Unmasking Neurodivergence: Navigating Late Autism & ADHD in Women - Part 2

Ever wondered why so many women with autism are diagnosed late in adulthood? Or why the signs were overlooked in the first place? We grapple with these intriguing questions, and more, in this episode's enlightening conversation with Katie Salmons, a seasoned professional in social work. We discuss the often-overlooked phenomena of late-diagnosed autism and ADHD, particularly in women, and delve into the art of masking, autistic burnout, and how women have been historically underrepresented in autism diagnosis.

We also journey with Katie into the fascinating realm of genealogy and its impact on mental health, with a particular focus on ADHD. The significance of psychoeducation, self-advocacy, and defense mechanisms is underscored, especially in families experiencing clashes of neurodivergent traits. Katie shares her unique experiences and insights gleaned from working with teenagers navigating significant struggles, including the contemporary challenge of technology addiction. Don’t miss out on this powerful discussion that offers a fresh and insightful perspective on neurodivergence.

This program is brought to you by:
Kindred Art Therapy
Visit https://www.arttherapync.com/ to schedule a free consultation.
- and -
Alynee Davis, PLLC
Visit https://alynnedavis.com/ to connect.
Alynne is a Licensed Clinical Mental Health Counselor and Coach.

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Transcript

Aubrey: 1:01

Welcome to Kindred Conversations, the show where we shine a light on local mental health professionals, who are the unsung heroes of our community. Join us as we delve into their journeys, strategies and the art of healing minds. Together, we'll break down stigmas and celebrate resilience. So today we're continuing conversations with Katie Sammons, a seasoned professional in the field of social work. Last week we ended the conversation talking about autism and this week we're picking back up talking more about just the process of people becoming identified with being autistic and I don't know how much of this that you've been just like made aware of, katie, but this new movement of people that are late diagnosed autistic.

Katie: 1:55

Yeah, I mean. Well, ironically, I have quite a few friends or fellow therapists that I know and cherish who just now, recently, within the past year or two, have been diagnosed with autism, and I want to say they are in their lower 30s. So, yes, not only is it happening late in teenage years, but it is also happening in adulthood as well, and I'm seeing that a lot Now.

Aubrey: 2:25

This is a neurodevelopmental disorder where you know there has to have been signs in early childhood for it to be a diagnosis, even when they're being late diagnosed. What is it about these individuals or their traits that is being overlooked or was overlooked for so many years?

Katie: 2:46

I mean, interestingly, I think we as a culture, maybe in schools, I think that we often just felt like kids or teenagers or people in their younger years were maybe just quirky or different or weird. And I want to throw out I use weird as a good way I am weird, and I do think that that was kind of like, well, they're just different, they're just, they're just weird and there's not anything quote unquote going on. I think that can absolutely be a big one. I also want to throw out.

Katie: 3:22

The ability for autistic folks to be able to mask in mirror behaviors is so profound, I mean, I think it can be a skill if it is not being harmful to them, but there is this amazing ability to mask in mirror that they can seem okay and like they're doing okay when really inside they might not be. So I'd say those, probably those two that are kind of co-occurring. But I'll also throw out where we are seeing the increase in late diagnosis is mainly in women. That is existing with ADHD as well, by the way, but I do think so much testing when it came to autism was around males, and so we didn't really have a deeper understanding in what autism in females could look like, and goodness, I mean we definitely didn't have any data on what autism could look like in any other gender. So I think there's a magnitude why females.

Aubrey: 4:25

Why females?

Katie: 4:26

Well, females, specifically, autism was looked at as a nonverbal diagnosis. There had to be issues with communication. There had to be issues with social communication or social interaction, and females naturally are good at that. We want to connect with other people, we are very social, and I think that was looked at as like okay, well, there's no way they have autism because they're very social and they want to have friends. And Autism is much more complicated than just wanting to have friends, not wanting to have friends.

Aubrey: 5:02

Yeah, so there's more to it, and some of it has to do with well, a lot of it has to do with just the way that information is processed and sensory information is processed. Yeah.

Katie: 5:18

Yeah, go ahead. Well, I will say I think you know sensory processing in general. I do think because women may also be more likely to be people pleasers or more likely to subdue themselves to please the people around them that they might forgo some of their own discomfort for the people around them to be comfortable, and I think we're doing better with that women out in the world. But I definitely think that was something that existed in the past.

Aubrey: 5:54

And how might somebody like what might somebody be noticing going on in their life that might make them question or like move towards, like, well, am I like what? What might be some things that they're like thinking this might not be right or this doesn't feel right that I'm living this way.

Katie: 6:15

And the big one that comes to my mind right now I want to say is autistic burnout. You know, if you are finding yourself being like, let's say, you're going on an outing or doing something fun with some of your friends, you know your number one maybe not fully being yourself and then you come back from that outing or fun event and you are completely exhausted because you had to mask that whole time. I would definitely say you might want to talk to somebody about what could be going on. It is not I don't like using the word normal, but I don't think it's healthy for individuals to feel like they can't be themselves and to be somebody else out in public, just to be, just to kind of crash in their own home and need to recoup for potentially days on end.

Aubrey: 7:12

I'm curious if you've seen whether that is a symptom that also is existent for ADHD, independently from autism.

Katie: 7:20

Oh, I think it could be Interestingly, and then we can come back to the subject. I was recently reading a bit of information and research articles about bipolar, and there actually is bipolar burnout as well. So I actually think burnout can exist for multiple diagnosis that are very unique to that diagnosis as well.

Aubrey: 7:43

Well, and burnout is just an experience that any human can have, just based on the fact that they're being stretched too thin.

Katie: 7:52

basically, oh, yes, absolutely, and yeah, I think, when it comes, in my opinion, when that comes specifically to autism, it is that that masking that is occurring, that to me is very unique to autism. I'm curious your thoughts.

Aubrey: 8:11

Well, my thought is is that you know, I've been exploring the diagnosis of autism for myself, and you know I've already previously been diagnosed with ADHD, and for me, adhd there's a lot of impulsivity and like that filter filtering of thoughts, like it's not always there.

Aubrey: 8:35

And so, you know, I've learned a lot of skills in the time that I've been an adult, but it oftentimes still requires a lot of energy and effort to just like appear quote unquote like normal so that I can get through a conversation and like be able to have relationships and like just kind of operate in what people experience and accept as normal. And so, you know, I can at times feel like overwhelmed or tired from keeping that going or being in someone's presence for long periods of time. Yeah, so then I questioned myself I'm like, well, you know, is it that I just have ADHD and that is? You know that I'm just feeling that like energy lowering because of that effort, or is there possibly something else that's there as well? And so that's something that I've been personally kind of exploring within other people's experiences. But there's so much hype about like combined autism and ADHD right now it's a bit confusing. There's still a lot of questions, I think, out there.

Katie: 9:50

Well, and I think there will continue to be, as really the umbrella of neurodiversity or neurodivergence specifically evolved. I think that I feel like I see a Venn diagram in my head right now of like where ADHD and autism really shares some symptoms and where there are some differences and it is very unique to many individuals, like I do think, with autism specifically. I know this is kind of a simple answer, but are there some specific interests there that you really stick with for a long, long time, or just that you really zone in on, and is that autism or is that also a hyper fixation of ADHD? There are so many connections that do exist.

Aubrey: 10:43

Yeah, and it makes me think like, well, maybe we need these labels autism and ADHD in order to be able to like talk about it and understand it from like a 30,000 foot view. But for every single individual, when you start really just getting to know that person and getting to learn about how they think and operate and all of that, nobody really fits into any one of these categories, right.

Katie: 11:11

Yeah, and it's interesting because they've always said this at least this is what I was taught, like 10 years ago when you meet one person with autism, you meet one person with autism. And I think, if we wanna expand that, when you meet somebody with neurodivergence, you meet one person with neurodivergence, and everybody can look very different from one another and can look very different than the simple diagnostic, symptomology and the DSM. They're all people and we have to pay attention to what are things that are maybe impeding in their lives and what are things that are allowing them to excel in their lives. So, yeah, focusing in on diagnosis sure, diagnosis are important for many, many things, but really symptomology and paying attention to that is even more important.

Aubrey: 12:04

So something that I wanna really highlight here is the heritability of neurodiversity, so the experience of those who are living with neurodiversity, who are either parents of or children of, those who also have neurodiversity, what have you learned in terms of, like, how that affects the family system and dynamics? I mean, it can vary, right, but like, what would you notice in your clinical work?

Katie: 12:35

Interestingly, I have some or I have and have worked with some amazing children and families who, once their child does get diagnosed with an neurodivergent diagnosis, they immediately start looking within and they're like, hmm, could I be having some of the same things go on with me? And then they do the research, they get evaluated, they get assessed and then they learn oh wow, I do those similar things and so you could actually really relate to that people's. I am seeing a lot of parents who their kid will get diagnosed and then they get diagnosed themselves, which is huge in terms of the family system work, because they're learning together, not only themselves, but also how they work together. And I'll throw out for parents who are not getting diagnosed or do not qualify for that diagnosis, they still do show a lot of empathy and, oh wow, I do something similar in that regard. Oh, now I know why. You know, when I ask you to do something, I have to ask you it five times instead of just the two. So I will say, with my families who work really, really well together and want to understand autism, we are seeing them grow as an entire family unit because they're learning how to work better together.

Katie: 14:04

I just I wanted to add something real quick. There is a lot of information being done around genealogy and you know what kind of genes we pass on to our kids and are some genes more resilient than others, and how that's looking. I am an addiction specialist as well and I have learned recently that we can sometimes, like we as human beings do have genes that can be more resilient or less resilient to, specifically, alcoholism and other substance use disorders, and I find that to be really fascinating in terms of this conversation, because I do think that we are kind of on the brink of learning and understanding potentially what types of and I want to throw this out we can have a whole discussion about, like mental health versus neurodivergent, and should they be included in the same bucket. But I do think that we are going to start to learn so much about mental health through genealogy and the passing on of our genetics, and I think I'm really excited to see what the future holds. I absolutely hope it is in my lifetime, yeah.

Aubrey: 15:22

So one of the pieces of information that I've learned in my ADHD trainings is about how, with ADHD, there's a statistical significance in a lower socio-economic status.

Aubrey: 15:37

And it makes me think about how oftentimes, when you have and I can't say this is always right, because there are those who maybe have learned earlier, have had certain things nurtured that didn't lead them to this, but oftentimes untreated ADHD looks like a good amount of anger and impulsivity. It can also look like addiction and I can see in its more mild forms, even where parents may like be in a certain energetic state, maybe come off in a way that can be seen as more aggressive, and then say, for example, because I do have a client in a family situation that's like this, where the child is maybe autistic and more sensitive and maybe being more triggered by the parent's behaviors I'm wondering, like, do you see those types of situations? Like, how do you go about working with those families where it's a neurodivergent trait and there's a clash happening?

Katie: 16:46

Oh yeah, I mean, we see that all the time as well, or I see that all the time as well, and I would say it is very individualized, right. We've got to see how open is the parent to understanding their impact on the child and vice versa, how open is the child able to communicate what they're experiencing, to create that shift. I will say I think there is a lot of psychoeducation that I have to do as a therapist to educate the parent on how their actions are impacting their child and a lot of assistance in helping the child self-advocate. And that can be a delicate balance because ultimately no family wants to be conflicting with one another. They do not want to be fighting, they do want to get along civilly and navigate life well. At the same time, there can be a lot of barriers in that process defense mechanisms, previous trauma, intergenerational trauma, their own mental health that we might have to navigate first before we're truly able to get to the solid conflict resolution tools and deep understanding, not surface level understanding and attempts.

Aubrey: 18:05

One of the examples that I think of is how often kids have learned from an early age to mask and then, oftentimes they maintain protective facades where they feel like they have to stay in a certain way in order to appease their parents. Thoughts or behaviors they might not be ready to change yet.

Katie: 18:31

Yeah, I think well, and there's fears that are wrapped into that masking, and I have. I mean, I have a student that I work and I call them students. I should call them teenagers, but I do have a teenager that I work with right now who gets very, very mad at their parents, and one of the things that we really have to work towards is when is gonna be an okay time that we talk about this? How can we bring this up where it's effective and it is breaking down their barriers to that's preventing them from communicating and wanting to improve this issue and feel like they're not gonna get yelled at or get in trouble for expressing their feelings? So, yeah, there's a lot of individual work that sometimes has to happen before we can even enter it as a family discussion.

Aubrey: 19:24

Yeah, so I imagine during that work that you're both talking to the child and you're talking to the parents.

Katie: 19:32

Yeah, I mean, and it'll depend sometimes, because sometimes I will just specifically work with the child and that can be for multiple reasons. Some of the teenagers I work with some of my neurodivergence for sure want to have their therapist. This is my therapist, this is not my family's therapist, and so I do sometimes work with other parent coaches or other parent therapists and we work together. Like the parent coach or the therapist works with the parents, I work with the kid and then we come together. That's not always the case. I do have some joint families as well, but I will say sometimes it's more beneficial to work separately and then come together than it is to work just together. So that can be complex sometimes. Yeah, for sure.

Aubrey: 20:23

So we talked a lot about autism, we talked about you coming into private practice and you're excited about all of that process and then you know within this Western North Carolina community that you're a part of. So, yeah, it's just an exciting journey that you're on and it's sort of, you know, the beginning of this leg of the journey.

Katie: 20:48

I'll say yeah, and you know, maybe to put this isn't necessarily a plug, but to connect some of these things you know I work with children who have a lot of different things going on really, sometimes really big struggles, plus potential addictions and I'll throw out and to connect us with autism, with my neurodivergent population, I am seeing a lot of technology addiction and the need to be on their phone all the time or the inability to get off when asked by parents, and we could talk a whole another talk on that subject. But I think that's something I'm seeing a lot to in my population that I genuinely love to work with and I'm excited to continue to get those clients.

Aubrey: 21:37

Well, I'll tell you, I swear there's not a single client out there that will tell me that they feel comfortable with their relationship, with their technology, that, like so many people right now, are really struggling with the doom scrolling.

Katie: 21:54

Doom scrolling, not understanding the context of what someone else is saying, getting upset because they didn't understand the context, saying something wrong and then getting canceled for it. How do you manage ghosting? I mean, holy moly, there's so much stuff to talk about.

Aubrey: 22:09

Well, katie. How can listeners find out more information about you? How would they get in contact with you? Email address, phone number?

Katie: 22:17

Yeah, so my current website is being updated, so please don't look there. But you can contact me either by text or call at 828-357-7957, or my email address at ksempowers at gmailcom. And then, lastly, if you just want to Google Katie Salman Psychology today in Arden, north Carolina, you'll find me there too.

Aubrey: 22:41

Awesome. Thanks so much, katie. And for those of you who are listening, you can find all of that information in the show notes. You can go on bizradious and find more of our awesome shows there. Be sure to like and subscribe.