about high-sensitivity…

Introversion/Extroversion is a personality dynamic on a continuum...meanings, people can be on the extreme ends or in the middle. It can change & move over time to some degree, depending on the person.

Introversion is when one gathers energy from time alone & extroversion is when one gathers energy by being with others.

There might be an assumption that HSPs are introverted, but there is a smaller sub group of HSPs who are Extroverts &/or Sensory Seekers.

HSPs may need more alone or quiet time to calm the impact of sensory inputs, but they'll need to look deeper to understand what this means for them on the introvert/extrovert continuum.

Forget what you think you know about Autism...If you've met one Autistic person, you've met one Autistic person...

Autism is a neurological, developmental-based diagnosis. It is often mis-diagnosed (undiagnosed) if big behavioral presentations are not obvious in childhood.

Autism cannot be "medicated" away & is not a disease, but a brain difference. Many if not most Autistic people are also HSPs.

1/2 of all who meet Autism diagnostic criteria experience ALEXITHYMIA (compared to 5% of the general population). This is difficulty identifying feelings & emotions....to be clear, this does NOT mean Autistics do not experience emotion (a terrible mis-conception about Autistic people).

Because the Autism Spectrum has sensory components, HSPs may think they are meeting criteria for Autism. The diagnostic criteria may be confusing as it is fundamentally based on observation of behaviors & not as much worded to describe the internal experiences of an Autistic person. Someone can be HSP & Autistic, which is quite common. I prefer the information in this article over the DSM diagnosis: Article

NOTE: the DSM diagnostic is based on what Autism presents like when (some) Autistic people are in DISTRESS. This is a big reason why some people may not see themselves in these criteria. Also, masking (a trauma response) can begin as early as infancy, which means we won't remember the ways in which we've altered ourselves on a behavioral or nervous system level.

The DSM diagnostics for Autism are as follows:

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):

**ALL 3 NEED TO BE PRESENT**

1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):

+AT LEAST 2 OF THESE 4 NEED TO BE PRESENT

1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).

2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).

3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).

4. Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

E. These disturbances are not better explained by intellectual disability

ADHD is a neurodevelopmental difference.

ADHD is a recognized diagnostic category defined by challenges in modulating attention. When the “H” is present there will also be challenges in “hyper-activity” (example: sitting still for periods of time). Sometimes HSPs get mislabeled with ADHD because of how easily they can be over-stimulated in classrooms or group situations.

Research indicates that ADHDers can also be HSPs, but the two have different & often opposite signatures in presentation, so it may actually make it harder to identify ADHD when a person is HS. No two people are alike...it may be complex to tease out.

Please be aware that the DSM diagnostic for ADHD is based on outward behavior & is undergoing needed scrutiny by the neurodiverse community:

link to diagnostic criteria

AuDHD is Autism & ADHD. It can sometimes be confusing to recognize because Autistic traits can be “cancelled out” by ADHD traits or vice versa.

Variable Attention Stimulus Trait describes all people with ‘ADHD’ traits even if not meeting the full criteria for an ADHD diagnosis.

There is a movement to adopt the term VAST over the term ADHD because the name itself “attention deficit” is inaccurate to describe what is happening for all who experience attentional issues.

SPD is a distinct diagnosis that HSPs can have, but is not the same as the trait of high-sensitivity. There are several categories within SPD that may include balance/coordination issues, Sensory Modulation & Sensory Discrimination. SPD also can be an indication of the presence of ADHD, Autism & other developmental disabilities. Treatment often falls into the field of Occupational Therapists & other sensory integration specialist, especially in childhood.

Misophonia is not a recognized diagnosis at this time. It is defined by strong, emotional responses to specific sound triggers (example: the sound of others chewing) & can trigger panic attacks & limit an individuals socializing among other things.

Misophonia & high-sensitivity can both be present.

I help Misophonia clients with the Safe & Sound Protocol. The SSP can help reduce the anxiety & panic experienced from auditory sensitivity....to be clear, this does not mean the misophonia is "cured" or entirely "goes away."

HSPs (like others) can develop OCD, which is an anxiety-based diagnosis. Some HSP sensory overwhelm can present similarly to OCD, but does not meet diagnostic criteria. Usually what looks like OCD is the result of sensory overload & decreases or ceases when sensory overwhelm is absent.

Synesthesia is when your brain routes sensory information through multiple unrelated senses, causing you to experience more than one sense simultaneously.

For example, certain musical notes/tones are experienced as specific colors to the person.

All HSPs have high empathy (picking up other people's emotions, body sensations & sometimes thoughts), but not all who have high empathy are HSPs. This is because high empathy does not always come with high sensory experience, a rich internal life, attention to detail, etc.

2 kinds of Empathy to consider:

Emotional empathy:  feeling same emotion, feeling distress in response to another’s plight, feeling compassion for another…

Cognitive empathy:  perceiving & understanding another’s emotions…

HSPs (like others) can develop & meet diagnostic criteria for Anxiety, Depression, Trauma & PTSD. The main difference is that HSPs may be more vulnerable to mental health issues & ESPECIALLY if their childhood was not one of increasing confidence, boundaries & emotional intelligence. HSPs are more negatively impacted by a negative environment. For example, not being emotionally supported by caregivers can cut deeper & manifest emotional issues that non-HSPs would not relate to. Something very subtle causes a strong ripple effect, because HSPs track things on a deeper level & young children, because of their brain development always think it’s about them.

HOWEVER, Sensory Burnout can be misinterpreted as Depression.

That said, care must be taken when considering pharmaceutical interventions as well as the social norm of taking meds without addressing lifestyle (business, overstimulation, lack of sleep, etc.).

C-PTSD stands for Complex Post Traumatic Stress Disorder. C-PTSD is not a DSM diagnosis, but has been widely adopted by the trauma community. One of the leading trauma therapists in the world petitioned to have it added to the DSM along with other professionals, but is has not been formally recognized in the diagnostic manual.

C-PTSD can complicate identifying many diagnoses & neuro-developmental differences. Also, individuals with sensory challenges are more prone to develop trauma (even if the events don't "seem that serious compared to others").