing Thoughts and Enhancing Focus

Both autism and ADHD are associated with executive function challenges, including difficulties with organization, planning, and focus. Writing and journaling can provide a structured way to manage these challenges. Whether it's making lists, setting daily goals, or simply outlining thoughts, the act of putting things down on paper can help individuals with ADHD and autism improve clarity and reduce overwhelm.

In fact, writing down goals and tasks has been shown to improve focus and productivity, which can be particularly helpful for those with ADHD who may struggle with attention and procrastination (Brown, 2005). Journaling can serve as a daily practice that supports better time management and task prioritization.

3. Exploring Neurodivergent Identity

For many adults diagnosed later in life, understanding how autism or ADHD has shaped their identity can be both enlightening and challenging. Writing provides an outlet to explore these insights and reflect on what it means to live authentically as a neurodivergent person. Journaling can help individuals reframe past experiences, moving from frustration or confusion to understanding and self-compassion.

Autistic adults, in particular, may find that journaling helps with processing sensory overloads or managing the emotional exhaustion of masking (Hull et al., 2020). By reflecting on these experiences, individuals can gain insight into what triggers stress and develop strategies for managing sensory or emotional overloads in the future.

4. Building Resilience and Mental Health

Regular journaling can contribute to emotional resilience by allowing individuals to track patterns, celebrate small victories, and monitor personal growth over time. Writing about positive experiences can shift focus from challenges to strengths, which is particularly empowering for individuals navigating the complexities of a new diagnosis. This practice aligns with the principles of cognitive-behavioral therapy (CBT), which encourages individuals to challenge negative thought patterns and reframe them into positive ones (Beck, 2011).

Conclusion

Writing and journaling offer numerous benefits for individuals navigating a late diagnosis of autism or ADHD. Whether used as a tool for emotional processing, organizing thoughts, or exploring identity, the practice can help neurodivergent adults better understand themselves, manage their daily challenges, and build a more authentic, fulfilling life.

References:

• Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95(3), 274-281.

• Brown, T. E. (2005). Attention Deficit Disorder: The Unfocused Mind in Children and Adults. Yale University Press.

• Hull, L., Mandy, W., & Petrides, K. V. (2020). Behavioral and cognitive differences in autism spectrum condition as a function of sex and gender. Autism, 24(2), 347-359.

• Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond. Guilford Press.

Here are 13 simple journaling prompts to help process an adult diagnosis of autism and/or ADHD.

1. What does my diagnosis mean to me?

Reflect on how receiving an autism or ADHD diagnosis as an adult has changed or affirmed the way you see yourself.

2. What past experiences now make more sense with this new understanding?

Think back to moments in your life where your neurodivergence may have influenced your behavior or feelings, and reflect on how those moments look different through the lens of your diagnosis.

3. How have I learned to adapt over the years without knowing my neurodivergence?

Write about the coping mechanisms or skills you developed before receiving your diagnosis, and explore how these have shaped your ability to function.

4. How has the diagnosis impacted my relationships?

Consider how your diagnosis might be changing the way you interact with others, both in terms of how you perceive relationships and how others respond to your diagnosis.

5. What are the strengths of being neurodivergent?

List the strengths you believe your autism or ADHD has given you—creativity, focus on special interests, resilience, etc.—and how they’ve positively influenced your life.

6. What are my biggest challenges, and how can I manage them better?

Reflect on the areas where you face the most difficulty, such as executive function, sensory sensitivity, or emotional regulation, and brainstorm strategies for addressing them.

7. How can I practice self-compassion as I adjust to this diagnosis?

Explore ways to show yourself kindness and patience as you learn more about your neurodivergence and its impact on your life.

8. What habits or routines help me manage my day-to-day life?

Consider what daily routines or structures help you feel more in control, and think about how you can incorporate more of these habits into your life post-diagnosis.

9. How has masking affected my mental and emotional health?

If you’ve engaged in masking—suppressing traits to fit neurotypical norms—reflect on how this has impacted you, and how you might approach authenticity moving forward.

10. What emotions have come up since learning about my diagnosis?

Write freely about the range of emotions—relief, frustration, grief, excitement—that have arisen since your diagnosis.

11. How does my diagnosis change the way I see my future?

Reflect on how receiving your diagnosis may influence your plans or goals for the future, whether in relationships, career, or personal growth.

12. How can I advocate for myself better, knowing I’m neurodivergent?

Explore ways to advocate for your needs in work, social settings, or healthcare environments now that you have a clearer understanding of your neurodivergence.

13. What do I need from my support system as I process this diagnosis?

Consider what you need from friends, family, and professionals to feel supported in your journey post-diagnosis, and how you can communicate those needs effectively.

What is an Adjustment Disorder?

In the interest of centralizing tools and resources, I’ll be featuring posts on some of the most commonly diagnosed mental health concerns. This post is a living document and is based on the DSM-5-TR, published in 2022, the latest guidebook for mental health diagnoses.

First up… Adjustment Disorder…

What is an Adjustment Disorder?

Adjustment disorder is a short-term condition that happens when you have great difficulty managing with, or adjusting to, a particular source of stress, such as a major life change, loss, or event. Because people with adjustment disorders often have some of the symptoms of clinical depression, such as tearfulness, feelings of hopelessness, and loss of interest in work or activities, adjustment disorder is sometimes informally called "situational depression."

An adjustment disorder is an emotional or behavioral reaction to a stressful event or change in a person’s life. The reaction is considered an unhealthy or excessive response to the event or change within three months of it happening.

Stressful events or changes in the life of your child or adolescent may be a family move, the parents’ divorce or separation, the loss of a pet, or the birth of a sibling. A sudden illness or restriction to your child’s life due to chronic illness may also result in an adjustment response.

Subtypes of Adjustment Disorder

There are six subtypes of adjustment disorder that are based on the type of major symptoms experienced. The following are the most common symptoms of each of the subtypes of adjustment disorder. However, each client may experience symptoms differently:

• Adjustment disorder with depressed mood.

  • Depressed mood

  • Tearfulness

  • Feelings of hopelessness

• Adjustment disorder with anxiety.

  • Nervousness

  • Worry

  • Jitteriness

  • Fear of separation from major attachment figures

• Adjustment disorder with anxiety and depressed mood. A combination of symptoms from both of these conditions are present.

• Adjustment disorder with disturbance of conduct.

  • Violation of the rights of others

  • Violation of society’s norms and rules (truancy, destruction of property, reckless driving or fighting)

• Adjustment disorder with mixed disturbance of emotions and conduct. A combination of symptoms from all of the above subtypes is present (depressed mood, anxiety and conduct).

• Adjustment disorder unspecified. Reactions to stressful events that do not fit in one of the above subtypes are present. Reactions may include behaviors like social withdrawal or inhibitions to normally expected activities, like school or work.

Adjustment Disorder vs. Major Depression

Adjustment syndrome/stress response syndrome has some symptoms that overlap with those of major depression. Unlike major depression, an adjustment disorder doesn't involve as many of the physical and emotional symptoms of clinical depression (such as changes in sleep, appetite, and energy) or high levels of severity (such as suicidal thinking or behavior).

Adjustment Disorder vs. Posttraumatic Stress Disorder (PTSD)

An adjustment disorder/stress response syndrome is not the same as posttraumatic stress disorder (PTSD). PTSD is a reaction to a life-threatening event that happens at least 1 month after the event, and its symptoms tend to last longer than in adjustment disorders/stress response syndromes. By comparison, adjustment disorders/stress response syndromes rarely last longer than 6 months.

Symptoms of Adjustment Disorder/Stress Response Syndrome (AD/SRS)

Adjustment disorder/stress response syndrome changes the way you feel and think about the world and your place in it. A person with AD/SRS has emotional and/or behavioral symptoms as a reaction to a stressful event. These symptoms generally begin within 3 months of the event and rarely last for longer than 6 months after the event or situation has ended.

In adjustment disorder/stress response syndrome, the reaction to the stressor is greater than what is typical or expected for the situation or event. The symptoms may cause problems with a person's ability to function; for example, the person may have trouble with sleep, work, or studying. It can have a wide variety of symptoms that are changes from someone's usual self, which may include:

• Feeling of hopelessness

• Sadness

• Frequent crying

• Anxiety (nervousness)

• Worry

• Headaches or stomachaches

• Palpitations (an unpleasant sensation of irregular or forceful beating of the heart)

• Withdrawal or isolation from people and social activities

• A new pattern of absence from work or school

• New and out-of-the-ordinary dangerous or destructive behavior, such as fighting, reckless driving, and vandalism

• Changes in appetite; either loss of appetite or overeating

• Problems sleeping

• Feeling tired or without energy

• Using alcohol or other drugs more

Symptoms in children and teens tend to be more behavioral in nature, such as skipping school, fighting, or acting out. Adults, on the other hand, tend to have more emotional symptoms, such as sadness and anxiety.

Additional Reading:

https://www.mayoclinic.org/diseases-conditions/adjustment-disorders/diagnosis-treatment/drc-20355230

AuDHD: Ways Autism and ADHD Co-Present

Autism and ADHD frequently co-occur, and when they do, they can present a unique combination of overlapping and distinct traits.

Here are some common ways in which autism and ADHD present simultaneously:

1. Difficulties with Attention and Focus

• ADHD: People with ADHD often struggle with sustaining attention, can be easily distracted, or may experience hyperfocus in some areas.

• Autism: In autistic individuals, focus may also fluctuate, particularly when they are not engaged in an area of special interest. Autistic people may also hyperfocus on their specific interests, similar to ADHD, but with a narrower or more intense scope of interest.

• Combined Presentation: Individuals with both conditions may experience severe attention difficulties, shifting between distractions and intense focus, depending on the situation or subject. The overlap can intensify both inattentiveness and hyperfocus, making it challenging to manage attention in everyday tasks.

2. Executive Functioning Deficits

• ADHD: Problems with executive functioning (planning, organizing, time management) are central to ADHD.

• Autism: Executive functioning challenges are also common in autism but might present alongside rigid thinking or difficulty adapting to change.

• Combined Presentation: In individuals with both autism and ADHD, executive functioning issues can be magnified. These individuals may struggle to prioritize tasks, manage time effectively, or switch between activities, which can lead to procrastination or an overwhelming sense of disorganization.

3. Sensory Sensitivities

• Autism: Sensory processing issues are a core feature of autism, with individuals often experiencing heightened or reduced sensitivity to sensory stimuli (e.g., lights, sounds, textures).

• ADHD: Sensory issues are not a diagnostic criterion for ADHD but can still be common, with some individuals being easily overstimulated or distracted by environmental inputs.

• Combined Presentation: Individuals with both conditions may exhibit significant sensory sensitivities, leading to overstimulation in busy or noisy environments. This can exacerbate attention issues and cause distress or difficulty functioning in certain settings.

4. Impulsivity and Hyperactivity

• ADHD: Impulsivity and hyperactivity are hallmarks of ADHD, leading to difficulty sitting still, impulsive decision-making, and restlessness.

• Autism: Autistic individuals may also show hyperactive behaviors, though these might manifest in repetitive movements (stimming) or as a response to sensory overload.

• Combined Presentation: When autism and ADHD co-occur, hyperactivity and impulsivity can be more pronounced. For instance, individuals may engage in both stimming and restless movements typical of ADHD, and impulsive actions might combine with rigid thinking or routine-seeking behavior, leading to frustration when routines are disrupted.

5. Social Communication Challenges

• Autism: Autism often involves difficulties with social interaction, non-verbal communication, and understanding social cues.

• ADHD: While social communication issues are not a diagnostic criterion for ADHD, people with ADHD can experience difficulty following conversations, interrupting others, or missing social cues due to impulsivity or inattentiveness.

• Combined Presentation: When both conditions are present, individuals may struggle significantly in social settings. They might miss social cues due to autism, and at the same time, they may be more impulsive in social interactions because of ADHD, leading to misunderstandings or difficulties maintaining relationships.

6. Emotional Regulation

• ADHD: Emotional dysregulation is common in ADHD, where individuals may experience mood swings, frustration, and difficulty controlling emotions.

• Autism: Autistic individuals may also experience emotional dysregulation, often related to sensory overload, changes in routine, or difficulty understanding their own emotions.

• Combined Presentation: Co-occurring autism and ADHD can heighten difficulties in regulating emotions, leading to frequent outbursts, meltdowns, or an overall sense of being emotionally overwhelmed. This can be particularly challenging in unfamiliar or overstimulating environments.

7. Sleep Difficulties

• ADHD: Sleep issues, such as difficulty falling asleep or staying asleep, are common in ADHD due to hyperactivity or an inability to "turn off" thoughts.

• Autism: Sleep difficulties are also prevalent in autism, potentially due to sensory sensitivities, anxiety, or differences in circadian rhythms.

• Combined Presentation: Individuals with both autism and ADHD may experience significant sleep challenges, struggling with both falling asleep and staying asleep, leading to heightened fatigue and exacerbation of symptoms during the day.

Conclusion:

When autism and ADHD present together, individuals can face unique challenges that require a multifaceted approach to diagnosis and treatment. Both conditions influence behavior and cognitive processes, but they do so in ways that can amplify the other. Understanding the nuanced presentation of both conditions allows for more targeted interventions, whether through behavioral strategies, accommodations, or medication.

Sources:

• Hull, L., Mandy, W., & Petrides, K. V. (2020). Behavioral and cognitive differences in autism spectrum condition as a function of sex and gender. Autism, 24(2), 347-359.

• Cortese, S. (2016). ADHD and autism: Common ground in diagnosis and treatment. The Lancet Psychiatry, 3(5), 408-409.

• Matson, J. L., & Goldin, R. L. (2013). Comorbidity of autism spectrum disorders and ADHD: Implications for assessment and intervention. Research in Developmental Disabilities, 34(9), 2351-2356.

Assertive Communication

Hey there, fellow non-confrontational people-pleasers struggling to have, express, and articulate your needs…

Do you relate to this SNL Sketch from last weekend about people pleasing? (go check it out if you need a laugh)

Are you tired of experiencing overwhelming anxiety every time you have to speak up for yourself?

Do you wish you could assert your boundaries without feeling like you're auditioning for a role in an action movie?

Well, grab your popcorn and buckle up, assertive communication may be something worth learning more about.

In the intricate web of human interactions, communication serves as the cornerstone upon which relationships are built, nurtured, and sustained. Among the various styles of communication, assertive communication stands out as a powerful tool for fostering mutual respect, understanding, and empowerment. Learning about assertive communication is not merely a skill to acquire but a transformative journey towards self-confidence, resilience, and healthier relationships.

"Being assertive does not mean attacking or ignoring others' feelings. It means standing up for your own rights and needs without violating the rights and needs of others." - Albert Ellis

Assertive communication is characterized by the ability to express one's thoughts, feelings, and needs in a clear, direct, and respectful manner.

Unlike passive communication, where individuals may shy away from expressing themselves, or aggressive communication, which often involves domination and disregard for others, assertive communication strikes a delicate balance between self-advocacy and empathy for others.

Key characteristics of assertive communication include:

1. Clear expression: Assertive communicators clearly state their thoughts, feelings, and needs using "I" statements. They express themselves in a straightforward manner without resorting to vague language or hints.

2. Respectful tone: Assertive communication is characterized by a respectful and calm tone of voice. It avoids yelling, sarcasm, or other forms of hostility, while still maintaining firmness and conviction.

3. Active listening: Assertive communicators actively listen to others, showing genuine interest and empathy in their perspectives. They validate others' feelings and opinions, even if they disagree with them.

4. Setting boundaries: Assertive individuals are able to set and maintain healthy boundaries in their interactions with others. They assert their rights and limits while respecting the rights and boundaries of others.

5. Confidence and self-assurance: Assertive communication reflects confidence and self-assurance. It involves standing up for oneself and expressing one's needs and desires with conviction, without feeling guilty or apologetic.

6. Problem-solving orientation: Assertive communicators focus on finding constructive solutions to conflicts or disagreements. They are open to negotiation and compromise while advocating for their own interests.

7. Non-verbal cues: Assertive communication involves appropriate use of body language, such as maintaining eye contact, using open and relaxed gestures, and having an upright posture, which convey confidence and sincerity.

Overall, assertive communication promotes healthy and effective interpersonal relationships by fostering mutual respect, understanding, and cooperation. It helps individuals assert their rights, express their needs, and build confidence in their interactions with others.

Why might someone lack Assertive Communication skills?

There are several reasons why someone might lack assertive communication skills:

1. Upbringing and cultural factors: Individuals may have been raised in environments where assertiveness was not encouraged or valued. Cultural norms and societal expectations can also influence communication styles, with some cultures placing a higher emphasis on deference or avoiding confrontation.

2. Low self-esteem: People with low self-esteem may lack confidence in expressing their thoughts, feelings, and needs assertively. They may fear rejection, criticism, or conflict, leading them to adopt passive or aggressive communication styles instead.

3. Fear of conflict or rejection: Some individuals avoid assertive communication because they fear conflict or rejection. They may prioritize maintaining harmony in relationships over expressing their own needs or preferences, leading them to be passive or accommodating.

4. Lack of communication skills: Assertive communication requires specific skills such as active listening, using "I" statements, and setting boundaries. People who have not learned or practiced these skills may struggle to communicate assertively.

5. Past negative experiences: Traumatic or negative experiences in the past, such as bullying, abuse, or rejection, can undermine a person's confidence and ability to communicate assertively. These experiences may lead to a fear of being vulnerable or speaking up for oneself.

6. Social anxiety: Individuals with social anxiety may experience intense fear or discomfort in social situations, making it difficult for them to assert themselves or express their thoughts and feelings openly.

7. Cultural or gender norms: Cultural or gender norms can influence how assertiveness is perceived and expressed. For example, women may be socialized to be more nurturing and accommodating, while men may be expected to be more dominant and aggressive. These norms can affect individuals' comfort level with assertive communication.

8. Lack of role models: If someone has not been exposed to assertive communication models or mentors, they may not have had the opportunity to learn and practice assertive communication skills.

Addressing these underlying factors through therapy, counseling, or assertiveness training can help individuals develop and improve their assertive communication skills over time. By building self-esteem, learning effective communication techniques, and challenging negative beliefs or fears, individuals can become more confident and assertive in expressing themselves.

Developing assertive communication skills takes practice and self-awareness.

Here are some steps individuals can take to improve their assertiveness:

1. **Understand assertive communication: (note: you’re already doing that if you’re reading this)** Learn about assertive communication and its key principles. Understand that assertiveness involves expressing your thoughts, feelings, and needs clearly, directly, and respectfully, while also considering the rights and feelings of others.

2. **Identify your communication style:** Reflect on your current communication style. Are you more passive, aggressive, or assertive? Recognize situations where you tend to struggle with assertiveness and the thoughts or feelings that arise in those situations. (Check out this quiz to dive in more)

3. **Practice self-awareness:** Pay attention to your thoughts, feelings, and physical sensations when communicating with others. Notice any patterns of behavior or automatic responses that may hinder your ability to be assertive.

4. **Set clear boundaries:** Identify your personal boundaries and be clear about what you are and are not comfortable with. Practice saying "no" when necessary and setting limits on others' behavior when it infringes upon your rights or well-being.

5. **Use "I" statements:** When expressing your thoughts, feelings, or needs, use "I" statements to take ownership of your experiences. For example, instead of saying, "You always interrupt me," say, "I feel frustrated when I'm interrupted."

6. **Practice active listening:** Develop your listening skills by actively listening to others without interrupting or jumping to conclusions. Show empathy and understanding by paraphrasing what the other person is saying and validating their feelings.

7. **Express yourself assertively:** Practice asserting yourself in low-stakes situations first, such as with friends, family, or colleagues. Start by expressing your opinions or preferences calmly and directly, using assertive body language and tone of voice.

8. **Manage emotions:** Learn to manage your emotions effectively, especially in challenging or confrontational situations. Practice relaxation techniques such as deep breathing or mindfulness to stay calm and composed.

9. **Seek feedback:** Ask for feedback from trusted friends, family members, or colleagues on your assertiveness skills. Be open to constructive criticism and use it as an opportunity for growth and improvement.

10. **Seek support:** Consider seeking support from a therapist, counselor, or assertiveness training program if you're struggling to develop assertive communication skills. A professional can provide guidance, feedback, and practical strategies tailored to your individual needs.

Tools, Tricks, Online Communities for Autistic, ADHD, and AuDHD Humans - especially fellow Late-Diagnosed adults

As a therapist focusing on providing assessment and support for adults seeking to learn if they too are part of the ever-expanding group of adults who are discovering Autism, ADHD, and the combo AuDHD experiences are aspects of their lives, I’m creating a library of resources, online communities, and meme libraries to facilitate and foster self discovery, community builidng, and a way to explore where we see ourselves amidst the stories of others online.

This list will evolve, expand, and shift over time as I delve more deeply into what’s available. If you have feedback on anything on this list and it’s value to be here - or not here - please reach out to me directly and I will do my best to get back to you.

For now, enjoy the list :)

Late Diagnosis Resource Library

Memes

• https://www.reddit.com/r/adhdmeme/ 

• https://www.reddit.com/r/ADHDmemes/

• https://www.reddit.com/r/anxietymemes/

• https://www.reddit.com/r/Audhdmemes/

• https://www.reddit.com/r/autismmemes/

Online Communities 

ADHD Specific

• https://www.reddit.com/r/ADHD/

• https://www.reddit.com/r/adhdwomen/ 

• https://www.reddit.com/r/ADHDthriving/

• https://www.reddit.com/r/ADHDWomenAfterDark/

• https://www.reddit.com/r/AdultADHDSupportGroup/

• https://www.reddit.com/r/adhd_anxiety/

• https://www.reddit.com/r/ADHD_Over30/

• https://www.reddit.com/r/ADHDers/

• https://www.reddit.com/r/irlADHD/

• https://www.reddit.com/r/ADHDUK/ 

Autism Specific

• https://www.reddit.com/r/autism/

• https://www.reddit.com/r/AutisticAdults/

• https://www.reddit.com/r/AutismInWomen/

• https://www.reddit.com/r/autismlevel2and3/

• https://www.reddit.com/r/AutismTranslated/

• https://www.reddit.com/r/AutismTranslator/

• https://www.reddit.com/r/AutismWithinWomen/

• https://www.reddit.com/r/Autistic_Women/

• https://www.reddit.com/r/AutisticLadies/

• https://www.reddit.com/r/AutisticPride/ 

• https://www.reddit.com/r/AutisticTherapist/

• https://www.reddit.com/r/AutismAfterDark/

• https://www.reddit.com/r/AskAutism/

• https://www.reddit.com/r/aspergers/

• https://www.reddit.com/r/aspergirls/

• https://www.reddit.com/r/AutismCertified/

• https://www.reddit.com/r/AutismCPTSD/

• https://www.reddit.com/r/GirlGuidetoAutism 

AuDHD Specific

• https://www.reddit.com/r/audhd/

• https://www.reddit.com/r/AuDHDWomen/

• https://www.reddit.com/r/AutismADHD/

• https://www.reddit.com/r/AutisticWithADHD/

Support for Partners & Relationships

• https://www.reddit.com/r/ADHD_partners/

• https://www.reddit.com/r/ADHDPartners/

• https://www.reddit.com/r/AdhdRelationships/

• https://www.reddit.com/r/ADHDparenting/ 

Irreverent / Non Advice Focused Subreddits (may not be suitable for all)

• https://www.reddit.com/r/SpicyAutism/

• https://www.reddit.com/r/TrueEvilAutism/

• https://www.reddit.com/r/evilautism/ 

Other Mental Health Focused Subreddits 

• https://www.reddit.com/r/Alexithymia/ 

• https://www.reddit.com/r/CPTSD/

• https://www.reddit.com/r/Anxiety/

• https://www.reddit.com/r/neurodiversity/

• https://www.reddit.com/r/BPD/ 

• https://www.reddit.com/r/bipolar/

Other Online Communities

Discord

• stay tuned! reach out to me if you have links to add here

Facebook Groups

• stay tuned! reach out to me if you have links to add here

Articles

• stay tuned! reach out to me if you have links to add here

Books

• stay tuned! reach out to me if you have links to add here

Videos

• stay tuned! reach out to me if you have links to add here

Content Creators

• stay tuned! reach out to me if you have links to add here

Tangible Tools

• https://www.reddit.com/r/adhdwomen/s/RRyFMFWqGQ

Online Tools

• Goblin Tools https://youradhdone.com/goblin-tools-review/

Late Diagnosis Integration Resources for Autistic Adults & our Friends, Family, and Community

As a therapist who’s also someone who didn’t know I was autistic until I was in my 30s, I can validate that diagnosis is the BEGINNING of a journey, not the end.

Late diagnosis can come with a whole host of emotions and - if you’re like me- those emotions can be overwhelming due to a number of reasons including Alexithymia, a lifetime of emotional suppression, and a general sense of feeling overwhelmed with a whole new lens on life.

I’ve written a blog on how to access a diagnosis and maintain an active wait list of folks looking for assessment in Oregon, Washington, Tennessee, and Florida.

This post will focus on resources for recently diagnosed adults and friends, family, and others who are connected to folks who’ve recently discovered a diagnosis and are looking for community, support, or to learn more about how to integrate the diagnosis into daily life, what it may mean, and how to support ourselves and others in self-discovery.

Recommended Resource Lists from Other Therapists

• Everything You’d Wanna Know About Adult ADHD and Autism by Dr Christine Henry

• In process - comment things to add

Over time, I plan to offer in-depth reviews of these resources, but for now, I hope this list is helpful for those seeking guidance.

Recommended Books

• Unmasking Autism: Discovering the New Faces of Neurodiversity Hardcover – April 5, 2022

• Autism in Heels: The Untold Story of a Female Life on the Spectrum Hardcover – December 4, 2018

• In process - comment things to add

Recommended Workbooks

• In process - comment things to add

Recommended Online Communities

• Autism Late Diagnosis/Self-Identification Support and Education

• Might Be Autistic

• Tell me you're neurodivergent without telling me you're neurodivergent

• Autistic Connections: is a great group for autistic folks and a lot of people there are late diagnosed- it's led by Matt Lowry, LPP, and he also has a cool podcast on iTunes and Spotify called Autistic Culture where he and his co-host examine autistic traits in different things from history, pop culture, etc.

Recommended Content Creators

• In process - comment things to add

Recommended Podcasts

• The Neurodivergent Woman podcast in Brisbane Australia

• Autistic Culture by Matt Lowry

• The loudest girl in the world podcast

• neurodivergent moments

• oh that's just my autism.

• When Neurodiversity Meets Exsistentialism

• Neurodivergent Magic

• Neurodivergent Narratives with Sandra Coral

• Coordinating Chaos with the ADHD Lady

• The Autistic Woman Society

• The Neurodiversity Podcast with Emily Kircher-Morris

• The Square Peg

Accessing Out of Network Health Insurance Benefits : Reimbursement Options

When utilizing Out of Network benefits you’ll likely need to pay your therapist the entire session fee at the time of service, and depending on your specific plan, your insurance company will mail you a check to reimburse a portion of that cost.

For information about how to Learn about your Out of Network Benefits, check out my blog post on this.

Some therapists have options to submit Out of Network Claims on your behalf and may establish their own policies and practices such as “Balance Billing” where the therapist will submit an out of network claim on the client’s behalf and the client will be responsible for a portion of the billed amount - depending upon the Insurance Company’s practices and policies. Other therapists may offer options to submit SuperBills on behalf of clients and have reimbursement sent directly to the client through various apps or billing services.

Ask your Therapist for a SuperBill

Some therapists have the option to give you something called a Superbill. This is essentially a fancy receipt with all the information your insurance company will need to file a claim. Once you get your Superbill from your therapist you can then use it to submit a claim for reimbursement following the processes outlined in the information you learned when you contacted your insurance company.

Submit the SuperBill to your Insurance Company Directly or Via an App

There are several ways to file a claim for reimbursement. Some insurance companies require you to do it through their website but you may also be able to use an app. There are a few options, the most common being Reimbursify. Reimbursement apps will help you through the process of filing claims, though they may charge a small fee.

Commonly Used Apps to file Out of Network Benefit Claims

I have not utilized these apps - yet - so I am not able to comment on how they work, but want to share these as options for current and prospective clients.

Screenshot from TheSuperBill.com

TheSuperBill - clients can check out of network benefits with TheSuperBill, submit SuperBills, track claims, and receive reimbursement, information about out of network billing, and support from TheSuperBill regarding claims if there are bumps along the road.

Screenshot from Reimbursify.com

Reimbursify - After clients receive a Superbill, they can submit SuperBills via Reimbursify, track claims, and receive reimbursement, information about out of network billing, and support from Reimbursify as needed about how to reach out to the Insurance Company

Thrizer - Thrizer is similar to Reimbursify and TheSuperBill and is an emerging app that works in similar ways.