The Neurodivergent Iceberg—the reason neurodivergence is so misunderstood
There's a specific reason most people misunderstand neurodivergence... and it has to do with the way neurodivergent conditions are diagnosed.
I created this graphic that shows the core issue, which I'll explain in detail in this post. Feel free to take a close look at the graphic before you continue reading.
The core issue basically comes down to one thing... the fact that neurological conditions are diagnosed almost EXCLUSIVELY by what's observable.
In other words... by behaviors diagnosticians can actually see... or what someone reports about their experiences that the diagnostician can tie back to something observable.
But, by definition, neurological conditions happen in the brain. That's what "neurological" means.
Everything else is downstream.
Not a single observable behavior *is the condition itself.*
They are all SIGNS of the condition... MANIFESTATIONS of the condition... but not the condition itself.
Because, again, the condition IS the brain wiring.
But it gets even more complicated and confusing when you think about neurodivergence through the lens of needs.
What are autistic needs?
What are ADHD needs?
What are OCD needs? Etc
There are actually three aspects to this that I have never seen anyone talk about in the way I'm about to...
There are 3 types of needs...
1. First level needs... what the actual condition directly causes a person to need.
Example... sensory needs. This is happening in the brain. Sensory inputs are routed differently in autistic brains, for example.
This need shows up in the form of behavior, but the behavior is not the need.
The need is what happens IN THE BRAIN when a person's brain wiring interacts with the world.
In other words, the interaction between the brain wiring and the environment CREATES the need.
Example...
A sensory need can cause a person to stim or to wear specific types of clothing. Which are observable behaviors. But the stimming and specific clothing (behaviors) are actually manifestations of what the brain needs in the context of its environment.
The NEED is how the brain's sensory wiring impacts a person in their own brain and body... and the BEHAVIOR is the stimming and clothing choices.
Now, before I get to the next level need, it's important to note that with first level needs, the observable behaviors don't show up as distress if the needs are regularly met. You'll see why this is important in a minute.
2. Second level needs... what BECOMES a need once that first type of need goes unmet. This is downstream from the original need.
Example... the need to not be overstimulated. The need to not be misunderstood. This need shows up AFTER a first level need goes unmet.
Now, this type of need also shows up in the form of behavior, but this is where *distress* shows up.
This is where unmet needs turn into VISIBLE distress and meltdowns.
(They also show up internally in the form of emotional distress, like anxiety, but you can't observe that.)
A person with a neurological condition may never display any sign of this second level need if their first level needs are always met.
It's impossible to know how common (or uncommon) it is for a neurodivergent person to have all their needs met all the time based on what we know about neurodivergence today, but I do believe it happens.
And I believe it explains why some formally diagnosed autistic people don't feel disabled by their autism.
(Which I have seen show up relatively frequently in online autism spaces. And, unfortunately, dismissed and invalidated, but that's a post for another day)
But back to the topic at hand...
3. Third level needs... what BECOMES a need when unmet needs *remain unmet* for extended periods of time.
This is even further downstream. This is where the neurological needs turn into physical ones that are extremely harmful to a person.
Example... sleep issues, stomach issues, cardiac issues, suicidal ideation... and more.
These are all needs... but they are different from first and second level needs.
They are observable MANIFESTATIONS of first level needs going unmet *for extended periods of time.*
If you address a person's underlying first level needs, this level of need should significantly minimize, if not go away completely.
(At least, as it relates to a specific underlying condition. It can get a lot more complicated if there are co-occurring conditions in the mix.)
The problem is, most people seeing the second and third level needs don't realize that those needs are actually manifestations of underlying unmet needs. They often misconstrue them as the condition itself.
Which causes them to focus on the surface level, observable issues rather than addressing what's actually causing those issues in the first place.
And if all you do is try and solve the surface level problem (like giving an autistic person anxiety medication when their anxiety is being caused by underlying first level autistic needs)...
The surface level issue will very likely persist indefinitely, and the person will likely live their life never getting the relief they desperately need, and very much deserve.
And THIS is where I think neurodivergent education and awareness needs to go.
And where I think the field of psychology and psychiatry needs to go... and evolve.
Because though observable signs of neurological conditions are a CRUCIAL aspect of helping people who are ALREADY struggling, even suffering in many cases...
Understanding the underlying brain wiring is how we PREVENT people from getting to that point in the first place.
And everyone deserves a life free from chronic distress, pain, and unnecessary suffering if we, as a society, can find a way to make it possible.
And I believe with every fiber of my being that we have the capacity to make this existence possible for neurodivergent humans.
We just need to see the big picture for what it is first.
And I think this... is it.