Written by Sam Mishra, The Medical Massage Lady
Sam Mishra (The Medical Massage Lady) is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology and lymphatic practitioner, trauma practitioner, breathwork facilitator, reiki and intuitive energy healer, transformational and spiritual coach, and hypnotherapist.
During a counselling session, my therapist asked if I was neurodiverse. At the time, I was somewhat taken aback by the question. I had never even considered the possibility of neurodiversity, despite the fact that I have complex PTSD, until that moment. Autism, ADHD, and other developmental disorders that exhibit atypical brain functioning in comparison to those considered neurotypical are commonly referred to as neurodiverse. However, PTSD may unquestionably be classified within the neurodivergent spectrum if neurodiversity is defined as a variance in neurological functioning that may result in challenges in daily life, including mental health disorders.
In this article, I will examine neurodiversity in terms of not only developmental disorders but also anxiety disorders and acquired mental health disabilities and trauma.
What is neurodiversity?
The term neurodivergence has gained prominence in recent years, with an estimated 15-20% of the global population identified as neurodivergent. Rather than constituting a distinct health condition, it serves as evidence that the brain operates outside of neurotypical norms. The boundless heterogeneity of human cognition and the distinctiveness of each individual mind suggest that researchers posit the existence of neurodiversity types that remain largely unknown. Rather than perceiving neurodiversity merely as a clinical classification, such as autism, there are additional types of divergence that remain undefined.
Neurodiversity encompasses neurological, neurocognitive, and neurodevelopmental variations, indicating that individuals with neurodivergence may process information, communicate, learn, interact, and perceive their surroundings differently than those classified as neurotypical. Neurodiversity elucidates the reasons behind an individual’s characteristics, thought processes, and behaviours.
Neurodevelopmental diseases, learning difficulties, and genetic abnormalities, such as autism, ADHD, and Down syndrome, are typically associated with neurodiversity. However, certain mental health conditions and stress-related disorders may also be classified as neurodivergent. Certain neurological variations associated with autism and ADHD may intersect with stress-related diseases, including PTSD, acute stress disorder, and adjustment disorder. These are exemplified by the emotional distress or behavioural alterations that arise from traumatic events.
Emotional regulation, hypersensitivity, and social anxiety may be indicative of PTSD, yet these are also prevalent qualities associated with autism and ADHD. Neurodiverse people may become more sensitive to stimuli when they are traumatised, which can lead to disorders like PTSD and other comorbidities. This heightened sensitivity makes them even more vulnerable to trauma and changes the ways they can cope with it. PTSD may be regarded as a form of acquired neurodivergence due to the dysregulation of the neurological system and the common characteristics of neurodivergence and PTSD. However, the convergence between these two factors is complex.
Nearly 50% of autistic children experience a minimum of two mental health disorders, while up to 81% of adults on the autism spectrum contend with a mental health issue. Additionally, 25% of adults with ADHD suffer from a mood disorder, and almost 50% are affected by an anxiety disorder. Although mental health disorders do not impact all individuals with neurodiversity, the data clearly indicates a correlation.
Acquired mental disabilities, which are not innate, can result from brain injuries, illnesses, or psychological stress and may manifest as attributes such as empathy, crisis management talents, and hypersensitivity. Certain features may induce challenges, while others may serve as strengths; yet, these qualities are undoubtedly integral to neurodiversity.
The link between trauma and neurodiversity
The majority of individuals will encounter some sort of trauma during their lives; however, the impact varies based on factors such as self-regulation ability, genetic susceptibility, and whether the trauma is a singular incident or part of a recurring cycle. For many individuals, trauma can become overwhelming, perpetuating a state of fear and hindering a sense of safety, potentially altering personality, especially in cases of early childhood and chronic domestic violence. Bessel van der Kolk posits that the emotional region of the brain may undergo functional and chemical alterations subsequent to trauma, resulting in PTSD for several individuals.
I frequently discuss social conditioning in relation to trauma. During early childhood trauma, individuals adjust their behaviour and language to ensure their safety by monitoring the behaviours and emotions of others. Over time, this can lead to the development of hypersensitive adults, which may serve as a protective mechanism; however, it can also result in misidentifying threats, leading to hypervigilance, chronic stress, and anxiety. This is a sentiment with which I, and undoubtedly many others, can identify. Additionally, having been raised in an environment devoid of empathy, this quality has been crucial in my profession and has benefitted many individuals. However, this favourable trait has also fostered people-pleasing behaviours and trauma bonding, resulting in my exploitation.
Due to trauma, we have been conditioned to anticipate crises to the extent that we must identify them for a sense of normalcy and security.
Individuals who have endured trauma, akin to individuals who are neurodivergent, possess numerous challenges that concurrently represent significant assets. For instance, although their dysregulated neural systems lead them to perpetually and often unconsciously pursue additional stress or crises, this same nervous system exhibits remarkable adaptability, allowing the individual to endure circumstances that appear insurmountable. Although our hypersensitivity may result in hypervigilance, it also enables us to perceive the world in a uniquely profound way, deeply affected by the events that occur. Although my empathy has fostered further trauma bonding, I take satisfaction in my willingness to assist individuals enduring their most challenging moments, perhaps due to my nervous system's heightened sensitivity to survival.
Acquired neurodiversity
Acquired neurodiversity denotes alterations in an individual's cerebral functioning resulting from an injury, illness, or medical condition. Acquired neurodivergence refers to the development of changes in cognition and behaviour. Although it is classified as a neurodivergent condition, individuals with acquired neurodivergence possess the potential for improvement in their condition. Nevertheless, symptoms classified as acquired neurodiversity may also decline over time.
For instance, obsessive-compulsive disorders and bipolar depression may enter remission with therapy, but obsessive thoughts, repetitive behaviours, and fluctuating cycles of mania and sadness can resurface rapidly.
Acquired and severe brain damage may result in difficult behaviour. These injuries may arise from surgical procedures, infections, tumours, convulsions, substance abuse, physical abuse, or cerebrovascular accidents. Behavioural alterations, including violence or inappropriate sexual conduct, may result in loss of employment, social isolation, and the disintegration of relationships.
Nonetheless, acquired neurodiversity, characterised by symptoms closely associated with ADHD and autism, is also seen in PTSD. Individuals with PTSD undergo alterations in brain structure following severe traumatic events, resulting in diminished functionality of the prefrontal cortex and hippocampus.
Should PTSD be considered neurodiverse?
Post-traumatic stress disorder (often abbreviated as PTSD) is an anxiety disorder that can manifest following exposure to trauma and is illustrated by extended symptomology such as altered arousal and reactivity, intrusive thoughts and memories, altered cognition and mood, and avoidance. These symptoms may result in modifications to brain structures and functions, especially in the processing of fear and stress. This not only causes us to frequently become triggered, prompting us to intentionally evade specific individuals or situations to escape these triggers, but it also alters our perceptions and emotions towards ourselves and our environment. This implies that we may become detached, or others may perceive us as discourteous. We may enter a state of hypervigilance, which results in impulsive behaviour that others may perceive as aggression.
The categorisation of post-traumatic stress disorder (PTSD) as neurodivergent is a matter of continued contention, yet the alterations in the brain are indisputable. Studies have shown that PTSD can affect brain regions, including the amygdala, hippocampus, and prefrontal cortex, which are involved in emotional processing, memory, and decision-making. These alterations may lead to brain function that deviates from neurotypical standards, thus warranting a classification of neurodiversity.
Nonetheless, some contend that classifying PTSD as neurodivergent is inappropriate due to its temporal characteristics. In contrast to most neurodivergent conditions, PTSD is typically neither chronic nor congenital; rather, it is a reaction to a stressful incident. Appropriate intervention can ameliorate the condition over time, suggesting that the neurological alterations linked to PTSD may be transient rather than enduring.
Comparing PTSD to ADHD and autism, the two most recognised forms of neurodiversity, reveals significant interconnections. Studies have associated early trauma exposure with the onset of ADHD and the likelihood of suffering from it in adulthood. Although numerous symptoms differ between the two, many are similar, albeit attributable to distinct causes. For instance, an individual with ADHD experiences difficulty concentrating owing to their inherent brain configuration, which may result in heightened restlessness and impulsivity. Individuals with PTSD experience difficulties concentrating, primarily owing to intrusive memories and ideas that disrupt their focus. Individuals with PTSD frequently exhibit hypervigilance and restlessness due to their persistent state of survival mode, continuously evaluating potential dangers. Nevertheless, these symptoms provide some commonality.
Alongside hyperarousal, restlessness, and attention span issues, both PTSD and ADHD demonstrate challenges in emotional regulation, sensory hypersensitivity, impulse control, and sleep disturbances. Both individuals exhibit forgetfulness as a result of impaired memory and face an elevated risk of victimisation and substance misuse.
Evidence indicates that trauma may precipitate the formation of autistic spectrum disorder; however, not all individuals with ASD have encountered assault, while traumatic experiences might intensify symptoms in those with autism. Data indicates that PTSD is more prevalent in those with autism compared to those without, although the diagnosis poses difficulties, as repetitive behaviours or communication deficits may be ascribed to one illness while neglecting the other.
The connection between PTSD and autism
PTSD may be more prevalent in autistic individuals due to their heightened exposure to stigma and increased susceptibility to maltreatment relative to non-autistic individuals. A study revealed that 72% of participants had encountered some type of assault. Autism may influence an individual's sensory processing and their response to stressful situations, rendering such occurrences appear more perilous. Social problems may hinder the pursuit of assistance, raising the risk of PTSD among those with autism.
Autism is not a treatable condition, whereas PTSD is; however, both share similar symptoms and complications, including sensory sensitivity, social difficulties, repetitive behaviours such as stimming, and challenges with self-regulation resulting in withdrawal or panic, avoidance, and loss of speech.
The diagnosis of either illness must consider that the individual may be unable to articulate their feelings or experiences, and in cases of PTSD, the condition may stem from multiple occurrences rather than a singular one. Symptoms may be exacerbated by the coexistence of another ailment, leading to hyperarousal; therefore, it should not be presumed that a symptom initially assigned to one condition signifies a complete diagnosis. For the same reason, engaging in repetitive behaviours due to avoidance does not automatically indicate the presence of a second disorder, as the symptoms often overlap. The fundamental reasons for symptoms must consistently be evaluated.
Read more from Sam Mishra
Sam Mishra, The Medical Massage Lady
Sam Mishra (The Medical Massage Lady), is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology and lymphatic practitioner, trauma practitioner, breathwork facilitator, reiki and intuitive energy healer, transformational and spiritual coach and hypnotherapist. Her medical background as a nurse and a midwife, combined with her own experiences of childhood disability and abuse, have resulted in a diverse and specialised service, but she is mostly known for her trauma work. She is motivated by the adversity she has faced, using it as a driving force in her charity work and in offering the vulnerable a means of support. Her aim is to educate about medical conditions using easily understood language, to avoid inappropriate treatments being carried out, and for health promotion purposes in the general public. She is also becoming known for challenging the stigmas in our society and pushing through the boundaries that have been set by such stigmas within the massage industry.
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Guest Pryal, K. R. (2024). The Struggles and Strengths of Trauma Disorders. Psychology Today.
Haruvi-Lamdan, N., Horesh, D., & Golan, O. (2018). PTSD and autism spectrum disorder: Co-morbidity, gaps in research, and potential shared mechanisms. Psychological Trauma: Theory, Research, Practice, and Policy, 10(3), 290-299.
Kerns, C. M., Newschaffer, C. J., & Berkowitz, S. J. (2015). Traumatic childhood events and autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(11), 3475-3486.
Lobregt-van Buuren E, Hoekert M, Sizoo B. (2021) Autism, Adverse Events, and Trauma. In: Grabrucker AM, editor. Autism Spectrum Disorders [Internet]. Brisbane (AU): Exon Publications; 2021 Aug 20. Chapter 3.
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van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
