More about Highly Sensitive People, Autism, ADHD, and Other Neurodivergences

I just got a wonderful comment from The Autlaw disagreeing with my recent post, Unpopular Opinion: “Highly Sensitive Person” is More than Just Autism.

That led me to edit the post a bit. I added a little more historical background to clarify what Elaine Aron has said and why it’s objectionable.

My post also didn’t discuss The Autlaw’s problem with the HSP label, so I’ll do so here.

I didn’t discuss the fact that the HSP label can be misused, by people other than Elaine Aron. People who don’t yet know they’re autistic (or otherwise neurodivergent) can use it to explain away their differences, then fail to look deeper. “There’s nothing wrong with me, I’m just highly sensitive and people don’t understand me,” they might say. The Autlaw describes their own experience doing just that. They appeared “normal enough” because they spent all their energy “masking” (hiding their differences). They used the label HSP to explain away what differences remained, and overlooked the possibility they might be autistic. Then, they burned out. The Autlaw warns that it’s tempting for undiagnosed, masking people to use the HSP label to deny any difficulties, but it hurts them in the long run. That’s an important warning to make, and I agree!

However, any label can be misused; that doesn’t make it illegitimate or bad. I don’t think there’s anything intrinsically wrong with the “Highly Sensitive Person” concept, so long as we recognize that it can apply to autistic and other neurodivergent people. What’s ableist is to be like Elaine Aron and deny that autism has positive aspects. What’s ableist is to assume that, because we have positive experiences with sensitivity, we can’t be autistic (or otherwise neurodivergent).

I’d also like to point out that:

  1. Autistic people aren’t the only neurodivergent folks who mask.
  2. Not everyone has the same experiences with the HSP label. I discovered HSP 2 or 3 years before I had reason to look deeper. When I “hit the wall” — in a situation where I could no longer hide or compensate for my ADHD — I didn’t even think about the HSP label. It certainly didn’t prevent me from seeking out a diagnostic evaluation.
  3. I’m sure you’re familiar with the property of logic that “all A’s are B” does NOT mean “all B’s are A.” For example, the fact that all hats are clothes doesn’t mean that all clothes are hats. Similarly, even if all autistic people are HSPs, it doesn’t follow that all HSP’s are autistic.

On the subject of my own flavor of neurodivergence, I normally wouldn’t deign to argue about it, but since I brought it up in the first place: yes, it’s theoretically possible that somehow, over 10+ years, I and so many other people have gotten it wrong and I’m really autistic. After all, adult women are often overlooked and misdiagnosed.

And, if that were true, it would be fine. I wouldn’t love being subject to autism stigma, but would appreciate the connection with autistic people.

However, most people who are undiagnosed or misdiagnosed aren’t observed by that many people with that many different perspectives and types of training, over that many years, for that many different reasons. A couple of these professionals were even neurodivergent themselves. Almost all of them interacted with me regularly for several years.

Most people who are undiagnosed or misdiagnosed are new to the concept of neurodivergence. I have spent almost 15 years now researching various neurodivergences from both first person and research perspectives.

It’s much more parsimonious and likely that I am not autistic according to existing definitions.

Now, on to the interesting part!

Do you really believe that about 20% of the human population (and other animal species) is autistic? That would mean there are 10 times as many people masking as are currently known to be autistic. That seems unlikely to me, though I suppose it’s possible.

Isn’t it more likely that HSPs have other neurodivergences, too? Or even that HSP is a neurodivergence, itself?

Autistic people have always driven the neurodiversity movement, so much so that disability advocates tend to forget that there are many types of neurodivergence. Everything isn’t autism. The image I made below shows 10 brain-based disabilities that could overlap with high sensitivity — and it’s not a complete list. (For example, I couldn’t fit migraines, a neurological disorder, or developmental language disorder, once known as Specific Language Impairment).

PowerPoint Venn diagram titled, “There are many kinds of neurodivergence which could overlap with high sensitivity.” A big circle labeled HSP is overlapped by 10 smaller ovals with the titles Anxiety, Depression, cPTSD, Traumatic Brain Injury (TBI), Epilepsy/seizures, Stuttering/Stammering, Tics, Dyspraxia/DCD, Dyscalculia, and Dyslexia. Group sizes and amount of overlap are NOT shown to scale.
Figure made by Mosaic of Minds in PowerPoint. Please do not recopy without credit.

How many dyslexic people are HSPs, and vice versa? That’s an empirical question — one requiring measurement of large, diverse populations of people.

My post is mainly about autism and ADHD, specifically. My best understanding, given the data I have, is that the population overlap looks something like the image below:

A PowerPoint Venn diagram showing a large blue circle representing HSP, a medium yellow oval representing ADHD, and a small red circle representing autism. The autism circle is almost completely within the HSP circle. The ADHD oval is more than half within the HSP circle. Most of the autism circle overlaps with the ADHD oval. A lot of the ADHD oval is within the autism circle.
Figure made by Mosaic of Minds in PowerPoint. Please do not recopy without credit.

We know that about 20% of people are HSPs, 2% are autistic, and about 10% are ADHD. The question is, how do these groups of people overlap? The above is my best guess.

Notice that autism overlaps mostly — but not completely — with HSP, because there are people who would claim to be hyposensitive.

ADHD overlaps significantly with HSP, but not as much as autism does with HSP. At the very least, those of us who tend towards impulsivity don’t “pause to check” and do a lot of the processing after the fact.

Then, of course, there’s the relationship between autism and ADHD, which we know is substantial but not complete, and it’s uneven — there are more autistic people with ADHD than ADHD people who are autistic.

Notice that there are people who are ADHD, HSP, and yet not autistic. Maybe quite a few of them.

Again, it’s an empirical question. But, given the size of the autistic, ADHD, and HSP population, I’m unlikely to be the only one.

What is so bad about the idea that HSP is a way of being neurodivergent?

PowerPoint Venn diagram titled “Hypothesized relationship between HSP, non-Highly Sensitive, and Neurotypical.” A blue circle is labeled “Highly sensitive = 20%.” A gray circle is “Not highly sensitive = 80%.” Most of the gray circle is filled with a yellow circle, labeled “Neurotypical = ?%”).
Figure made by Mosaic of Minds in PowerPoint. Please do not recopy without credit.

What is so bad about the idea that HSP can be autism…or ADHD, or PTSD, or traumatic brain injury, or SPD, or dyspraxia, or dyslexia…etc.?

What is so bad about acknowledging that HSP can be more than just autism, so long as we understand that being highly sensitive is compatible with having a disability?

Thanks for helping me think through this issue a little more clearly and explain it better!

Loved this story? Hated this story? Got tales of your own to share? Tell me all about it at Mosaic of Minds’ current home on Substack.



Mosaic of Minds and Other Musings

Emily Morson explains research on neurodivergent brains through the lens of cognitive neuroscience, SLP, & lived experience.