What is a neuropsych anyway? What is AuDHD? - Neuropsychs Explored Part I

Isabelle shares the results of her neuropsych with David: she is AuDHD! As a grown human learning she has AuDHD (ADHD + Autism Spectrum Disorder), what does it mean to 'get a neuropsych?' What even IS a neuropsych? Who gets one and why? How does high-masking autism look like for Isabelle? Busting myths, calling out fun factoids, and celebrating this news and the decrease of suffering it has brought to gain self-understanding and acceptance. ---Isabelle is SO EXCITED to see David's face. Because for the last few recording sessions she hasn’t been able to see his face. And now she can see his face. She doesn’t know she misses it, and David is wagging his tail and doesn’t know if she’s making any sense. The checking for understanding is missing. Isabelle got back her neuropsychological assessment results back. She has “severe” ADHD and also, is high-masking autistic. A fairly common question is: do I need to get a neuropsych? What does it do? David names we can all know something but this is different from the actual experience of it. Are there electrodes to your head? (no) How many magnets are you exposed to? (none) Is there a flowchart?  Isabelle doesn’t know a ton about assessments but she knows a little more now. So, for each job title or profession, you can administer different types of assessments, which involve data from interviews, and written/verbal tests—and a “neuropsychiatric assessment” is conducted by a neuropsychologist, someone who is skilled at administering and interpreting test results as well as being super savvy about neuroscience and the brain. It’s a battery of tests that is designed to help someone determine a psychological diagnosis (and how a diagnosis impacts your thinking, behavior, feelings, functioning, etc.). Isabelle’s experience was, she had used up her deductible and one of her kids as well as her and Bobby decided they wanted to learn more about themselves and get a neuropsych. And she wanted to test it out because she always had a little more mustard on the hot dog of ADHD, more auditory sensory stuff. So Isabelle went in for about an hour long interview and asked me a lot of directive, specific questions. No electrodes, sitting in a cozy office. She was asking questions about friendship, life history type questions about her childhood. With ADHD and Autism, you’re talking about neurodevelopmental conditions, meaning it’s baked in and showing up throughout your life. She was asking a lot of questions about what it was like for Isabelle socially, the years of bullying and taking things very literally, social faux pas, being late to catch on to social subtext or data. And stimming? Which applies to all neurospicy folk. David likens it to a car exhaust—it’s not anxiety, it’s repetitive movements that let out extra steam and overstimulation, when your senses have taking in too much it helps you release. Isabelle thought it was anxiety! But she…actually isn't very anxious. She likes wearing tight clothes and textures, she flaps her hands and holds her hands like a t-rex. She’s realizing how much she would be overloaded after a day, and she would pace, and wiggle her hands, she needs detailed handwriting, and she just wants to be left alone under her weighted blanket. And be crying. She’d say “and I'm overhwlemed because I had a hard day at work!” When for her, she was missing a crucial piece of information. Which is she went to Target, and was under fluorescent lights, and some random stranger talked to her and she didn’t understand it, and then when she said “what?” He looked at her funny, and THAT connected more to the state she found herself in than having a bad day at work. Sitting with uncomfortable feelings and anxiety is different—David names that with anxiety, people can be thought of as fragile, and that can be helpful—but when it’s applied to someone who is neurodiverse, who isn’t fragile, it can be pretty frustrating. David describes how he sits and bounces his leg pretty fast and his whole body will be shaking (best kind!) And David is sitting there stimming, and people turn to him "it's okay, it’s just a doctor's office” and they assume he's anxious, but he’as actually in an ADHD stupor and he’s bored and waiting and feeling good. So much of how people are perceived has a significant element of judgment. Over and over again because she's sitting still or pacing or rocking on her feet—they read Isabelle as impatient or angry, blew her mind. When you see her rocking back and forth and expressionless she's super happy and chill, but you take it as a signal she needs to mask and explain and do things to signal she’s happy and sometimes she doesn’t understand it herself so she just says “yes, I am angry.” And she thought she was a liar—because she’d be dishonest, she’d agree with someone else and say “yeah, I’m antsy.” Even if she wasn’t. David points out that that’s not lying, that’s masking. David speaks to how complicated lying is in neurodiversity, because friends will say “I’ll see you tomorrow night" but then there’s an Impulsive moment and it doesn't happen. How integrity can be perceived, and what you want to own about ourselves. Going back to the assessment process, she had a student in a room and Isabelle likes this because (she’s realizing) it helps her play the eye contact game. David describes the hack of looking at people between their eyebrows instead of in their eyes. Isabelle owns that for her, not for every neurons-icy or otherwise human, she feels like she's gazing into a person’s soul when she makes direct eye contact. It feels rude to her to look at her eyes without a closer emotional bond and without consent, and she looks a bit higher and eyebrows give her data and when she's looking at someone's eyes its too much. David shares: it’s ten times more stimulating to look someone in the eye (10 times more neurons fire). WHAT?! yes. Isabelle is sobbing and confused saying “am I crazy? Am I making up that I am on the spectrum for some weird reason?” She was also listening to see if getting a neuropsych is worthwhile for her (for school or work accommodations)? ADHD was so obvious to Isabelle, but this was causing her distress: the idea and theme in her life of being the last to know something obvious. Increased understanding reduces suffering—what are choices? What are your needs? So much about what shouldn’t or should? What parts of things can you embrace v. ‘Toughing it out.’ Isabelle was in there after an hour and some change. Bobby also went in for a half hour and came out and got resources on ADHD and doesn't seem like he'd get a lot out of a neuropsych and if so, it’s not causing any pain, and maybe you already know what you know and you don’t go through this? Side note, this is not a prerequisite for self-diagnosis. This is a systemic hurtle, it can help you understand the world around you or help you get accommodations around specific areas of work, v. Being in school. But bear in mind, it’s not just for kids.Eye contact being more stimulating than not in general --in short, it connects to nervous system arousal (even brings in the fight/flight system) as well as dopamine loads and social conventions (like reciprocal communication) but in short, this study sums up a bunch of studies across time that show how eye contact is perceived and impacts nervous systems. (Source: Frontiers in Psychology) Why eye contact may be EXTRA overstimulating for autistic individuals (Source: Scientific Reports, 2017): hint, ...