What it's like being a Neurodiverse Woman with Monique Mitchelson

0:04 This is Crappita Happy and I am your host Castunn. I'm a clinical and coaching psychologist. I'm mindfulness meditation teacher and of course author of the Crappita Happy books. In this show, I bring you conversations with interesting, inspiring, intelligent people who are experts in their field and who have something of value to share that will help you feel less crappy and more happy. Hello and welcome. Before I jump in to today's episode, I just wanted to say thank you so much to everybody who has been messaging me and been in touch supporting me with my alcohol free goal. I am very happy to come back this week and report that I am staying strong. So we've crossed the two week mark now, and I feel great apart from having a head cold and having sciatica, both of which are slowly improving. Apart from those two things, I am feeling really good. And I was just saying to my daughter yesterday that I feel like I have slipped back into not drinking just as easily as I slipped back into drinking. And what I attribute that to, honestly, is what I said last week about building that muscle memory, like having that lived experience and it being kind of familiar to me now to just not drink, even after almost two years of being back kind of drinking fairly regularly.

1:38 So on that I just wanted to say to you, if you are one of those people who is on this path, if you're thinking about giving up or even breaking any habit, you know. I even had people messaging me who are not drinkers, but they've got other habits that they feel like they need to break, things that they're doing really compulsively that they know is bad for them, and they struggle to break the habit. So in that year before I stopped drinking for good when I said for good, obviously two years almost, but before I took that really extended break, I had spent more time not drinking than drinking. But it was on off, on off. I'd have a week break, I'd feel really good, and then i'd go out and catch up with friends and I would drink again. I'd have another couple of weeks off, and then I would give into a craving and I would drink again. And this was just an on off thing until it went off permanently. And I attribute my being able to stop and stay stopped for a really long time to all of those little periods of not drinking and building that muscle memory and having that experience and my body and brain getting used to not reaching for a glass of wine when I normally would and just slowly, slowly, slowly, slowly creating a new different way.

2:50 So I think we focus so much on the slip ups and the setbacks and when we don't do what we said we were going to do, and I would really encourage you to focus on all of the times that you do do what you said you were going to do, even if you have a slip up, even if you had a setback. It's fine. That is normal. That is because you're a human being, and that is that is how change happens. I've talked about this before on the podcast. So that's what happens, that's how it goes. It's perfectly fine. Focus on all of those little baby steps and all those periods that you're building up of practicing breaking that habit. So that's all I wanted to say. Thank you for support, really really appreciate it. Now let's get onto today's episode. Today my guest is Monique Mitchelson.

3:34 So she is a clinical psychologist. She is a neurodivergent woman, and she is one half. She's a co host of the Neurodivergent Woman podcast, which is enormously successful. She's got a real interest in how neurodiversity presents in women and girls, particularly because it has been typically underdiagnosed and underrepresented. She knows all about this topic. She's passionate about it, and she has her own lived experience as well as her experiences as a clinical psychologist and as an expert. Who is really really passionate and is a strong advocate in this space for autism and ADHD generally and particularly about how they affect women. She's absolutely fabulous. She's a wealth of information. If this is of interest to you, if you have a daughter, if you yourself, a friend, a sister, you want to have a better understanding of what this looks like and what the experience is like for people, and how you can be more aware and more supportive and affirming for people with neuro divergent brains. Stay tuned, you'll really enjoy this conversation.

4:40 Here is Monique. Monique. Welcome to the Crappy to Happy Podcast. Thank you so much for having me on. Monique you are a clinical psychologist as I am, and you are also a podcast host. You are one half of the Neurodivergent Woman podcast, which I've heard great things about it, and I was so excited to get you onto my show because this is an area that is clearly not my area of expertise, and it is obviously something that you're really passionate about. And I was just saying to you, O fair Monique, that you know, even as a clinical psychologist, I feel like I don't know a lot about this topic, and you were saying, it's not something where we were really taught a lot in our psych degrees, was it.

5:25 No, It's interesting, but it really wasn't, you know. I think we had a couple of lectures on it in undergraduate school and then in the masters, like a couple of mentions, but nothing comprehensive. I learned most of what I know about it actually afterwards working in a private practice that specialized in autism and ADHD. And like many things we learn, once we get out into the field and on the job, that's when we learn all this stuff, and that's when we realize how little we actually know. It's interesting that you say you worked in a practice. Let's start there specialized in autism and ADHD. So let's just start for listeners with the basic definition of what we mean when we say neurodivergent.

6:06 And most of us do, I think, tend to automatically think of ADHD and autism. But it's broader than that, isn't it. So how would you define it? Yeah, great question, because I guess we're hearing the term neurodivergent neurodiverse a lot, particularly since COVID it's been in a lot of conversations and media, much more public awareness about it. But basically, the term neurodivergent means that you have a brain that is different to what we would call the neuromajority. So the term neurodivergent or neurodiversity comes from biodiversity. That an ecosystem has all different types of you know, plants, animals, fluorofauna, like everything in it that works together so that the system as a whole can flourish and thrive and for the preservation of you know, different species and like the ecosphere, and so the same applies to human neurology. You know, we have all different types of neurology. Yes, so we actually need neurological diversity as well. We need all types of brains, not just for survival of the human species, but to thrive. And the ideas that neurodivergent people often have a different perspective, a different view because our brains are different, and so the ideas In the two thousands, with the Internet era, a lot of autistic people were hopping online and they

7:38 came up with this term of being neurologically divergent from the norm, or neurodivergent to kind of use too, I guess, refer to themselves. And then there came a term neurotypical, which just means neurologically typical. And if you're part of that majority, I suppose that have that more average brain type neuro neuronormal. Basically, Yeah, I love that definition. I love that parallel with biodiversity and how everything is necessary for the well being of the whole system. That's great. Do you know what the percentage is monique of neurotypical versus various types of neurodiversity or do we not know that because of we've been so underdiagnosed, which was we will get to in a minute. But do we have an idea.

8:26 Yeah, it's really, I guess, a fascinating debate at the moment because some people are going, oh, my gosh, you know, why are the rates you know increasing? Are people being over diagnosed? And actually what's happening is because there's now better understanding, particularly in the past five to ten years, about what things like autism and ADHD in particular look like in people who were the adults and not children, and then particularly women. You know, a lot of the previous diagnostic criteria and research and where the ideas of autism and ADHD have come from have come from primarily studying white boys. So anyone who's not a white boy would struggle, you know, in the past. I guess if you weren't really diagnosed in the past five or ten years, you may not have been diagnosed or picked up, if that makes sense, because the facts of being on that particular population. So with more like people coming forward and talking about their experiences of being autistic and ADHD, you know what that looks like being an adult, being a woman, a lot more people recognizing those traits in themselves are going, oh, I didn't realize, you know, that's what being autistic was.

9:50 I thought it was a five year old boy that is obsessed with trains, So that I think stereotyping is starting to get broken down, which. Is really good. And with neurodivergents that is broad, so anyone who's different also includes things like learning differences, you know, dyslexia, dyscalculia, movement differences like dyspraxia, things like that are genetically and neurologically based. Like even ticks and turettes and OCD are now you know, debated as coming under the neurodivergent umbrella. So when we're interesting, yeah, when we're. Looking at the percentage of people that are neurodivergent versus neurone typical. At the moment, the rates are increasing because people are more accurately getting diagnosed. So it particularly people from older generations in your forties, fifties, sixties, people are now getting diagnosed that would have been missed and so that's going to you know, nearly double I would say probably the prevalence rates. So the prevalence of autism used to be considered one to two percent. Now across Australia, the UK, and even countries like Japan, they're thinking it's more three to four percent, and that may still be an underestimation. When we're looking at ADHD. The worldwide prevalence is five to seven percent of people in people under eighteen, but it drops to around three four percent in adults,

11:23 and that's probably incorrect because again, there was this idea that first ADHD was a behavioral disorder that if you just star charted people and gave them rewards, that the ADHD would be cured. Then there was an idea that it was a mental health disorder that could be cured and fixed. And in twenty thirteen, ADHD actually got moved into the neurodevelopmental category of our psychology Bible, which is the DSM five. And so we know that ADHD is a neurodevelopmental difference that you're born with. It is mostly genetic, like autism or just Z is mostly genetic, and it persists across the lifespan. So for the prevalence to be a lot hiring children but then lower in adults is incorrect.

12:10 It's just showing that this idea that previously people thought you could grow out of ADHD. But what we're finding is people often do mey support across the lifespan because actually adult life is hard, and you know, particularly when you're getting to high school and post school, like trying to you know, study after school, go to UNI or vocational studies, trying to work, having children, juggling a family, getting promotions at work, stepping up into more responsibilities, opening your own business, and for women in particular, hitting peri, menopause and menopause, those are all areas where you know, often autistic and ADHD people will need ongoing support with and those are times when it can get unmasked in adults and in particular women because of the mental load and some of the gender norms and things like that.

13:05 That's all so interesting. So I'm going to go back now. You said we looked at little white boys back when we studied psych. It was little boys being disruptive in the classroom. We all have that definition. So when you say it looks different in girls and it looks different in adults, I would love for listeners who are hearing a lot about this but not really sure what those distinctions are. How does it present differently in girls? And I know ADHD and autism are two different diagnoses, but how do they present differently in girls? And how do they present differently in adults. Yeah, that's really I think important to go through because there are so many new divergent adults and women in particular where they are actually living life on hard mode and they're finding things so difficult and draining and you know, having really a lot of difficulty coping being in burnout all the time, mental health issues, and so it's really important for neurodivergence to be identified so that you know what actually works for your brain and what doesn't work for your brain and why, because a lot of people actually start beating themselves up and feeling like they're failing at being neurotypical when actually they're not neurotypical. They're neurodivergent.

14:25 And neurodivergent people we think differently. We often thrive in certain environments and when we're adapting things to our brains. So yeah, it's so important to know or not if you're wanting to go from crappy to happy, if you're neurodivergent or not. It's an important sort of role in well being in mental health. Yeah, one hundred percent. So for example, if you're a girl with ADHD, for example, how might that be different as a parent of a girl. How might that look compared to just a hyperactive little boy. Yeah, absolutely, So with girls, what we'll often see is in attention in terms of people will present with a more inattentive type. But even if they have a combined type of ADHD, so they are hyperactive impulsive as well, the hyperactivity and impulsivity will be missed because it may not look like what hyperactivity looks like in a young boy.

15:24 So the hyperactivity or impulsivity that may present in girls with ADHD would be talkativeness, so really not being able to stop chit chatting. And often there'll be comments in school report cards around you know, disrupting the class, but it will be more around someone you know so and so as a chatterbox, or you know so and so is distracting the other students. There'll be also mental hyperactivity, so when you have ADHD, you might actually your normal will be having ten different streams of thoughts out once in your head all the time, and having difficulty sleeping because of having ten different streams of thoughts that never stop, and that's the normal. There'll be physical hyperactivity, so feeling like you really need to move and fidget to be able to learn and pay attention, but it may be more suppressed or masked. It may present in things like twirling your hair, chewing your clothes, fiddling with your jewelry, squeezing your toes inside your shoes because maybe you've been told off for making too much noise in terms of tapping your feet or tapping your fingers on the desk, or humming and whistling. You know, I definitely got told that in school that I was annoying to the other kids in the class because of some of those things.

16:47 And they'll be also like an insatiable need for sometimes information, you know, and paying attention to the class material unless you're really interested in it will be really hard to do. So girls with ADHD will tend to do really well in the subjects that they're interested in, but find it very difficult to concentrate on anything that they don't have a passion for. And then what we see is girls as well will often compensate more for their ADHD, so they might start to use their diary and calendars and alarms, and so sometimes when it comes to high school or later on in life, when we're doing screen it's for ADHD in girls and women I'll have to kind of say, look, can you please fill out this screener as to what your baseline is without all the ten different compensatory strategies you use every day to try and get by and actually educating people. Well, actually, most neurotypical people don't need to set fifty alarms a day to remind themselves to do, you know, brush their teeth or take the medication or you know, things like that. So it'll be constantly losing track of things, having difficulty holding information, and you're working memory as well, so as soon as you try to remember something, something else will happen and will push it out, and being really easily distracted and blurting things out in conversations.

18:11 Sometimes with girls, will often see with the hyperactivity is impulsivity. So what girls and women also report is finding that it's harder to regulate their emotions. You know, that's a really big struggle. And also with impulsivity in you know, adulthood and teenagehood, there'll be sometimes trying to chase jopamine through addictions, so spending addiction, sex addiction, alcohol, drug addictions sometimes and then often we'll see with girls talking in tangents, so people with ADHD move in a circular fashion through life that don't work in a linear way, So linear ways like A to B, B, two, C, C to D in your thoughts and in your actions. When you're an ADHD, you kind of in a circle. So you start doing something, then you get distracted and move to doing something else, and eventually you come round again to what you started and you might finish it, but it's kind of sometimes takes longer and has more branches of other things that you're going and doing, so sometimes it's harder to finish things. It's harder to start stuff and do stuff that's really boring, like your tax return or something like that. So, yeah, there's some of the features that we'll see with girls with ADHD and women as well.

19:31 And what's your because you're in a neurodivergent woman, monique, what's your particular flavor of neurodiversity? What are you diagnosed with? Yeah, so I got late diagnosed in my thirties with both autism and ADHD, so I would be considered an AUDHDR autistic ADHDR, so I'm level one autistic and then ADHD combine type and myself getting diagnosed, I got diagnosed after my husband got diagnosed, so he also an autistic ADHD then might be other got diagnosed with ADHD, and my mom at sixty six then got diagnosed with ADHD. So it's genetic and it really runs in my whole extended family on both sides. Yeah, so I've got uncles that have dyslexia. My dad's also in eur diivergin. Yeah, so it's our normal, if that makes sense.

20:26 Which would make it much harder to spot, right when all the people around you think and act and behaving particular ways, there is no sense that you were different. I guess in school and other environments like that, you might pick up on differences and things might feel hard, like you said, like I'm doing life on hard mode. But I'm guessing that it would be much harder to make that identification when everybody around you was sort of in the same boat. Yeah. Actually, my mom was really shocked when we went through my primary school and high school report cards for my kind of diagnostic assessment, and there was so many comments about my behavior that supported both an autistic and ADHD diagnosis, including one of my primary school teachers putting in monique is certainly unique and I was like, I'm quite sure what to make of that comment, and my mum was shocked because I got really good grades, but I struggled socially and struggled with some of the other things around, you know, classroom dynamics and teachers and stuff like that. But because my parents, for them, that was normal, Like they never picked up on it, if that makes sense, because they grew up in neurodivergent families too, with neurodivergent parents, so yeah, it's in the generation extents.

21:46 M Yeah. Yeah. What was it like for you getting that diagnosis? What did it mean for you? It was really helpful because I think, you know, and the research actually backs this up. You know, there's been a. Study like in the past year or so where they looked at adult women getting an autism diagnosis. In particular, for myself, I found it helped me to be more accepting and self compassionate and let go of I guess some of the expectations to try and fix myself, if that makes sense, and perfectionism and things like that, and that's mirrored in this study. You know, the studies showed that for adult autistic women, they found it helped them be more assertive about what their needs were and actually be more active and taking care of themselves and doing self care activities. They felt like there was a bit of a grieving process for you know, not getting support earlier on and having to put effort into masking and things like that, which impacted their mental health. But overall they found that actually getting a diagnosis helped them accept themselves and be more compassionate towards themselves, which I think is really lovely.

23:00 Yeah, very very much. You talked before about the masking and masking and camouflaging, and you mentioned all of the alarms and all of these compensatory strategies, which I'm sure many women do and equally have not necessarily made that connection that, oh, actually most people don't need to do this, or they use it as evidence that there's actually just something wrong with me. I'm just such a scatter brand and disorganized and why can't I just be better and different and more organized, et cetera. But what are some of the other kind of masking things that women particularly might do if they're not aware that they have a neurodivergent brain.

23:42 Yeah, so with ADHD, the masking is usually more around you know, trying to appear that you can pay attention to conversations or information and that your mind hasn't gone off and gotten distracted or on another track. Sometimes as well, can be trying to suppress wanting to interrupt and blurt something out because you know you'll forget it if you don't say it right that second, because it's hard to hold in your working memory. With autism, what we see in autistic girls and women is often differences in social approach. So for example, autistic people tend to really socialize and their whole world, your whole brain is orientated around your intense interests, and sometimes those have been referred to as special interests. So for example, when you're autistic, the main thing that you think about, want to talk about, share information about, or do will usually relate back to an intense interest that you've had and it usually lasts for years.

24:46 So one of my interests is psychology, and that's been very helpful in terms of very helpful assistance in getting through the training program because it's quite a long and rigorous pathway. And yeah, like having an interest in people and how they work and figuring them out, probably partially due to being autistic. And not having that inbuilt neurotypical manual if that makes sense of why do people say the things that they say or why do they act the way that they act, and actually having to figure that out manually usually takes a lot of time and a lot of effort to do. And that's where the masking comes in, because sometimes when you're yourself and you want to talk about your interests, you know, like a certain species of lizard or your rock collection or whatever it is, you know, not everyone wants to kind of listen to that extensive, you know, infodump about that. Or sometimes being autistic as well, you might stim you might have sensory differences and find sensory information you need more of it or you need much less of it. So sometimes it's masking discs comfort and distress at what would be an easy situation if you did have a neuro typical brain. Sometimes it's masking is really trying to socialize in a more neurotypical way, which is sometimes more around

26:17 recognizing a social hierarchy and socializing around keeping and maintaining relationships in that more neurotypical way, whereas for autistic people it's really more just interrupting each other and going on about your interest and if you find someone else with the same interest, it's amazing. So with the masking, it's often like forcing yourself to make eye contact because eye contact can be very uncomfortable for autistic people, or sometimes you don't know how long to hold it for or how to time it correctly. It can be making sure you have the right expression on your face, otherwise sometimes you'll get told that you have a resting bitch face.

26:59 So autistic people will sometimes tend to have a bit more of a monotone voice or what we could call flat affects, so not having the same micro expressions as a neurotypical person timed the same way as well, so animating your face, using the right gestures, making eye contact, modulating your voice tone, and knowing exactly the right thing to say at the right time. So it's a lot of work. It's something that usually neurotypical people and ADHD only people will be able to coordinate pretty effortlessly, like it won't drain them, But for an autistic person coordinating all those things at once, it usually overwhelms the brain and that's where people then struggle to keep up or it's taking so much energy that they're extremely drained by social situations. Yeah.

27:53 Interesting, Minik. You mentioned before the Bible, the psychologist bubble, the dear autism, and ADHD in the manual are called autism, spectrum disorder, and attention deficit hyperactivity disorder. What do you think about the term disorder these days as a descriptor. I think that's a great question, because you know, I tend to work through what we would call the neurodiversity affirming lens, So that's kind of affirming the person's neurodivergent identity and coming at it from the point of view that neurodivergent people not only have a different neurology, but we actually have our own cultural and social norms, you know, rather than a deficit, if that makes sense, there's actually cultural differences. And there's this theory called the double empathy theory that's come out in the past, you know, ten twelve years, that speaks to that, and it kind of theorizes that, you know, before when we had the theory of mind with autistic people, which was a theory that came out and what you know we would have got taught at UNI, which is that autistic people lack empathy because they don't I guess they're not able to read other people's you know, facial expressions, or read their emotions or understand their thoughts and things like that. And this other theory, the double empathy theory, challenges that and goes well. Actually,

29:24 autistic people, when they're interacting with other neurodivergent people, tend to be able to communicate overall, you know, okay, but when there's a cross communication from autistic to neurotypical, then there's a bit of a breakdown, and this double empathy theory also goes well, Actually there's a communication breakdown on the other side too, that often neurotypical people find it hard to read autistic people and understand their intentions and their thoughts and their emotions just as much. But unfortunately, when you're in a minority, you're the one that tends to get blank if communication goes wrong. And so this is more putting the emphasis on, well, actually it's just a cross cultural barrier than the fault of autistic people all the time, and that both parties should make an effort to actually understand each other's not just the emphasis being all on autistic people to learn neurotypical speak basically. So, yeah, it's a bit of a different perspective.

30:24 Yeah, it is. The interesting thing is, so you talked about being late diagnosed. If we think about people who were early diagnosed but who had this label put on them that they've got something wrong with them, that's been the message, hasn't it like it's a disorder, it's a deficit, and how that impacts people's sense of themselves and their self worth and what they're capable of. For you, working in this field, what do you see as being the downstream consequences of that when people get to later in life. Yeah, it's really hard because sometimes when you don't get a diagnose, you then don't receive supports, and often people burn out in adulthood and have quite poor consequences for their mental and physical health due to stress. But then if you do receive an early diagnosis and you're not receiving neurodiversity affirming supports or an explanation of the diagnosis, that's neurodiversity affirming, but instead is based in the I guess medical model, which really pathologizes difference. It's based more on trying to cure physical stuff if that makes sense, whereas you can't actually cure autism basically you can't really turn an autistic person into a neurotypical person. And so of course looking at it through that framework, you know, of trying to cure and fix someone and saying that it's a deficit and a disorder is going to make them feel bad about themselves and alarm their parents and cares as well. And often the narrative around autism has

31:57 been extremely negative. So when we're looking at the nineties and the two thousands, there would be ads, particularly in America, speaking about autism in the same vein as it being akin to cancer or AIDS actually, and when we look at yeah, seriously, like the Grim Reaper ad that was out in Australia, remember that, Like there's ads in America where this is scary voice going autism is like coming for your child and taking your child away from you, Like it's a monster to defeat. Like yeah, And unfortunately some of those organizations still exist today. And I focused on eradicating autism and doing yeah, a lot of genetic research and things like that, and so I work more from the social model of disability, which is what then your diversity affirming model is based on and it's actually going disabled people have always existed, you know, it's far back in society, as you know, we go and we have a place in society, and that the word disability is different to disorder, okay, And the word disability is also framed quite negatively, Whereas I do identify as a disabled person, but I see it as a neutral term.

33:20 Right. I've never been able to work full time, and there's lots of things that I can't do, but I save my energy for the things that bring me joy and that I can do. And so when we're looking at the term disability through the social model of disability, it's basically saying that you may have a difference or a condition that creates difficulty or impairment with doing something. So say maybe you're a wheelchair user and your legs don't work like a person who you know doesn't need to use a wheelchair, right, and so your legs do work differently. There is a disability present. But what also contributes to that experience of disability is the fact that society doesn't really account for disabled people and it's not accessible for disabled people. So is it the wheelchair and like your physical disability that disables you, or is it the fact that the building you're trying to enter doesn't have a wheelchair ramp? You know that you don't have access to transport to get to that building, right, So its just bringing, I guess, a real reflection on some of our views and attitudes towards disability. And one of the isms that I think often isn't talked about, Like, you know, we talk about racism and sexism, but something called ableism often isn't talked about, and it certainly wasn't talked about when I went to university to do my psychology degrees. Right, No,

34:53 not at all, and not at all. I don't think probably sexism was talked about much either, to be honest. Unfortunately all racism, but. None of them really. No, it's a bit of individualized psychology. Yeah, but that's a great point. And also even now that we are talking about ableism, I think most of us probably think about the wheelchair example, and we don't necessarily think about the term ableism in terms of these other forms of disability and the neurological kinds that we're talking about here. Yeah. Absolutely, And you know, sometimes disability can be visible, and sometimes it's actually invisible, and sometimes it fluctuates as well, you know, like people can have what we call dynamic disability where at some times in their life they can do more. At other times in their life they can't do as much or they can't do things in the same way, and so sometimes the narrative around autism and ADHD doesn't take that into account. And as well, like a lot of the systemic things aren't really accessible for autistic and ADHD people, like school isn't designed for learning unless you fit in a very narrow box. A lot of you know, university and employment isn't designed to be inclusive, and there are a lot of barriers to things being accessible.

36:15 So I'm currently consulting on the National Autism Strategy in Australia as a lived experience and a clinical member of the Diagnosis, Services and Supports working Group. And the National Autism Strategy that's going to be released at the end of the year in Australia is all about trying to make society in Australia more inclusive and safe for autistic people on all levels of society and educate the public more about autism. Because of the amazing mis conceptions. Yeah, yeah, good for you. Many women particularly, we're talking about neurodivergent women predominantly here. Well we're not, that's what your specialty is. But for neurodivergent women there are often cocurring mental health issues, anxiety, depression, things like that. What's the rate of that and what's the reason for that.

37:07 Yeah, So for autism in general, regardless of gender, seventy to eighty percent of autistic people have a co occurring mental health condition, and the more common of those are anxiety depression OCD, eating disorders, and trauma. Unfortunately, So I guess the thing is with autism and ADHD as well. Like, we're not trying to cure or fix autism when we're working in psychologists. It's more about looking at the cold, curring mental health conditions that can come along with being autistic. So having maybe an unrecognized or undiagnosed disability, getting a lot of negative feedback, you know, or bullying. So people often experience that from school age or earlier, and then finding life more difficult but not knowing why, and so of course people then blame themselves, you know, and go, well, maybe it's because I'm a failure or I'm not good enough or I'm lazy, if that makes sense. So, unfortunately, some of the things like trauma, anxiety, and depression come from more societal factors. And then sometimes as well, you know, when you're autistic, your brain is more detail focused. Autistic brains process information differently, you know, and so it can lead to becoming overwhelmed more easily as well. So sometimes there's those things. But if you're in the right environment and you have good supports, that really helps with mental health.

38:42 And unfortunately, physical health conditions are really prevalent in autistic and ADHD people. So, yeah, there's research showing that autistic kids are twice as likely as neurotypical kids. To experience chronic pain. Is that right. Yeah, Autistic people are also more likely to experience neurological conditions like seizures and epilepsy other things, and the research shows that if you're autistic, your chance of having any physical health condition is much higher. Yeah. So many of the people that I specialize in working with, like my area of expertise is working with neurodivergence in women, but also trauma, chronic pain, and chronic illness. So most of my clients and myself have you know, experience of chronic illness.

39:36 Unfortunately, wow, and do we know what the reason for that correlation is. Well, some of it is potentially genetic. Some of it is linked to the higher likelihood of having conditions like Ella's dan loss, which is a connective tissue disorder that leads to you know, having a lot of other things. Some of it it could be ongoing stress and burnout as well, unfortunately, And yeah, some of the research shows that autistic women in particular are more vulnerable to experiencing what we call central nervous systems sensitivity disorders, so those are things like chronic fatigue, fibromyalgia, so potentially having perhaps a more sensitive system and being more overwhelmed by sensory information as well. And unfortunately, many of the statistics about autism or you know, are quite similar with ADHD people too, So ADHD people also have very elevated levels of mental health issues and physical health issues. And not to get into anything too depressing, so it's a bit of a trigger warning here, but unfortunately, your life expectancy is a lot lower due to different factors if you are autistic and ADA, and the research is showing it's usually for autistic people your mental health care and your physical health

41:06 care needs not being met versus factors for neurotypical people that would influence that. Then for ADHD people, it's when the ADHD is not actually treated and it's more things around like accidents, car accidents and again trigger wanting suicides, things like that. Yeah, well it's really serious, isn't it. Yeah, that's why this is so important to talk about. Yeah, yeah, exactly exactly. So what I want to ask you is there will be women out there who are thinking, oh, they've heard all of the talk, they've seen all of several public figures coming out and talking about their diagnosis. There's this increased level of awareness just generally in society about the rate of underdiagnosis in women, and there will be many women who are thinking, oh, actually, I'm pretty sure I've lady got ADHD. I reckon, I've got autism.

42:00 And they'll be thinking, oh, well, is it worth going and seeing somebody? Is it worth getting a diagnosis? I've been I've survived up until now, I've got on with it up until now, Like, what would be the point. So what's your answer to that? Monique is it worth while getting a diagnosis, and what are some of the things that might be available to those women if they do get a diagnosis that could actually really be helpful to them. Yeah, so I think with that question, a lot of the times diagnosis is actually inaccessible for people because you know, currently the public system in Australia, it's very difficult to get any access to professionals that would be able to diagnose autism or ADHD, particularly in adulthood. And then when we're looking at going privately for a diagnosis, you know, often it takes a lot of time for the clinician and also the tools that we use are quite expensive, like the testing materials that we pay for as clinicians, and the time it takes to write up a report and be thorough. So often getting a diagnosis can cost around two thousand dollars, so that can be really hard for a lot of families. And so this is where there's a bit of a debate around self diagnosis. And I guess with that it's hard because there'll be certain cases where there might be a lot of complexity going on and it could be really helpful to get what

43:32 we call a differential diagnosis process. So making sure that you know everything has been looked at really thoroughly, because there might be more than autism and ADHD going on as well for the person. But I think things are hopefully going to change for the better with the National Autism Strategy coming out, There'll be hopefully a lot more supports for people because currently, particularly if you get diagnosis level one autism, there's not much support out there for people, and it's really more often people getting a diagnosis, like an official diagnosis for validation to know and to then be able to figure out, okay, well, what strategies are going to work for an autistic brain versus a neurotypical brain with anxiety and depression, and you know that is really helpful information to know there is more support available.

44:25 How your support needs are, So if you're more level two or three in terms of you know, needing significant support, but even accessing things like the NDIS is quite hard at the moment, whereas with ADHD, getting an official diagnosis, a lot of people will seek that because you know, they want to trial ADHD medication, which ADHD medication is one of the oldest psychiatric medications. It's been around since the fifties. It's being quite well tested, and it does tend to work for the majority of people who are adhds and be very helpful in terms of reducing some of those negative like life and risk factors that I talked about previously. So yeah, like, sometimes there's more tangible stuff that can be offered for helping support ADHD than autism.

45:17 But that doesn't mean that autistic people who have lower support needs don't deserve support, you know, particularly if you're level one autistic doesn't mean no support needs. It just means you know, you do still need some support, not no support. So two things I want to ask you about that. Number One, you totally get it can be very cost prohibitive to get a diagnosis, and that's frustrating for many many people. Do you know if somebody has private health insurance, can they Well, I guess it's going to depend on the fund. I'm just thinking of people whether there's any rebate available for the diagnosis if they want to go private. Yet there is an amount that you can sometimes get back on private health, but it is small. And then something I guess you know has been raised with the creation of the National Autism Strategy is that there was some funding through Medicare that could go towards an autism assessment, but it's for people under the age of twenty five, and that's not really fair. So no, it's very frustrating because as I've had to explain unfortunately to you know, clients and things like that, they like in disbelief. They're like, well, does the government think that autism doesn't exist in people over twenty five?

46:32 It stops it twenty Yeah, So it's. Like, well no, But again, like a lot of the current supports and funding really is more focused on children, and when we're I guess looking at that critically, it's really is that about like potentially early intervention, where we're trying to intervene early to help children have better quality of life and you know all of that, or is it that we're trying to have a lot of funding thrown kids under the age of eighteen so that by the time they turn eighteen they're no longer appearing autistic. If I'm going to be cynical about that, If that makes sense, they no longer need support and you know, other government funding and stuff like that. And that's again from that more medical model around trying to cure or fix or reduce an impairment and return a person from being disabled to what we would call a quote, you know, normal level of productivity of being a member of society.

47:34 And that's not really valuing people with disabilities who may not be able to work full time or you know, quote unquote contribute to society. Very capitalist, isn't it. It is very capitalist, you know. And it's not recognizing too that. Yeah, a lot of autistic people want to work and study, but doing so full time may not be actually great for their health and mental health. And often yeah, like a lot of the support stops at high school, stops after eighteen when people do need ongoing support, you know. So it's quite shortsighted. Yeah, for sure. And the other thing I wanted to ask you super quick is for people who are not familiar, is it possible to explain really briefly, like the what is the difference between for example, a level one, level two, level three? Like we used to have these terms aspergers and autistic and et cetera, but now we don't. So can you give an indication of what some of those distinctions are to as we get go through the levels? Yeah?

48:34 Absolutely so, how I would look at it. You know, is when we're talking about level one autism, it's basically saying that the person meets a diagnostic criteria. To meet the diagnostic criteria, showing that you know you're socializing differently, you're not socializing in a neurotypical way, you have a special interest, you have sensory differences, you know you really need routine rituals you may have always forget them before. Basically, it's showing that you meet the diagnostic criteria and that you know there's distress or there's difficulty with functioning to I guess a neurotypical level, which is working full time, being able to maintain full time study, maintaining lots of different relationships in a neurotypical way. Right, So when you be considered level one, basically you will have differences with socializing and communication, some challenges, and you need support. That's basically what level one means. So often I'll see that people who are level one, they may be able to work full time and like finish school and stuff like that, but it's taking a toll. So you may be able to work full time, but then when you come home from work, you're collapsing and you're not actually able to interact with anyone. You're not able to go out for those after work drinks, go to the gym, do the

50:06 grocery shopping in that sensory environment, interact with your partner or your friends or you know, your children, even because you're so drained from masking the whole day and you actually need all your week nights to recover and you're spending most of your weekends barely doing your chores and recovering from working full time. So often level one people do better long term from what I've observed, clinically working four days a week and having that one day off to recover, and then they're able to kind of have a better quality of life and do more. And then when we're looking at level two people, it's basically, you know, you need substantial support. So it's often people that you know, if they would have worked more than two maybe three days a week or attend school more than two or three days a week, they're really struggling. And that may be due to having a much more sensitive nervous system or processing all of the sensory information, the social information, the cognitive information completely overloads their system, and then they're spending a lot of their time unfortunately in meltdowns, shutdowns, self harming, feeling suicidal, using addictions to get through and cope.

51:21 Whereas when we see people working that more two to three days a week and having the rest of the week off to recover from that rest, then people are usually more able to take care of themselves, like do their hygiene tasks, prepare food for themselves, be able to you know, be with friends and socialize and stuff like that. And often level two people might need a lot more one on one support and prompting to kind of do those tasks. Then we have level three people, and again it's needing very significant, substantial support. So these would be autistic people where they may or may not have a color current intellectual disability, and that is usually around thirty forty percent of autistic people not just autistic, but they also have a cold current intellectual disability. And so they also may be non speaking, so they may communicate through noise or echolalia, but they may not communicate through babel language the way that a neurotypical person would. And so level three people often require yeah, like round the clock twenty four to seven you know, support to do what they want to do, what they need to do. So, yeah, I hope that helps, just describe the different levels, because often I find that no one's really explain the different levels for people, even when they've received a diagnosis. They don't actually know what that means for them and also exactly their functional capacity in terms of pacing themselves so

52:52 they don't end up in burnout. Yeah, that's really helpful, really helpful, Manik, this has just been so interesting. I could probably ask you loads more questions, but I'm going to direct people who are interested to just check out your podcast, The Neurodivergent Woman. Obviously you've got a website for the podcast. What about you personally? Do you have a place where people can go to find out more about you? Yeah, so I have our website. If you just type Montic Mitchelson into Google, it will pop up. It's hot pink, you can't miss it. And I also think it's one of my favorite colors. Yeah, me too. Oh nice meeting someone else.

53:32 Who like loves me. That's very pink exactly Why not like own it? But yeah, I also have a book coming out on the first of July, and yeah, I co wrote it with another clinical psychologist, Jennifer Kemp. We're both neurodivergent clinical psychologists in Australia. And yeah, it's called the Actually I always forget what it's called. The Neurodivergence Skills Workbook for Autism and ADHD. Yes, that's the one, So thank you for looking it up for me. It's going to be out and we've written it so that hopefully it is accessible for people.

54:14 It's a work book and I'll be also released by an audiobook as well to try and help it being more accessible for people. Well, congratulations, that's amazing. I mean writing a book is no mean feed. Well done and thank you for all of the work that you're doing. This is so helpful. I think people will have will have learned a lot and anything else I need to know. There's loads of resources on your website and on the Neurodivergent podcast website. Thank you so much for your time today, Manie. It has been such a pleasure. Thank you so much for having me. If you enjoyed this episode, please share it with a friend and hit the subscribe button so that you don't miss new episodes. If you would like me to email you whenever there is a new app. Just join my mailing list over at my websitecast done dot com and as always I cannot wait to catch you next week for another fabulous episod of Crapy to Happy