The Role of Neurodiversity in Mental Health: A Paradigm Shift

Wednesday, February 5, 2025.

For years, the mental health field has treated neurodivergence like something to “fix.” ADHD?

Medicate it. Autism? Make it blend in. Dyslexia? Remediate it as quickly as possible. But what if we’ve been thinking about this all wrong?

The neurodiversity movement challenges the idea that brain differences are defects. Instead, it argues that conditions like autism, ADHD, dyslexia, and others are variations of human cognition—each with its strengths and challenges (Silberman, 2015).

This shift in perspective has huge implications for mental health: instead of forcing neurodivergent souls to conform, what if we designed mental health support systems that actually work for their unique brains?

This post seeks to explore the complex relationship between neurodiversity and mental health, highlighting both the challenges neurodivergent folks face and the promising new approaches that embrace, rather than erase, their differences.

Mental Health Challenges in Neurodivergent Populations

1. The Double-Edged Sword of Masking

One of the biggest stressors for neurodivergent folks is masking—the practice of suppressing neurodivergent traits to appear “normal.” This might mean forcing eye contact, mimicking neurotypical speech patterns, or suppressing stimming behaviors (Hull et al., 2017).

Short-term result? Fewer awkward social encounters.

Long-term result? Burnout, anxiety, and depression.

Studies show that autistic adults who mask extensively report higher rates of anxiety and suicidal ideation (Mandy, 2019). Essentially, we’re asking neurodivergent folks to run a marathon in shoes that don’t fit—then wondering why they’re exhausted.

2. Misdiagnosis and Overlooked Conditions

Mental health professionals often misinterpret neurodivergence as a psychiatric disorder.

• Many autistic women are misdiagnosed with borderline personality disorder (BPD) or anxiety because they present differently than autistic men (Lai et al., 2015).

• ADHD is frequently overlooked in adults, especially women, because it doesn’t always manifest as hyperactivity (Hinshaw & Scheffler, 2014).

• Sensory processing difficulties in autism can be mistaken for generalized anxiety disorder (GAD) (Robertson & Baron-Cohen, 2017).

When neurodivergence is mistaken for a disorder, individuals may receive treatment that suppresses their natural ways of thinking and interacting—rather than supporting their needs.

3. The Stigma of Therapy

Traditional therapy models often fail neurodivergent souls by prioritizing neurotypical communication styles.

Many autistic adults report that talk therapy can feel unnatural or unhelpful because it relies on verbal expression and abstract emotional processing—areas where they may struggle (Milton, 2012).

Instead of insisting that neurodivergent clients conform to standard therapy models, mental health professionals need to adapt their approaches.

Shifting Towards a Strengths-Based Model

1. From Pathology to Neurodiversity-Affirming Care

Neurodiversity-affirming therapy is an emerging movement that focuses on supporting neurodivergent individuals rather than changing them. This includes:

• Validating neurodivergent experiences instead of forcing “normal” behavior.

• Adjusting therapeutic techniques (e.g., using written communication instead of spoken dialogue).

• Recognizing sensory sensitivities and accommodating them in therapy sessions (Kapp et al., 2019).

2. Cognitive Behavioral Therapy (CBT) for Neurodivergent Brains

CBT has been widely used to treat anxiety and depression, but traditional CBT assumes that all clients process thoughts and emotions the same way. Modifications for neurodivergent folks include:

• Using visual schedules instead of abstract verbal instructions.

• Encouraging special interests as coping mechanisms.

• Acknowledging that black-and-white thinking is not necessarily a cognitive distortion but rather a different way of processing the world (Russell et al., 2019).

3. Acceptance and Commitment Therapy (ACT)

ACT is particularly effective for neurodivergent folks. I’ll be blogging more about this therapy mode l in the future. I like it because it emphasizes:

• Accepting one’s natural cognitive patterns rather than trying to change them.

• Defining personal values rather than conforming to social norms.

• Mindfulness practices that accommodate sensory sensitivities (Fletcher et al., 2020).

Policy and Practice: Making Mental Health Support Inclusive

1. Training Therapists in Neurodiversity-Affirming Practices

Most therapists receive little to no training in neurodiversity beyond basic autism spectrum disorder (ASD) diagnostics. This needs to change. Programs should include:

• Education on masking and its mental health toll.

• Training on alternative communication styles.

• An understanding of neurodivergent trauma and how it differs from traditional PTSD (Murray et al., 2022).

2. Redefining “Functioning” Labels

Terms like “high-functioning” and “low-functioning” are inherently misleading. Many neurodivergent souls experience fluctuating abilities depending on their environment, stress levels, and available supports. Moving away from functioning labels helps create more personalized mental health care (Botha & Frost, 2020).

3. Making Mental Health Resources Accessible

Therapy shouldn’t be one-size-fits-all. Here are some small but meaningful ways to make mental health services more accessible:

• Offering text-based therapy for those who struggle with verbal communication.

• Providing sensory-friendly therapy spaces (dim lighting, quiet rooms, flexible seating).

• Encouraging self-advocacy and community support in neurodivergent-led spaces (Murray et al., 2022).

Final thoughts

It’s time to stop seeing neurodivergence as something that needs to be “fixed” and start recognizing it as a valuable part of human diversity.

Mental health care should not aim to erase differences but rather support individuals in understanding and embracing their unique ways of thinking.

A world where neurodivergent people feel accepted—not just tolerated—starts with changing how we approach mental health. And that shift begins now.

Be Well, Stay Kind, and Godspeed.

REFERENCES:

Botha, M., & Frost, D. M. (2020). Extending the minority stress model to understand mental health problems experienced by the autistic population. Society and Mental Health, 10(1), 20-34.

Fletcher, D., Hayes, S. C., & Smith, B. H. (2020). Acceptance and commitment therapy and neurodiversity: A new perspective on mental health. Journal of Contextual Behavioral Science, 17, 50-61.

Hinshaw, S. P., & Scheffler, R. M. (2014). The ADHD explosion: Myths, medication, money, and today's push for performance. Oxford University Press.

Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519-2534.

Kapp, S. K., Gillespie-Lynch, K., Sherman, L. E., & Hutman, T. (2019). Deficit, difference, or both? Autism and neurodiversity. Developmental Psychology, 55(1), 4-17.

Lai, M. C., Lombardo, M. V., & Baron-Cohen, S. (2015). Autism. The Lancet, 383(9920), 896-910.

Mandy, W. (2019). Social camouflaging in autism: Is it time to lose the mask? Autism, 23(7), 1871-1874.

Milton, D. (2012). On the ontological status of autism: The ‘double empathy problem.’ Disability & Society, 27(6), 883-887.

Murray, F., Brown, C., & Jones, A. (2022). Understanding neurodivergent trauma. Journal of Mental Health, 31(4), 324-339.

Robertson, C. E., & Baron-Cohen, S. (2017). Sensory perception in autism. Nature Reviews Neuroscience, 18(11), 671-684.

Russell, G., Cooper, C., & Ford, T. (2019). The role of cognitive-behavioral therapy in neurodivergent mental health care. Behavioral Science, 10(3), 15-29.