Many of us have a diagnosis that has something to do with the way our mind works—and if not, we probably know someone who does. It’s nearly impossible to hang out in the 21st century without encountering people who have attention deficit hyperactivity disorder (ADHD), bipolar disorder, anxiety disorder, obsessive compulsive disorder (OCD), depression, autism spectrum disorder (ASD), and other neuropsychological conditions. These conditions fall under the umbrella of neurodiversity, which states that there are normal variations in the human brain that lead to these behavioral traits. (The neurodiversity concept is particularly associated with autism, but embraces all other neuropsychological conditions too.)
Having a diagnosis for these conditions can allow some people access to supports and services that help them meet their full potential (e.g., academic accommodations). However, some believe that receiving a diagnosis can be stigmatizing or othering, and question the value of diagnosing people for traits that are likely normal variations in human behavior.
Behavioral health and disability advocates are working to change the way that these conditions are understood. Their key point: Different kinds of minds come with different kinds of strengths (as well as challenges). Many unconventional thinkers and innovators—people who may have been considered mentally ill, disabled, or eccentric—have made critical leaps in the sciences, arts, and technology. The concept of neurodiversity acknowledges and helps us accept these natural human differences.
Diagnosing difference: What is “normal” anyway?
An important question to ask is: When is it beneficial to diagnose neurodiverse traits as medical conditions? Some believe that the increase in diagnoses for these varieties in human behavior is the result of medicalization. Medicalization refers to “the idea that we’re turning all human difference into a disease, a disorder, a syndrome,” says Dr. Peter Conrad, professor emeritus of sociology at Brandeis University in Massachusetts. He specializes in “how conditions get to be called a disease and what the consequences are.”
“I think we are restraining what is perhaps a very normal spectrum of human personalities into a very narrow idea of what is normal,” says Deneil H., an undergraduate at Binghamton University in New York.
In recent decades, the diagnostic criteria for many neuropsychological conditions have broadened. “More and more human behavior has been defined as a disorder, especially around the edges,” says Dr. Conrad. “Human problems are increasingly medicalized, especially sadness. Nine percent of children are diagnosed with ADHD, according to the Centers for Disease Control and Prevention (CDC) . At that rate, it’s something that’s fairly normal and not necessarily a pathology.”
Medicalization isn’t necessarily a bad thing; it has helped countless people access treatment and supports that work for them. Like with anything else, there are pros and cons.
The risks of medicalization include:
- Being uncomfortable with the premise that there’s something wrong with us.
- Neglecting to tackle relevant societal factors, such as discrimination and poverty, that prevent people from meeting their potential. “Medicalizing behavioral issues, like substance abuse, frames them primarily as individual problems as opposed to collective social problems,” says Dr. Conrad.
“I am concerned that other underlying issues may be ignored (the diagnosis could be an easy explanation for a more complicated problem).”
—Online student, State University of New York, Empire State College
The benefits of medicalization include:
- Reducing any negative judgment attached to certain conditions.
- Conditions defined as illnesses can be covered by health insurance, improving access to treatment and accommodations.
So when is a diagnosis helpful? When is it not?
These types of diagnoses can help us understand ourselves and figure out what helps us meet our fullest potential. This might involve environmental supports (e.g., a quiet classroom), behavioral approaches (e.g., a mindfulness routine), some kind of therapy or life coaching, friends and partners who get it, or medication.
For some, though, the prospect of a diagnosis is problematic. A diagnosis may seem judgmental, stigmatizing, or overly simplistic. We may ask ourselves:
- Does this mean I’m not “normal”? Can I be happy with myself as I am? Does this label me?
- What should I do with my diagnosis?
- How can it help me?
The answers aren’t black and white, and are largely up to an individual’s unique circumstances and point of view. But one thing we do know is that neurodiverse people have made (and continue to make) huge contributions to our world.
Many modern-day celebrities and historical figures are thought to be neurodiverse. Some have spoken about it openly, while others are based solely on speculation—though the evidence is strong.
The super-scientists Albert Einstein (the theory of relativity) and Isaac Newton (the law of gravity) were probably autistic, according to an article in the Journal of the Royal Society of Medicine.
Thomas Jefferson, our third president, likely had Autism Spectrum Disorder (ASD), according to Norm Ledgin, author of Diagnosing Jefferson: Evidence of a Condition That Guided His Beliefs, Behavior, and Personal Associations (Future Horizons, 2000).
Richard Branson, businessman extraordinaire and founder of Virgin Group, has acknowledged in interviews that he has dyslexia and ADHD.
Sinead O’Connor has talked about her experience with bipolar disorder.
Other candidates for bipolar disorder include Kurt Cobain, Marilyn Monroe, Vincent Van Gogh, and Emily Dickinson.
Actor Leonardo DiCaprio, who has OCD, played Howard Hughes, who also has OCD, in The Aviator. “He let his own mild OCD get worse to play the part,” said the psychiatrist who advised him on set (speaking to Scotland on Sunday, 2005).
“The more we learn about the spectrum of neuropsychiatric behaviors in humans, the better we can regulate conditions that may pose a risk to a person’s ability to function. [That said,] I am concerned that there’s an overemphasis on what’s ‘normal’ when we ought to celebrate our differences in varying capacities.”
—Second-year graduate student, Boise State University, Idaho
How neurodiversity helps
The concept of neurodiversity is helping to de-stigmatize these conditions while also improving access to supports and services. Dr. Christina Nicolaidis, a professor at Portland State University, Oregon, is committed to a pro-neurodiversity approach in her clinical practice and academic research. She points to ways that this mindset supports us:
Valuing ourselves and accepting our needs
“A neurodiversity-based approach can be conducive to dealing with the dissonance between accepting yourself, understanding yourself, and being happy with who you are, while also acknowledging that you may need supports, accommodations, and medical treatments.”
Advocating for ourselves and others
“The neurodiversity movement sees people with disabilities as members of a minority group that have a right to be treated equitably. It encourages you to work towards reducing stigma and discrimination, to advocate for one’s legal rights, and to fight for equal access to health care and other services.”
Accessing health care and other supports
“In my clinical experience, a strengths-based and neurodiversity-type approach is extremely important for helping doctors understand, communicate with, and support their patients.”
Peter Conrad, PhD, professor of social sciences, Brandeis University, Massachusetts.
Ari Ne’eman, co-founder, Autistic Self Advocacy Network, Washington DC., Former Obama-appointed member, National Council on Disability.
Christina Nicolaidis, MD, MPH; professor in social determinants of health, Portland State University, Oregon; co-director, Academic Autistic Spectrum Partnership in Research and Education (AASPIRE).
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