If you’ve ever found yourself staring at the ceiling long after bedtime, mind racing with thoughts, or tossing and turning from discomfort, you’re not alone. Sleep can be elusive for many neurodivergents (NDs), particularly those with autism, ADHD, or hypermobile spectrum disorders. Despite exhaustion, falling and staying asleep can feel impossible.
The reasons for these struggles vary. A heightened sensory system might make every little sound or flicker of light feel intrusive. A restless mind, common in ADHD, can keep a person awake with an endless stream of thoughts. And for those with hypermobility conditions like Ehlers-Danlos syndrome, physical discomfort can make finding a comfortable sleeping position a nightly challenge.
Why Sleep Matters More Than We Realize
We all know sleep is important, but for NDs, poor sleep can amplify existing challenges. Lack of rest can increase anxiety, make emotional regulation harder, and reduce focus and executive functioning. If you already experience sensory sensitivities, sleep deprivation can heighten them, making the world feel even more overwhelming.
And for those with hypermobility, exhaustion only compounds chronic pain and fatigue, making day-to-day activities feel even more draining. In short, getting enough quality sleep isn’t just about feeling rested—it’s crucial for mental and physical well-being.
Why Standard Sleep Advice Often Falls Short
Many people struggling with sleep are given the same advice: avoid screens before bed, maintain a consistent bedtime, or drink chamomile tea. While these tips may help to some extent, they often don’t address the deeper issues that NDs face.
Instead of relying solely on traditional sleep hygiene practices, it’s important to explore solutions tailored to the specific needs of NDs.
Rather than forcing yourself into a rigid sleep routine that doesn’t align with your brain or body, consider experimenting with approaches that accommodate your unique needs.
Creating a Sensory-Friendly Environment
For those sensitive to stimuli, reducing sensory overload before bed is key. Try using a weighted blanket for deep-pressure comfort, adjusting room temperature to avoid discomfort, or incorporating white noise machines to drown out background distractions. Even small changes—like switching to softer bedding or blackout curtains—can make a big difference.
Easing a Restless Mind
If your brain refuses to slow down at bedtime, structured relaxation techniques might help. Journaling before bed can provide an outlet for racing thoughts, while guided meditation or breathing exercises can shift your focus from mental chatter to physical calm. Reducing stimulating activities, like intense conversations or fast-paced video games, in the hour leading up to bedtime can also help ease the transition to sleep.
Finding the Right Sleep Position
For those with hypermobility, joint pain and discomfort can make it difficult to find a comfortable sleeping position. Experimenting with different mattress types, pillows for joint support, or even compression garments might help reduce nighttime pain and improve sleep quality.
Working with Your Natural Rhythms
NDs often have unique circadian rhythms, which means forcing an early bedtime may not be realistic. Instead of fighting your body’s natural patterns, consider gradually shifting your bedtime in small increments or allowing for flexibility in your sleep schedule when possible.
Seeking Professional Guidance
If sleep struggles persist despite your best efforts, seeking support from professionals familiar with neurodivergence may be beneficial. A sleep specialist, occupational therapist, or doctor knowledgeable about autism, ADHD, and hypermobility can provide more personalized interventions. In some cases, options like melatonin, cognitive-behavioral therapy for insomnia (CBT-I), or physical therapy for pain management may be helpful.
Sleep Isn’t One-Size-Fits-All
Ultimately, there’s no single magic fix for sleep struggles, but understanding your unique challenges is the first step toward finding solutions that work for you. By making small, tailored adjustments—whether through sensory modifications, relaxation techniques, or flexible sleep schedules—you can begin to improve your sleep quality and, in turn, your overall well-being.
Have you found any strategies that help you sleep better? Share your experiences in the comments!
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
Many autistics and ADHDers experience more than just neurodivergence. For some, their bodies seem to betray them—resulting in pain, instability, and exhaustion. One such hidden struggle is hypermobile spectrum disorders (HSD) and Ehlers-Danlos syndrome (EDS), conditions that affect connective tissue and, consequently, almost every system in the body.
For those with hypermobility, something as simple as taking off a shirt can become a painful ordeal. Joints can sublux (partially dislocate) or fully dislocate with minimal effort, leading to intense pain and long recovery periods. Hypermobile individuals may also experience fragile skin, slow wound healing, chronic fatigue, and circulation issues, such as postural orthostatic tachycardia syndrome (POTS).
The Hypermobile Diagnostic Struggle
Despite the serious implications of HSD and EDS, diagnosis is often a long and frustrating journey. Many medical professionals misattribute symptoms to anxiety, fibromyalgia, or simply growing pains, leading to years of confusion and untreated suffering. Since the medical field is still catching up with research on hypermobility, many doctors are unaware of the condition’s full impact, especially in neurodivergents (NDs).
Like autism and ADHD, hypermobility disorders exist on a spectrum. Some people may experience mild joint instability, while others face life-altering pain and frequent dislocations. The lack of general awareness means that many NDs are left undiagnosed, struggling to piece together their symptoms.
The Neurodivergence Connection
Research has begun to uncover an interesting overlap between neurodivergence and hypermobility disorders. Many autistics and ADHDers report hypermobile joints, fragile skin, and chronic pain. Scientists suspect that whatever genetic factors contribute to autism and ADHD may also play a role in connective tissue disorders.
This link adds another layer of difficulty for NDs already navigating a world designed for neurotypicals (NTs). When combined with executive dysfunction, sensory sensitivities, and motor coordination challenges, hypermobility can make daily life feel like an uphill battle.
The Daily Challenges of Hypermobility
People with hypermobility often experience:
Frequent joint dislocations and subluxations – Even basic movements can lead to sudden, sharp pain.
Chronic fatigue – The body has to work extra hard to stabilize weak joints, leading to exhaustion.
Slow wound healing and fragile skin – A simple scrape can take weeks to heal.
Digestive issues – Many individuals with HSD/EDS develop irritable bowel syndrome (IBS) and food sensitivities.
Dysautonomia and POTS – Blood pooling in the legs causes dizziness and fainting when standing.
Strategies for Managing Hypermobile Autism & ADHD
Although hypermobility presents unique challenges, there are ways to manage symptoms and improve quality of life:
Physical Therapy – Strengthening muscles around weak joints can reduce dislocations and long-term damage.
Joint Supports & Braces – Using compression sleeves, braces, and KT tape can help stabilize joints.
Low-Impact Exercise – Activities like swimming, Pilates, or yoga (with modifications) help maintain strength without excessive strain.
Dietary Adjustments – Following a low-histamine or low-FODMAP diet may help manage digestive issues related to HSD.
Hydration & Salt Intake – Increasing both can help manage POTS symptoms.
Medication & Supplements – Antihistamines, pain management medications, and specific supplements can help alleviate symptoms.
Pacing & Spoon Theory – Learning to conserve energy throughout the day can prevent excessive fatigue and flare-ups.
The Importance of Recognition and Advocacy
For NDs with hypermobility, receiving a proper diagnosis can be life-changing. It provides validation and opens the door to appropriate accommodations and treatments. Advocating for oneself in the medical system is essential, but it can also be exhausting. Seeking out knowledgeable specialists, such as a rheumatologist or geneticist, can make all the difference.
There’s still much to learn about the relationship between autism, ADHD, and hypermobility, but awareness is growing. If you suspect you might have HSD or EDS, researching resources like The Ehlers-Danlos Society and connecting with online communities can be incredibly helpful.
Final Thoughts
Living with hypermobile autism and ADHD comes with unique struggles, but knowledge and the right strategies can make a significant impact. If your body feels like it’s working against you, know that there are ways to improve your daily life. Seeking support and making small but meaningful adjustments can lead to greater stability, less pain, and a better overall quality of life.
Do you struggle with connective tissue-like symptoms? Sound off in the comments!
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
Have you ever wondered why dystopian fiction resonates so deeply? Why so many neurodivergent (ND) folks find themselves drawn to these stories of oppression, survival, and rebellion? Perhaps it’s because, for many of us, dystopia isn’t fiction—it’s a daily reality.
As an autistic and ADHD therapist, I’ve seen firsthand how ableism structures our world in a way that excludes, punishes, and marginalizes NDs. The struggle to exist in a system designed for neurotypicals (NTs) often forces us to mask, suppress, and overcompensate, leading to exhaustion, anxiety, and internalized shame.
But before diving into these parallels, let me share a short fictional excerpt that reflects the lived experiences of many NDs.
A Dystopian Reflection
Imagine a future where a pandemic has erased humanity’s capacity for empathy. Society becomes a place where deception and manipulation are survival skills, and those who remain kind are outcasts. One individual struggles to navigate a world that sees their honesty as foolishness and their empathy as weakness.
At home, their parents criticize them for failing to conform. At school, they’re ostracized. Attempts to challenge injustice result in punishment. Seeking refuge in books and video games, they create their own worlds to escape the cruelty of the one they live in.
Sound familiar?
For many autistics and ADHDers, this isn’t just a story—it’s life. We grow up painfully aware that we are different but unable to explain why. Our deep empathy, sense of justice, and unique way of experiencing the world often make us targets rather than allies. And when we speak up, we’re told we’re too rigid, too emotional, or too much.
Ableism as the Silent Oppressor
Ableism—the belief that NT functioning is superior—permeates every aspect of society. Schools, workplaces, and social spaces are structured to accommodate NT needs while dismissing those of NDs.
Most office spaces are sensory nightmares. Open-plan environments are overwhelming, social interactions are forced, and expectations around communication favor NT norms. Employers often expect ND employees to “just deal with it” rather than making reasonable accommodations.
Schools demand that ADHDer children sit still, remain silent, and suppress their natural learning styles. Autistic students are punished for stimming or struggling with social interactions. Instead of adapting the environment to meet diverse needs, institutions enforce compliance, leading many ND students to associate learning with trauma.
Because NDs behaviors are often viewed as problematic, many of us learn to mask. We camouflage our traits to fit in, suppressing stims, forcing eye contact, and mimicking NT speech patterns. But masking comes at a high cost—leading to burnout, identity erosion, and mental health struggles.
The Double Standard of Accommodation
Consider this: When an ND requests an accommodation—like adjusting the room temperature or asking for a seat change—it’s considered reasonable. But when an ND asks for a quiet workspace, flexible deadlines, or sensory-friendly environments, it’s often met with resistance.
Even something as simple as requesting a classroom change due to a noisy air conditioning unit can feel like an undue burden. This reluctance to provide accommodations reinforces the idea that our needs are “too much.”
Breaking the Silence: The Power of Self-Advocacy Amid Ableism
Many NDs internalize shame, believing they are burdensome for needing accommodations. But advocating for ourselves isn’t just about personal survival—it benefits everyone.
When we challenge ableist structures, we create ripple effects that help others. Speaking up about sensory issues in a classroom, for example, can lead to changes that improve the learning environment for all students, ND or not.
Here’s how we can start dismantling this dystopia:
Reject the shame: Recognize that needing accommodations is not a failure, but a right.
Speak up: Whether at school, work, or in medical settings, advocate for what you need.
Find community: Connect with others who understand your struggles. Shared experiences build resilience.
Educate others: The more people understand neurodivergence, the harder it becomes to justify exclusion.
Final Thoughts
In dystopian stories, oppression is often met with rebellion. The rise of the neurodiversity movement is our rebellion—an effort to dismantle ableism and demand a society that values ND people for who we are, rather than who we’re forced to pretend to be.
Little by little, we are chipping away at this dystopia, advocating for change, and refusing to be silent. And one day, when these rigid structures crumble, we will build in their place a world where all minds are valued equally.
What has been your experience navigating an ableist world? Share in the comments!
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
Accessing ADHD medication isn’t just about filling a prescription—it’s a constant battle. Unlike many other mental health challenges where medications are more readily available, ADHD medication is burdened with extra hoops to jump through. These barriers disproportionately affect those who rely on stimulant medications, leaving many without the treatment they need to function.
The process is exhausting: prior authorizations, frequent refill requirements, and the stigma surrounding stimulant medications all contribute to the problem. Add to that the ongoing stimulant shortage, and what should be a simple, routine healthcare matter becomes a frustrating and even disabling ordeal.
ADHD Medication Shortages: A Crisis with No End in Sight
For several years now, the U.S. has been experiencing a shortage of medication like Adderall and Ritalin. The reasons are complex, involving manufacturing limits, increased demand, and regulatory constraints. But the outcome is simple: ADHDers are left scrambling to find their prescribed medication, often having to switch to alternatives that may not work as well or even going without entirely.
Imagine needing medication daily to function, only to be told month after month that your pharmacy is out. For many, this can lead to worsened executive dysfunction and a severe drop in quality of life.
Insurance and Prescription Barriers
Even when ADHD medication is available, insurance restrictions can create additional roadblocks. Many ADHDers must navigate:
Prior authorizations, where doctors have to prove the necessity of ADHD medication before insurance covers it.
Quantity limits, requiring multiple pharmacy visits for a single prescription.
Frequent reassessments, even for adults who have had a stable diagnosis for years.
These barriers assume that ADHD medication is inherently more dangerous or prone to abuse than other mental health treatments, reinforcing stigma and making care unnecessarily difficult.
The Call for ADHD Medication Parity
Other mental health conditions do not face these same restrictions. If someone with anxiety, depression, or bipolar disorder can access their medication without excessive red tape, why should ADHDers be treated differently?
Parity means equal treatment. It means that ADHD medication should be covered and dispensed as easily as any other psychiatric medication. It means that stimulant shortages should be taken seriously as a public health issue, not dismissed as a minor inconvenience.
What Can We Do?
The fight for ADHD medication parity starts with awareness and advocacy. Here’s how we can push for change:
Call on policymakers to enforce parity laws and remove unnecessary restrictions on ADHD medication.
Raise awareness about the impact of ADHD medication shortages and advocate for improved pharmaceutical regulations.
If you’ve struggled to access ADHD medication, you’re not alone. It’s time for healthcare systems to recognize ADHD as a legitimate medical challenge deserving of equal treatment. Let’s demand ADHD medication parity—because no one should have to fight this hard for basic care.
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
What if survival meant becoming someone else—every thought filtered, every gesture rehearsed, every word chosen to match what others expect of you?
That’s the world Shayan lives in. He’s the protagonist of Nepo, my new YA sci-fi novel. But for many of us—especially those of us who are autistic or ADHD—it’s not fiction. It’s our lived experience.
Nepo is the book I needed as a teen. It’s also the book I needed as an undiagnosed neurodivergent (ND) adult—someone trying desperately to understand why the world felt like it wasn’t made for me.
The Mask We Wear to Survive
Like many NDs, I learned early that being “different” meant being misunderstood. I walked funny. I spoke differently. I was obsessed with bugs, then words, then fiction. Social cues felt like an invisible game with constantly changing rules—and I was always one move behind.
I learned to mask. Masking meant smiling when I was in sensory overload. It meant pretending not to care when I was excluded. It meant hiding the parts of me that didn’t “fit.”
So when I sat down to write Nepo, I wasn’t just creating a sci-fi story—I was creating a mirror. One where a character like Shayan, forced to perform for his survival, could give voice to something deeply personal: the unbearable weight of never being allowed to just be.
From Hollywood Glamor to Dystopian Control
I spent seven years in Los Angeles, working in film and media. I saw the curated personas, the constant pressure to stay “on brand.” Celebrities weren’t just people—they were products.
That’s what inspired Nepo‘s world. Shayan isn’t just any clone—he’s bred to replicate a long-dead Hollywood icon. His every move is scripted. One misstep, and he’s discarded.
Fame in Nepo is a cage. And for NDs, the pressure to perform—to meet neurotypical (NT) standards—is often a cage, too. One lined not with gold, but with shame, anxiety, and burnout.
A Future That Feels Familiar: Enter Neuropunk
I call Nepo “neuropunk.” It’s a subgenre I’m helping shape—one that centers ND experiences in speculative fiction. Think cyberpunk, but instead of focusing on tech, neuropunk focuses on how ND minds resist systems built to control or erase them.
In Nepo, society is split between the privileged “enclavers” and the oppressed “endis”—a mostly neurodivergent underclass whose labor sustains the city but whose identities are erased.
It’s dystopian, yes. But let’s be honest—it’s not far from reality.
Shayan’s Realization: The Egg Cracks
Shayan doesn’t know he’s “endi.” He just knows he feels…wrong. Like something doesn’t add up. That feeling of disconnection? Of not knowing why you’re always the odd one out? That’s familiar to many ND readers.
Eventually, Shayan discovers the truth—he’s not broken. He’s just different. ND.
It’s the “egg crack” moment. The moment so many of us experience when we finally get the language to describe our brain. When the mask starts to slip and we realize—maybe we never needed it in the first place.
That realization is liberating. But it’s also complicated. Because unmasking doesn’t erase years of shame. It doesn’t instantly rebuild your identity. And it doesn’t stop the world from demanding conformity.
Masking Hurts—But So Does Being Real
One of the questions Nepo asks is: What happens when the mask becomes who you are?
That’s what makes masking so insidious. Over time, it erodes our self-concept. We lose track of where the performance ends and where we begin. We internalize the idea that our real selves are unacceptable. That survival means self-erasure.
I’ve seen this pain in my clients. I’ve lived it myself.
And I wanted Nepo to hold space for that grief. To say: You’re not alone. You’re not broken. You’re reacting to a world that hasn’t made space for you.
Storytelling as Resistance
Speculative fiction gives us the distance we need to tell the truth.
Nepo isn’t just about one clone’s rebellion. It’s about systemic oppression, identity, and the radical act of self-acceptance. It’s about choosing authenticity in a world that punishes it.
And at the heart of the story is a plea: Let us be real. Let us be whole. Let us be seen.
Representation That Goes Beyond Stereotypes
I didn’t see myself in books growing up. Autistic characters, if they existed, were usually emotionless geniuses or comic relief. Rarely were they nuanced, messy, real.
I wrote Nepo for the readers like me. For the weird kids. The hyper-focused teens. The stimmers. The ones who got in trouble for being “too much.” The ones who’ve spent years trying to figure out why they feel alien on their own planet.
Shayan isn’t a trope. He’s a full person—conflicted, hopeful, and worthy of belonging. Because all of us are.
A Free Gift (And a Small Request)
If this story resonates with you, I’m offering Nepo as a free digital download for a limited time. All I ask is that you leave a review—let me know what spoke to you, what challenged you, what stayed with you.
I wrote Nepo because I believe stories can heal. And I hope it helps you feel just a little more seen, understood, and unmasked.
Have you ever felt like your life was a performance? Have you had your own “egg crack” moment?
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
When I decided to pursue an autism diagnosis, I was hoping for clarity, self-understanding, and maybe even a bit of support. What I wasn’t expecting was to have my neurodivergence compared to a fatal, degenerative disease.
The psychologist I spoke with didn’t offer validation or encouragement. Instead, he presented a hypothetical scenario involving Huntington’s disease, a terminal neurological condition. “Would you even want to know?” he asked, as if discovering I was autistic would be akin to receiving a death sentence.
My stomach sank. I wasn’t calling for a philosophical debate—I was trying to book an appointment for my autism diagnosis.
The Harm of Medical Ableism
Experiences like mine are, unfortunately, not uncommon. Many autistics face skepticism, dismissal, and outright ableism from medical professionals when seeking an autism diagnosis, especially later in life. This can take the form of:
Gatekeeping autism diagnoses by making the process unnecessarily difficult or discouraging individuals from seeking answers.
Invalidating autistic experiences by questioning the legitimacy of self-identification or framing autism as an inherently negative condition.
Perpetuating harmful stereotypes that paint autism as a tragedy rather than a natural variation of neurodivergence.
The psychologist’s comparison to Huntington’s disease wasn’t just offensive—it was wildly inaccurate. Autism is not a degenerative illness. It is not a death sentence. It is a different way of experiencing and interacting with the world. Yet, the way some medical professionals handle autism diagnoses can make it feel like a burden rather than an empowering revelation.
Why an Autism Diagnosis Matters
For many, receiving an autism diagnosis is not about seeking a label—it’s about gaining access to understanding, accommodations, and community. Knowing I was autistic allowed me to:
Identify my sensory sensitivities and social communication differences as valid, rather than as personal failings.
Advocate for my own needs in work and social settings.
Connect with other autistics who shared similar experiences.
Not knowing, on the other hand, often leads to years of struggling with unidentified challenges, self-doubt, and unnecessary hardship. An autism diagnosis can be a transformative moment, allowing individuals to understand their experiences in a new light.
The Importance of Perseverance
After my frustrating encounter, I didn’t give up. I kept calling around until I found a professional who was willing to listen. Eventually, I got my autism diagnosis—and it was life-changing. It validated what I had known deep down but had struggled to articulate.
If you are seeking an autism diagnosis and face similar roadblocks, don’t let one dismissive professional deter you. Your experiences are real, and your struggles deserve recognition. Keep pushing forward. The right support exists—you just have to find it.
The Need for Change
That said, medical professionals must do better. They need to:
Approach autism diagnoses with compassion and respect.
Recognize that autistics are the best experts on their own experiences.
Dispel outdated, harmful misconceptions about autism.
Autistics shouldn’t have to fight for their autism diagnoses, nor should they be made to feel like their existence is a tragedy. Neurodivergence is a part of human diversity, and it’s time the medical field treated it as such.
Final Thoughts
An autism diagnosis is not a label—it is a tool for empowerment. It helps autistic people navigate the world with greater understanding and access to the support they need. By fostering a more inclusive and neuroaffirming approach, medical professionals can ensure that autistics are met with dignity, respect, and the care they deserve.
If you have been met with resistance or ignorance in your pursuit of an autism diagnosis, know that your experience is valid. Your struggles are real, and you are not alone. Keep advocating for yourself, seek out supportive professionals, and remember—your neurodivergence is not a flaw. It is a part of who you are, and you deserve to be seen and heard.
Have you faced challenges in getting an autism diagnosis? Share your story in the comments.
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
For many autistics and ADHDers, stepping outside isn’t a simple task—it’s an exercise in endurance. From unpredictable noises to overwhelming crowds, the world outside can be exhausting and even painful. Here’s why sensory overwhelm makes going out so difficult, and how it impacts daily life.
The Unseen Battle of Going Outside
For neurotypicals, stepping outside might seem effortless. For me, it’s a calculated risk. The moment I leave my house, I brace myself for a wave of sensory overwhelm—the bright, flickering lights, honking cars, and the endless chatter of people.
It’s not just annoying. It’s exhausting.
Every sound, smell, and visual detail seems to crash into my brain at once, with no filter. My ADHD means I struggle to tune out irrelevant stimuli, and my autism makes everything feel too much, too fast, too loud. The result? I burn out before I even reach my destination.
The Chaos of Public Spaces
Public spaces are an unpredictable sensory minefield. One moment, I’m fine. The next, a sudden noise—an ambulance siren, a child screaming, or harsh sunlight—sends my nervous system into overdrive.
Shops, train stations, and crowded streets all come with their own brand of overstimulation. The sheer number of people moving unpredictably about can be stressinducing.
I’m constantly on edge, trying to manage the discomfort while also masking—pretending I’m “fine” so I don’t stand out. But masking takes energy, and before long, I’m mentally and physically drained.
The Exhaustion of Social Expectations
Going outside also means navigating unspoken social rules. Eye contact, small talk, dodging people on sidewalks—it’s all an exhausting mental game. Unlike neurotypicals, who instinctively follow these social norms, I have to consciously process every interaction.
If I miscalculate—speak too bluntly, react too slowly, or misread a situation—I risk being judged. The stress of trying to “act normal” adds another layer of exhaustion on top of the sensory overwhelm.
Why Staying Inside Feels Safer
At home, I control my environment. I can keep the lighting soft, the noise minimal, and avoid unpredictable social interactions. There’s no pressure to mask, no overwhelming sensory input, and no need to constantly adjust to a world that wasn’t built for me.
But the downside? Isolation. Avoiding the outside world means missing out on experiences, friendships, and opportunities. It’s a constant tug-of-war between self-preservation and the desire to engage with life.
Finding Ways to Cope
While I can’t change the world, I can adapt. Here are a few ways I manage:
Noise-canceling headphones – Blocking out overwhelming sounds helps me focus and stay calm.
Sunglasses or tinted lenses – Bright lights are a major trigger, so I reduce the strain however I can.
Planned outings – Knowing exactly where I’m going, when, and for how long helps me prepare mentally.
Going outside as an autistic/ADHDer isn’t a simple task—it’s a sensory endurance test. From chaotic public spaces to social expectations, every outing requires energy that I don’t always have.
If you relate to this struggle, know you’re not alone. It’s okay to set boundaries, to take breaks, and to advocate for environments that support neurodivergent needs. When feeling dysregulated, consider trying some of these self-care techniques.
Do you experience sensory overwhelm when going outside? How do you cope? Let’s talk in the comments!
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
Autistic/ADHD individuals learn early on that if they want to survive in a society shaped by systemic ableism, they have to mask their true selves.
But over time, masking damages our self-worth. And it may fuel internalized ableism. So why then do we persist in doing it?
While accommodations are sometimes made for people with disabilities/who are neurodivergent (ND), they are by far the exception to the rule.
In the case of autism and ADHD, accommodations can be even less likely, due to what clinicians call “disguised presentation”. That is, neurodivergence isn’t always that obvious, in some cases because the autistic/ADHDer is working very hard to keep their struggles hidden.
Neurotypicals (NTs) as a result may expect NDs to meet the same standards as people just like them, setting the bar for acceptance impossibly high.
When NTs expect ND folk to think and behave as they do, the moment the ND individual drops their mask—for example, by being overly direct or failing to read social cues—the NT will attribute that lapse to another cause, such as them being “selfish” or “rude”.
They may even respond by criticizing, judging, punishing, and excluding the ND.
Systemic ableism & microaggressions
The issue here is not merely that NTs are intolerant of neurodiversity and the differences it presents. It’s that NTs, in general, operate from baseline expectations that are ableist.
Most are oblivious to the extent to which this ableism informs their thinking, resulting in microaggressions: the “commonplace daily verbal, behavioral or environmental slights, whether intentional or unintentional, that communicate hostile, derogatory, or negative attitudes toward stigmatized or culturally marginalized groups” (see Microaggressions in Everyday Life).
Microaggressions can happen even within the families of ND folk. For instance, I remember my own parents calling me “antisocial” for my tendency to choose the company of books and computers over that of other human beings.
They also play out at school, with kids slapping all kinds of hurtful labels upon their ND peers.
I recall even teachers telling me that I lacked “common sense”, and that my handwriting was “poor” and “sloppy”. Turns out, all of these traits were part and parcel of my being ND.
But even having a diagnosis doesn’t necessarily guarantee understanding and compassion.
Shortly after I was told I was autistic, I had a friend suddenly touch me from behind. When I reacted with shock and explained my reasons, this friend responded by cussing out my “Asperger syndrome”. (Note: This was my diagnosis at the time. It is now considered to be an outdated term and no longer exists in the Diagnostic and Statistical Manual of Mental Disorders).
Rather than apologizing for having startled me, this friend did what so many NTs did and called out my autism as being the problem.
Miscommunications & Theory of Mind
These misunderstandings are compounded by issues related to a skill called “Theory of Mind”.
Theory of Mind (ToM) has been defined as: “the ability to recognize and understand thoughts, beliefs, desires and intentions of other people in order to make sense of their behaviour and predict what they are going to do next”.
Researchers have claimed many ND folks have impaired ToM. What I’ve noticed however is that our unusual thinking style and behavior can also general a kind of temporary ToM impairment among NTs.
That is, NTs tend to ascribe NT motives to everyone, but doing this to ND folk can lead to confusion and misunderstanding. Turns on, there’s a name for this: the double empathy problem.
To give an example: when I got into trouble as a child, I would usually be upfront about the truth, believing that my confession would be taken at face value.
But protesting my innocence or admitting to my naivety would rarely win me favors. In one case, an adult suggested I was “stupid” for expecting them to believe my story.
What happened here was that this individual couldn’t fathom my intentions, and thus concluded my being honest had to be an act of deception.
Another example of this misattribution occurred during a visit to my parents. My mother told me she was going to fetch a can of tomatoes to make pasta sauce. With her fingers, she indicated that the can would be about the size of a bucket.
Knowing my mother had a tendency to bulk-buy, I assumed she indeed meant the can would be the size she suggested. Because of my impaired ToM, I interpreted her gesture literally.
When I expressed my confusion over why she wanted to use such a big can, it didn’t occur to my parents that I was genuinely confused. Instead, they accused me of being a smart aleck.
We mask because authenticity is risky
As I’ve mentioned, this tendency of NTs to not adjust expectations when dealing with an ND individual can sometimes be the result of the disguised presentation.
Specifically, when NDs present themselves as NT. In some cases, this camouflaging is deliberate, with the ND trying to mask their struggles for fear of being judged, attacked, or marginalized.
Like NTs, autistics want above all to be accepted for their authentic selves. But when ND authenticity collides with ableist expectations, as in the situations I’ve described, disaster can result.
Due to the double empathy problem, it can be hard to understand NTs and anticipate how they might react to our actions. So we become master imitators and concealers.
We mask, knowing that by hiding our neurodiversity, we are shielding ourselves against a perplexing and often hostile world.
Sometimes these compensations can be positive and adaptive, such as wearing headphones whenever out in public to compensate for sound sensitivities.
Other times, they are maladaptive. For example: avoiding talking about one’s interests, for fear of misreading social cues and rambling on.
But masking is self-defeating
NDs will often tell themselves that they need to change in order to fit NT expectations. But this really is an expression of internalized ableism.
Furthermore, ignoring your needs and hiding your differences as an ND is almost always self-defeating.
Years ago I had a friend who would invite me to the movies. Personally, I find sitting in a movie theater to be sensory torture, with people constantly rustling bags and crunching on popcorn.
Rather than explaining this to my friend, I went along with her invitations, usually at great discomfort to myself.
Feeling shame over my sensory problems, I refused to tell her about the issue. Eventually, I started making excuses for not being able to join my friend, who came to believe I was intentionally avoiding her.
Difficulties with executive function are common among ND folk. Personally, in the past, as a result of my ADHD, I have struggled with self-organizing, managing my time, and staying on track.
One time, a manager unloaded on me over this, accusing me of being self-absorbed and irresponsible.
Rather than reacting defensively, I admitted my mistakes and asked this manager how I could improve certain executive function skills. She replied by telling me that my request was “beyond the scope of her role”.
It was one thing to turn professional feedback into a personal attack, but to then deny me support was quite another.
This is, unfortunately, a common experience for NDs. Often we’re told that we have done wrong, without being told how to course correct.
Systemic ableism creates internalized ableism
Until I was diagnosed as autistic and ADHD, I didn’t have a framework by which to explain or defend my difference. Having long been challenged and attacked over my ND traits, defenses have usually felt necessary.
Of course, even without having fully understood the whys and hows of my challenges, I could have still spoken up and tried to negotiate accommodations.
What stopped me, however, was the belief that I was somehow choosing to be difficult. Having internalized ableism, I had come to feel inferior and ashamed of my differences.
My self-esteem consequently became conditional upon the approval of others. This led to me adopting a workaholic lifestyle in a bid to prove my worth to myself, and to others.
Personal boundaries blurred, to the point that I feared I was always somehow responsible when something went wrong.
Such was my shame that even after my diagnosis, I shied from the company of other NDs.
I convinced myself that the people who frequented autism and ADHD support groups weren’t like me, that I was somehow more “high functioning”—a term I’ve since realized is ableist.
What I feared—but dared not acknowledge—was that to be in their company might make me “one of them”.
Ableism creates so much stigma around disability/neurodivergence, that despite everything I knew, I still believed my autism and ADHD to be a kind of flaw or personal shortcoming.
Wrap up
Systemic ableism oppresses NDs by demanding we abandon our identities and silence our needs.
We can start countering it by leaning into authenticity, the practice Brené Brown defines as “letting go of who we think we’re supposed to be and embracing who we are”.
One immediate way we can embrace our authentic ND selves is by seeking out fellow NDs around whom masking isn’t necessary.
The ND community exists to normalize individual experiences and to combat the stigma that can make being disabled/neurodivergent such an isolating experience.
ND readers, how does ableism show up in your life? Do you recognize any of the forms of internalized ableism I’ve described here? Drop a comment below.
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
Many of the messages we get as neurodivergents (NDs) living in an ableist society remind us that we’re different. And this difference, more often than not, is treated as a negative—at the cost of our self-esteem.
When confronted with the unique traits and behavior of NDs, many neurotypicals (NTs) typically respond with discomfort, annoyance, hostility, and even vilification.
Sometimes they do it out of ignorance—a knee-jerk reaction to something they don’t understand. They may also simply view autism and ADHD as a “deficit” or “fault” that needs to be corrected.
Acknowledging areas for growth
There is a tendency within the ND community to react defensively to the “neurodiversity-as-deficit” paradigm by casting being ND exclusively as a strength.
Given many of us feel that being ND is an intrinsic part of our identity, it makes sense that we should feel compelled to defend it.
Personally speaking, I would much sooner rather celebrate my strengths than look at myself through the lens of inferiority.
At the same time, I recognize that being ND can come with some downsides. For example, I find my various sensory sensitivities to be a nuisance. And I wish I could form and sustain relationships with the ease enjoyed by many NTs.
Should I treat these downsides as a reflection of my worth? Definitely not. That said, I do think there is value in recognizing our personal areas for growth. For me, this is developing stronger social skills.
Self-esteem starts withacknowledging strengths
Areas of growth aside, I think there is merit in focusing on strengths. Being autistic, for example, can convey quite a few. For example:
We enjoy peer relationships characterized by absolute loyalty and impeccable dependability
We are free of sexist, “age-ist”, or culturalist biases; able to regard others at “face value”
We are willing to share our mind, irrespective of social context or adherence to personal beliefs
We have an ability to pursue personal theory or perspective despite conflicting evidence
We seek an audience or friends capable of enthusiasm for unique interests and topics
We take consideration of details and spend time discussing a topic that may not be of primary interest
We listen without continual judgment or assumption
We are interested primarily in significant contributions to conversation, preferring to avoid “ritualistic small talk”, or socially trivial statements and superficial conversation.
We seek sincere, positive, genuine friends with an unassuming sense of humor
And as employees, we are also known to be: reliable, persistent, perfectionists, easily able to identify errors, technically able, and to have a sense of social justice and integrity.1
We are also willing to question protocols, can be highly accurate, attentive to detail, logical, conscientious, knowledgeable, original in problem-solving, honest, and likely to thrive on routine and clear expectations.
In a majority of situations, these qualities are quite beneficial. They also contradict the ND-as-deficit paradigm.
Are you ‘strengths blind’?
Strengths vary from individual to individual, and may manifest physically, mentally, emotionally, socially, or spiritually.2
We may not be aware of those strengths and how they may have helped us to cope with the challenges of day-to-day life. But they’re still there, regardless.
Firstly, there’s a lack of awareness of said strengths, resulting from not practicing self-awareness or feeling disconnected from our identity.
Secondly, we may not see our strengths as meaningful. Thirdly, we may downplay them as ordinary, rather than extraordinary.
And fourthly, we may overuse our strengths to the point that they create problems. One commonly overused autistic strength for instance is passion.
To elaborate: autistics can have something of a reputation for wanting to share knowledge about their areas of interest, even with the most casual of acquaintances.
If we’re not careful, we may end up talking at length and scarcely allow the other person to get a word in edge wise.
In fact, we can become so caught up in the act of sharing that we fail to take notice of the subtle—and not-so-subtle clues—that the other person is getting annoyed, or feeling frustrated and overwhelmed.
Yet in moderation, this character strength can be hugely advantageous. Passion for instance can enable us to become leading specialists in our chosen fields.
Putting our strengths into practice
So, how do we overcome strength blindness? By increasing awareness of our strengths. We can start doing this by reaching out to our closest friends and family members and asking them what they like most about us.
Some common strengths or qualities are creativity, curiosity, judgment, love of learning, perspective, bravery, perseverance, honesty, zeal, love, kindness, social intelligence, teamwork, and fairness.
Other qualities are leadership, forgiveness, humility, prudence, self-regulation, appreciation of beauty, and excellence, gratitude, hope, humor, and spirituality.
The great thing about character strengths is that most are not in any way shaped by our being ND.3 (Small caveat: many autistics may struggle with social intelligence and teamwork, and yet we also love to learn and are very curious.)
Once you’ve identified our strengths, select your topmost three. Now ask yourself, what activities do you do in service of those strengths?
Chances are when you do those activities, you’ll feel great about yourself. Why? Because they are impactful, and because they provide satisfaction.
Strengths-based habits improve self-esteem
If you’re struggling with self-esteem issues, make a conscious plan to do at least one of the three activities when you feel down or like you’re struggling. Not only will this affirm your strengths, but it will also improve your self-esteem.
If love is one of your strengths, perform a kind act for someone, such as buying a friend a gift. If appreciation of beauty is a strength, visit an art gallery or public garden.
If creativity is a strength, pick up a pen or paintbrush and start creating.
Of course, doing the occasional activity can only take you so far. If we really want to grow our self-esteem, we should make these activities into habits.
Set aside a regular time in which to do each of the activities you identified. Incorporate them into your daily or weekly schedule, until they become habitual.
Wrap up
Why is making activities into habits important? Because habits create a powerful snowball effect.
The more we exercise our strengths, the more they feel like a part of our character. The more we orient our character around our strengths, the more capable we feel.
The more capable we feel, the greater our sense of self-worth. The greater our sense of self-worth, the more likely we are to embrace our strengths. And so the cycle goes.
What are some of your strengths, and how do you express them?
And what’s one new habit you could commit to over the coming week to develop awareness of your strengths? Share your responses in the comments.
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
Living within an ableist society, neurodivergent (ND) folks often experienced marginalization. But to experience it within the ND community is not something most of us would expect.
Consider young autistics and ADHDers who go in search of community online, only to have a total stranger blast them for using terminology some have deemed inappropriate.
Any sense of belonging and acceptance this person might have found is suddenly withdrawn the moment they express themselves.
This was my experience, and one I believe is shared by many. The policing of ND identities is a very real phenomenon, and one I think requires further discussion.
The people responsible for this behavior—I’m going to call them “gatekeepers”—have a tendency to treat our community as monolithic.
According to these gatekeepers, only their worldview is endorsed, while all others are incorrect and subject to harsh criticism.
Knowing that one could be punished by such folk for speaking “out of turn” creates a chilling effect in online discussions. And so it’s the voices of the gatekeepers that usually end up being the loudest—to the exclusion of all others.
Some disclaimers
I want to make it clear that many advocates within the ND community do important work. And I’d like to believe that most of them are motivated by genuine compassion. Yet the gatekeeping approach to advocacy raises a number of concerns.
Full disclosure: I am speaking today as someone who is autistic and has ADHD. Any opinions I share here are entirely my own.
I acknowledge that my ability to speak out in the first place is a privilege. Not everyone in our community enjoys this privilege.
I also want to acknowledge that NDs have been marginalized and oppressed throughout history.
Widespread ableism means that the status quo largely exists to serve the interests of neurotypicals (NTs). This is why challenging the status quo and fighting for ND empowerment are so crucial.
Gatekeeping in the ND community feeds toxic shame
That said, I believe some gatekeepers challenge for the sake of challenging in and of itself. What doesn’t help is when they behave in a way that can be dogmatic, if not militant.
These gatekeepers appoint themselves the authority, defining what is “good” and “bad”, “right” and “wrong” for everyone else.
Typically, they take a very strong stand on hot-button topics, like the use of person-first language, the term “Asperger”, or the naming of autism and ADHD as pathological disorders.
Yes, these are important topics worthy of discussion, but discussion can’t happen so long as one party feels they have a monopoly on the truth, as gatekeepers so often do.
Believing in their own righteousness, many gatekeepers will label those who disagree with them as ignorant, ableist, and oppressive.
Demonizing people in this fashion feeds shame. In the words of Brené Brown:
“Shame is the fear of disconnection—it’s the fear that something we’ve done or failed to do, an ideal that we’ve not lived up to, or a goal that we’ve not accomplished makes us unworthy of connection. I’m not worthy or good enough for love, belonging, or connection.”
Nobody likes to feel this way. Everyone—and I mean everyone—wants to feel worthy of love and belonging.
Worse still, if the intention of gatekeepers is to create shape, when they shame others, they undermine their capacity for change. As Brown goes on to explain:
“Shame corrodes the very part of us that believes we can change and do better… In fact, shame is much more likely to be the cause of destructive and hurtful behaviors than it is to be the solution.”
There is a history of NTs weaponizing shame against ND folk. So when ND folks shame both NTs and other NDs, it is—to say the very least—problematic.
Gatekeeping drowns out other voices
Gatekeepers claim there is a consensus within the various ND communities, one again that usually aligns with their own personal beliefs.
But in fact, no such consensus exists. These communities comprise diverse individuals who identify and express themselves in a variety of ways.
No one has the right to speak for every member, just as no one has the right to silence those who don’t agree with their points of view.
One example of this is when gatekeepers whitewash autism, painting it exclusively as a positive while failing to acknowledge that it may be experienced by others with mixed feelings, or as a negative.
Similarly, many gatekeepers frame autism as a mere social challenge caused by systemic ableism. This social model of autism has been adopted as an alternative to the medical model, which has sometimes been used to oppress autistic folk.
But romanticizing autism in this fashion dismisses the reality of those individuals who experience autism as a debilitating disability.
Likewise, gatekeepers who insist that autism is an intrinsic part of our identity fail to admit that this isn’t the case for everyone.
By dominating discussions about autism, gatekeepers fail to hold a space for other community members and even compromise their right to self-expression.
Gatekeeping ignores privilege
What a lot of gatekeepers don’t realize is the ability to advocate is a privilege that not all ND folk get to enjoy.
For example, many individuals on the autism spectrum experience some form of intellectual disability and/or are nonspeaking.
These individuals may not have the opportunity to express how they feel. And so, their wishes go unheard, and their needs unaddressed.
If the inclusion of all ND individuals is our priority as a community, why then are so many of us assuming the right to speak for others?
Again, by virtue of being the loudest, gatekeepers get to decide what issues receive the most attention.
Their advantages allow them to privilege their own voices, rather than elevating those more disadvantaged than them.
Gatekeeping undermines coalition-building
The final issue I want to address is the “us vs. them” attitude gatekeepers take towards the medical community and parents of ND folk.
We know, for example, that ND folks have been treated horrifically in the past. The Nazi regime for example actively murdered our forebearers, so it stands to reason that many of us might treat medical authorities with suspicion.
The problem begins when some gatekeepers claim all researchers want to “cure” autism—an action compared to eugenics. This is a smear campaign.
Consider those autistic individuals living in full-time care who are prone to frequent seizures, meltdowns, self-injury, and violence. They undoubtedly experience autism in a way that differs vastly from that of privileged gatekeepers.
Many researchers are working to enhance the quality of life for such individuals, and yet gatekeepers continue to accuse these professionals of endorsing ableism.
Similarly, when desperate parents of autistic folk reach out to the community seeking understanding, insight, and support, often they are shut down and declared the enemy.
Instead of building coalitions with community allies, some gatekeepers sideline them.
Gatekeeping is not social justice
Gatekeepers may be part of a social justice movement, but there can be no justice so long as one party assumes the moral high ground, dominates the discourse, and bullies both allies and NDs alike.
I gave up my previous career to enter social work with the hope of serving the ND community. Yet I’m troubled by the knowledge that should I ever fail to measure up to the demands made by ND gatekeepers, I’ll be judged and shamed.
This leads me to wonder, are these individuals truly invested in serving the ND community? Or are they just traumatized individuals who are now inflicting that trauma upon others?
Gatekeepers often point out that words can oppress, only to themselves use words in an oppressive way.
The result, more often than not, is not dialogue, or mutual understanding, but very public social media attacks upon someone’s intelligence, knowledge, values, or character.
Wrap up
Have you experienced some form of ND gatekeeping? Or do you completely disagree with the points I’ve raised here? Let me know in the comments.
Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.
