Short Stuff: Trauma and Personality

Following on from last week I'm going into why some neurodiversity isn't genetic. How childhood trauma can shape a brain in ways that look a lot like neurodivergence and why so many people get handed the wrong diagnosis.

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Well, hello and welcome to your Friday five minutes. Bit of a meaty one today. 'cause it follows on from last week's short stuff episode, which was about neurodivergence, ADHD, autism, that sort of thing. And how a lot of the mental health struggles that come with it aren't really coming from the brain itself. They're coming from the mismatch between that brain and a world that wasn't built for it. And I left a bit out deliberately 'cause I thought it deserved its own space. And that's trauma. Because the brain doesn't stop developing the moment you're born. It carries on developing for years, if not for life. But in those really early years, it is incredibly responsive to the environment it finds itself in. So if a child grows up with chronic neglect or unpredictable caregiving, or never quite knowing if today's a good day or a bad day with the people supposed to be keeping them safe, the brain adapts to that. It has to. And then later on in life, that can look remarkably similar to ADHD or autism. Trouble with attention. Because a brain that grew up scanning for danger never learned to switch the scanning off. Trouble with emotional regulation. Because nobody was there to help regulate the big feelings when they were small. Sensory overwhelm. 'cause a nervous system that's been on high alert for years doesn't have much spare capacity for filtering anything out. And this is where diagnosis gets messy. What you get diagnosed with can depend an awful lot on who is doing the assessing, what they're trained to look for. And there's a well-known pattern, particularly for women where undiagnosed autism or ADHD often alongside trauma, gets diagnosed instead as borderline personality disorder or emotionally unstable personality disorder, which I think is only a very slightly better name. But if I'm honest, neither is brilliant. And the reverse happens as well. Real trauma getting waved off as just anxiety or just depression and the actual shape of what's going on is missed entirely because the label that gets reached for is whichever one the assessor is most familiar with. Which means for a lot of folk, the diagnosis they've carried around for years might say more about their assessor than what's actually going on for them. One thing worth mentioning about borderline is that it often involves an intense sensitivity to abandonment and signs that somebody's pulling away. And there is research showing that this isn't just being a bit sensitive. When researchers look at brain activity during social exclusion experiences, the areas involved in emotional regulation light up far more strongly in people with borderline. There is a genuine measurable difference in how the threat of rejection gets processed in the brain. You might have been simply ignored, but your brain is gonna react as if somebody's just set fire to your dog. And it's not through choice. This is totally unconscious. And interestingly, studies following people whose symptoms have eventually gone into full remission 'cause of a lot of work and therapy that still shows that heightened sensitivity to rejection is still there. It might be there for life to some degree. An alarm system permanently calibrated a bit more sensitively 'cause of what it learned to expect very early on in life, which starts to sound a lot like something we talked about with autism and ADHD because the work there isn't to become neurotypical. It's learning that your read of a situation might genuinely differ from everyone else's and learning to hold that gap rather than trusting the alarm blindly. And I wonder if something similar applies here, not switching the alarm off completely, 'cause that might not be realistic, but learning to recognise when it's going off and that it going off doesn't necessarily mean what it's telling you is true right now. Obviously, I go into a lot more about this on the full episode over on Patreon, including where personality disorders might or might not fit under the Neurodivergence umbrella, which honestly, even experts don't agree on. So if any of this rang a bell, that's where you'll find me every single week. I'll leave you to it. Look after yourself this weekend. I'll speak to you soon.