The Hidden Cost of Masking: Understanding gender differences in Autism, and how to embrace neurodiversity
by Angela Candrilli
November 19, 2024
Masking has become a popular term in the autistic community to describe the ways in which autistic individuals try to appear neurotypical. Some common examples include, limiting stimming behaviors, maintaining eye contact during conversations, and imitating social gestures. While at first glance this may appear adaptive, masking actually harms neurodiverse individuals. Individuals with autism in particular describe masking as exhausting and research has shown a positive association between masking and symptoms of anxiety and depression. Others say masking can lead to an identity crisis, since individuals cannot tell the difference between their personal preferences and engrained masking practices. This new understanding of masking has also shed light on the ethics of “social skills groups” for the ASD population.
The differences in socialization for men and women can lead to gender differences in masking. It has been thought that autistic women mask more often than men, which may contribute to the well-known issue of under-identification of autism in women. There are some plausible reasons for this gender difference. Preliminary research has shown that autistic traits tend to be more accepted in males than females. Similarly, there can be greater social pressure for women to fit in with their peers, and to put others needs before their own. For example, child and adolescent females often feel more pressure to make close social connections, while it is more acceptable for a male child to play by himself or have more acquaintances rather than friends. In fact, a lot of research has shown that there is little difference in the social reciprocity of autistic and non-autistic girls! Although these autistic girls tend to initiate friendship more so than autistic boys, again, they are more at risk for underdiagnosis and developing emotional distress due to a lack of self-awareness stemming from a late/absent diagnosis, and due to engaging in masking.
Knowing that masking can negatively impact our autistic children, the question comes, how do we support them? The first step is to have a comprehensive, early evaluation that includes social communication, since typical behavioral observations do not always account for potential masking. It is important to encourage children to embrace who they are and their interests rather than conforming to the mainstream. Additionally, helping autistic individuals identify potential triggers or situations in which they feel more inclined to mask can help prevent negative effects that come with masking. Similarly, make sure you or your child is surrounded by a supportive network of people who accept and embrace autistic traits. Finally, seeking support can be vital to reducing the burden of masking. If you or someone you know may benefit from speaking with us about navigating masking or getting an initial diagnosis, please reach out today for a free consultation call.
I can’t calm down: Election anxiety
by Dana Serino, PhD
October 30, 2024
The US seems divided ahead of election day. Except perhaps there is one thing we can all agree on, that there is a heightened sense of anxiety or unease in the air, a familiar feeling we’ve had to contend with on a variety of levels over the past few years.
How to protect your energy and maintain emotional stability:
Limit news/social media or consider a detox
Many worry that being uninformed is taboo, but there’s a danger in having too much information or overconsumption. Before engaging with election news, try setting a timer for 10-15 minutes per day to ensure your consumption does not go unchecked.
Warning signs of overconsumption:
1. Are you choosing screens over connection? Are you reading news or Twitter in the company of loved ones? Of course I don’t mean the sacred after-the-kids-go-to-bed-veg-on-the-couch-time.
2. Are you ignoring the timers for “one more article”?
3. Are you making exceptions for news alerts, or articles that friends or family forward your way?
Fill your cup
This is not the week to skip any self-care – in fact, even if you don’t regularly engage, please add more self-care to your routine this week!
Exercise, or move your body in a meaningful way this week. While the goal is to rigorously exercise at least 3-4 days per week for 45-60 minutes, if you can squeeze in 5-15 minutes daily, that’s great too.
Therapy. Talking to a trusted therapist about these conflicted feelings and anxiety will help it improve. The goal is not to remove all anxiety, but to make space for the anxiety.
Do something inherently relaxing! This looks different for different people, but can include a massage, a facial, retail therapy, a romantic dinner, a night out, getting to bed early with a good book, etc.
Get out in nature. I know, you probably are reading this from the concrete jungle and it feels ridiculous. But even if you can get some fresh air and feel the sunlight on your face every day this week, that’s a win.
Meditate. A lot of people think that meditation means sitting in a cross-legged position in silence. It can definitely be that, but that also sounds a little torturous to those who do not meditate and struggle with being present.
I like The Fit Mind app. It is great for building a meditation practice. The sessions gradually increase in length over time, and you will rarely ever be sitting in silence.. I prefer to lay down to meditate, right before bed!
Set boundaries. If someone is engaging in political talk, you do not have to engage. If necessary, excuse yourself from the situation. Decide how you will respond when someone asks who you voted for/if you’re happy with the outcome of the election. Think through how the holidays will be this year with the outcome of the election. Would it be a better idea to book that holiday flight to a secluded beach somewhere instead?
If you are struggling with election anxiety and having difficulty implementing some of these suggestions on your own, we can help! Take a step toward feeling better by reaching out today for a free consultation call.
Put on the Oxygen Mask: Caring for Yourself While Supporting Your Child
by Christine Clark, PsyD
September 25, 2024
It’s a phrase that almost all of us have heard before: put on your oxygen mask. Airlines always play the safety video prior to takeoff explaining that in case of emergency, we must put on our own oxygen mask and make sure we are okay before we can help others. Over time, this safety practice has been applied to other settings, including self-care or, taking care of our own mental health needs.
Parents, guardians, and caregivers of children with mental health challenges are at particular risk for burnout or overlooking self-care. No matter what a child’s diagnosis may be, the impact it has on the parent is life changing and results in decreased social opportunities, increased isolation, feelings of judgment, and lack of time for one’s own interests and personal time. Combined together, parents and caregivers face higher levels of anxiety, depression, isolation, and a sense of grief, or loss, for what they had hoped for their child and for their reality.
Parents and guardians must understand these feelings are shared by others in their position and it’s something that can be reduced through establishing a positive support system and reaching out for help when needed. Making time for yourself to enjoy your own interests, spend time with friends, and get support from a mental health professional is important. Trying to find time to do this can be a challenge, however it is not impossible! Carving 5 minutes into your day whenever or wherever you can to do something you enjoy is a great start. Calling or messaging an understanding friend or family member to keep your social connections going is essential.
Sometimes though, the feelings parents experience can be too overwhelming, and that is when therapy is helpful. In therapy, parents are able to focus on their own feelings and experiences with support for their stress, thoughts and feelings without judgment. Taking time for oneself can be a challenge, however in doing so parents are better able to care for themselves and provide support for their child.
If you are a parent and in need of support, grab the oxygen mask by reaching out today!
Why a neuropsychological evaluation is important for diagnosing AD/HD
by Dana Serino, PhD
January 31, 2024
Far too often, I see providers seeking a diagnostic evaluation with a psychiatrist for possible AD/HD. While there is nothing inherently wrong with this approach, I argue that this is not the best practice. I know this because I also rely on the same methods psychiatrists utilize, but I augment this approach with cognitive measures, record review, and collateral information. Most importantly, I assess neurocognitive abilities for a possible attention deficit using the gold standard in AD/HD assessment and base my decisions on research and clinical expertise. Attentional data and self-reports are also compared against several other data points, including your intellectual functioning, emotional and personality functioning, and executive functioning. Often, I consult on cases with an international team of neuropsychologists. Collectively, these methods are vitally important in determining with utmost certainty whether you or your loved one has AD/HD.
Why? At times people assume that they have AD/HD, when instead it can be something else – anxiety, depression, personality factors, trauma, etc. A recent study found that mental health information posted on social media platforms are inaccurate ~70% of the time. That’s not to say that people are not experiencing challenges with sustaining their attention, organizing their life, and inhibiting their impulses. But proper diagnosis is important, because this will ensure targeted treatment moving forward. AD/HD is also one of those diagnoses that are deeply tied to one’s sense of self. Undiagnosed individuals must work toward reframing their beliefs that they are lazy, unmotivated or flawed in some way, and instead learn to embrace their “neurospicyness.” Finding out that your challenges are instead due to deficient dopamine seen in AD/HD can be a gamechanger in your self-conceptualization. The AD/HD evaluations that I offer utmost diagnostic certainty, to foster growth, healing and acceptance.
If you’re seeking validation, diagnostic clarity and treatment/life recommendations based on your unique cognitive and emotional landscape – reach out today!