48: The Hidden Fees of ADHD and Autism

There are overlapping levels of hidden fees of ADHD and Autism for adults that largely remain unrecognized. If you thought most challenging phase of life was the “not knowing why I’m suffering” phase, be prepared. One of the bigger obstacles to overcome is the continual discovery of new hidden financial, physical, mental, emotional and vocational expenses of being an adult with ADHD and/or Autism. The only thing more costly than the coping mechanisms and compensatory self-soothing is the painful awareness of the numerous parts of daily life that require extra effort to maintain.

WELCOME BACK TO ANOTHER EPISODE OF YOU DON’T SOUND AUTISTIC WITH BLAKE AND RACHELLE. BLAKE IS AUTISTIC. RACHELLE IS NOT.

You Don’t Sound Autistic is a mental and emotional health awareness podcast. Each week we do our best to represent both neuro-perspectives and talk about the continual discovery process of life on the spectrum. Our goal is to illuminate, uncover and transparently discuss life with multi-diagnosis and through a multi-generational neurodivergent lens.

After reading this summary, listen to the podcast to hear additional insights and stories told only on the podcast.

The Hidden Fees of ADHD and Autism (2:33)

The world we live in built with thousands of neurotypical assumptions in the areas of executive function (planning and organizing) and social capabilities. Areas of daily life that require self-representation during interactions with businesses (both as a consumer and potential employee) assume a high baseline largely unwritten rules for communication, responsiveness and urgency. Some of these expensive categories include:

Forgetfulness
Impulsiveness
Missed opportunities due to mis/under interpreted social cues
Punitive (late fees on paying bills)
Financial impact created by lack of social confidence to seek higher paying jobs
Health/prescription insurance
Disability/services eligibility

Hidden fees of Cleaning: 80% Decision energy / 20% Doing energy (5:06)

(Emotional & Physical Fees) Every object and idea in our home needs a place to live. Sometimes we gather more things, clothes or ideas at home than we have space for permanently. Often times, we receive an influx of gifts, mail or collateral from work or family members that wasn’t intentionally acquired and now demands your attention. Surprisingly, the larger objections to cleaning is about the effort needed to make the decisions below and less about moving to do it.

“Do I need to keep this or can I trash it?”
“Is this an (unexpected) opportunity that I’m going to take advantage of right now?”
“Do I want to keep this or can I let go of this idea/thing/opportunity and focus on my current projects?”
“If I keep this, where will it live permanently?”
“Do I need to clear out space before I can find a permanent home for this?”
“Do I need the physical thing or can I better manage it digitally?” (won’t apply to everything)

We are NOT expected to have answers for everything immediately. Sometimes we do need to hold onto things and let the decision making process play out. Sometimes we hold onto things for fear that as soon as we let them go, we’ll need them creating (financial & physical fees) additional cost for replacements.

Designate an area for “Decisions In-Process (DIP)” using a wicker or decorative baskets.
Put it somewhere that can be easily seen and not hidden or covered.
Make a practice to go through it from time to time, revisit the questions and transition what you can.
This process requires you to ask yourself questions and sit with the silence while you calibrate to your answers. With practice, you’ll gain confidence in your evaluation process and your answers.

Hidden fees of too many changes at once (6:07)

(Prioritization, Mental and Emotional Fees) It’s important to put a reasonable boundary around the quantity of change you’re dealing with at any given time. There are times where life won’t give you those options but when it does, KNOW YOUR OPTIMAL LIMITS. This isn’t a restriction, it’s an optimization. Trying to process too many decisions or changes at once will feel like a threat and could bring the whole house of cards down at once.

Feeling Panic: “I have to drop everything and do what you asked me right now”
- Compensation For: ADHD poor short term and working memory. Fear of forgetting.
Feeling Pressure to follow up: “Did you complete ‘x’ yet?” and then asking again 20 minutes later.
- Compensation For: ADHD Zone Momentum aligning your short term energy with task completion.
Feeling Anger: “I need you to drop what you’re doing and do this for me right now”.
- Compensating for: Impact of waiting for another person to tag-team a task that might destroy your AHDH Zone Momentum.
Feeling Overstimulated: “Too much sensory/mental/emotional input is hitting me at once. STOP!”
- Compensating For: Sensory differentiation challenges due to sensory overload.
Feeling Loss of Control: “I’m feeling pushed out of my comfort zone and disconnected my from routine.
- Compensating For: Emotional distress caused by the threat of the unknown. Feeling alarmed.

Hidden fees of visual-based reminders (6:58)

(Organizational, Mental and Emotional Fees) It’s OKAY to want your Everyday Life Items (ELI’s) for hobbies, supplies and regularly used items out where you can see them. It’s okay to create spaces for these things to live outside of fully enclosed drawers. The challenge becomes when you’ve blended your DIP (Decisions In-Progress) items with your ELI’s into one big never-moving pile and you can no longer remember which is which.

Helpful Spaces to Create:

Remember Me Basket – For the things you need visual reminders about:
- Keys, Sunglasses, empty gum containers that need to be replaced. Practice using it daily to reinforce.
Remember Me Whiteboard or Monthly Planner – For information you need to write out and re-read often
- Scheduled appointments, Bill pay reminders, new goals or ideas that you want to remember
Decisions In-Progress Baskets: For paper (mail, invitations, sales) For ideas you haven’t made a decision about yet. Avoid baskets with lids as this will hide the contents and increase forgetfulness (trust me).
Habit Tracker Calendars which can hold multiple habit reminders in one place for an entire month

Hidden fees of hiring help & communicating boundaries (8:55)

(Mental & Emotion Fees) While we can hire people to walk our dogs and clean our house, anytime we invite someone into our inner space it can feel overwhelming and even threatening. Your life is not designed with typical household assumptions for where things go or how you like processes to be completed.

Things to consider while considering hiring help.

Maids: Can you clearly articulate how and where your belongings go to reduce guessing and misplacing?
Maids: Which areas of the house are okay to clean and to what extent (e.g. vacuum floors only)
Dog Walkers: Where do you want the dog leash returned to and what’s the process for post-walk water?
Generally: What are my expectations for where things go, how things are used, cleaned and put away?

Hidden fees of creating routines (9:22)

Routines are incredibly helpful for providing structure for the repeating daily tasks. However, routines are costly to your daily assessment process. Meaning, once a routine is set, our mental and emotional neuropathways dig in and build neuro-highways that fast track physical and mental movement through a series of pre-determined sequenced steps. There is no room to deviate based on how you feel that day or consider any unique scheduling requirements that you have to account for (like appointments, errands or social engagements).

Routines create an autopilot muscle-memory response that can be both helpful and inflexible. Try this instead:

Habit Tracker Calendars: Space for multiple tasks that allow you to customize them month to month
Energy-Paced Strategies: Instead of one rigid routine, try 2-4 strategies that maximize your energy flow
- Low Energy Days: Daily care + rest, read, relax, catch up on sleep, hot bath, or play music
- Mid Energy Days: Daily care + quick easy errands, laundry, pick up house, get organized, or be social
- High Energy Days: Daily care + workout, clean house, trim the yard, or tackle the bigger projects

Hidden fees of cluttered living spaces (13:30)

Clutter may feel insignificant but in fact, it’s quite the opposite. Clutter can quickly, silently and continuously trigger a low-grade Fight or Flight response by creating excessive visual, olfactory and tactile stimuli which overwhelm the processing centers of the mind. (1)

Clutter grows in piles which adds to frustration when finding keys, wallets and items needed everyday
- Remember Me Basket – For the things you need visual reminders about
Clutter increases irritability and decreases our ability to relax (physically, mentally and emotionally)
Clutter creates time/energy/planning distractions.
Clutter increases our visual numbness to the piles of indecision.
Clutter creates or exacerbates anxiety for numerous reasons:
- Fatigue: How much energy is it going to take to clean this?
- Panic: Am I going to find something I forgot to take care of and now I’m facing a penalty
- Guilt: I never should have let it get this far
- Shame: I’m a messy person and don’t have the energy to fix it and keep it clean
- Defeat: I give up. It’s too much. I’ll never get better at this and I’ll always struggle.
Clutter overpowers creativity by taking over the open spaces that allow us to visualize new ideas.

Hidden fees of hygiene avoidance (14:26)

Our Behavioral Immune System is a combination of our psychological processes (that trigger us to notice infection risks) and behavioral impulses (from emotions, cognitive memories, social perceptions) to follow through with hygiene routines. When our behavioral immune system has become maladapted (behavior that prevents you from making adjustments in your own best interest) there are consequences (2):

New or worsening fear of social rejection due to hygiene appearance or odor
New or worsening overspending to buying various potential hygiene products and not returning them
New or worsening social isolation to avoid negative or rejection-based feedback
New or worsening self-image and self-esteem due to lack of feeling uncared for or inferior
New or worsening sensory sensitivities due to firing and wiring sensory avoidance neuropathways
New or worsening physical infection or disease due to bacterial, fungal or viral growth
New or worsening anxiety and/or depression due to lack of movement and mental engagement

Hidden fees financial overwhelm (16:56)

(Mental, Emotional and Financial Fees) Yes, we’ve made daily life easier with online technological advancements in bill pay, auto pay and payment reminders through email and text. But now we’re in reminder overwhelm and payments can STILL get missed.

Payment Notification Overwhelm: Too many emails and texts to read and take action
Short-Term Memory Signups: Starting a new service without integrating usage into daily life
Buried Late Fee Reminders: Too many marketing emails hides important messages
Financial Penalties: Late fees, Overdraft fees, Service interruption and reactivation fees

Financial Impowerment Solutions

Money Management Software
- Quicken (Online & Desktop Applications)
  - Features: Automatic transaction integration with major banks and credit card companies, Bill Pay projections, Budget Management, Loan Payment Planning and more
Financial Management Services (free with upgrade options)
- Truebill now Rocket Money
  - Features: Managing Subscriptions, spending insights, bill negotiation, autopilot savings, credit scores, and budgeting support

Hidden fees of living in chronic fight or flight (18:09)

(Physical, Mental & Emotional Fees) Living in chronic alarm in the brain can cause “Stress System Malfunction” and lead to (lifestyle and) life threatening disease (3) While we need our stress response to detect threats from our environment, social settings and new or worsening illnesses, our bodies are to downregulate from the stress response of the sympathetic nervous system (SANS) and to return to restful, regenerative processes managed by the parasympathetic nervous system (PANS).

Failure to downregulate keeps the body living in a chronic stress response which can put us at risk for many various physical, mental and emotional diseases and disorders and trigger changes to our gene expression:

Hormone Dysregulation (Stress triggers release of corticotropin-releasing hormone (CRH))
Adrenal Fatigue
High Blood Pressure
Insulin Resistance
High Cortisol (can lead to belly fat)
Digestive Issues
Obesity
Heart Disease
Cancer
High cholesterol and triglyceride levels
Dysfunctioning mood, motivation, memory formation, temperature, appetite and pain regulation
Dysregulated growth, reproduction, metabolism and immunity
Threat Hypersensitivity (Threat detection system perceives minor sounds and movements as threats)
Trauma-sensitivity (triggers trauma response to smaller stimuli or news of events happening to others)
Anorexia nervosa, malnutrition, obsessive-compulsive disorder, anxiety disorder, alcoholism, substance abuse, and hyperthyroidism
Insomnia, ADHD, major depressive disorder, narcolepsy and bipolar disorder especially when onset occurred during childhood
And more…

Hidden fees of neuropsychiatric evaluations (24:24)

(Financial, Emotional and Mental Fees) Deciding to seek an evaluation and confirmation of suspected diagnosis seems like the most challenging part of the process. I wish it was. Sadly, finding an evaluation provider that has opening and prices their services within your budget are also big obstacles. Assuming you make it over those hurdles, the most challenging part is the waiting.

Waiting Time: Managing anxiety between scheduling and arriving for the appointment (weeks to months)
Symptom Waves: While waiting, symptoms can intensify and/or reappear
- Try to use these waves to record how you feel, when the waves start/stop and what works/doesn’t
Cost of Treatment Plan solutions: Out of pocket medications and/or nutritional supplementation
Waiting Periods:
- Time for medications to titrate up to reach full dose potential or down to ween off and change meds
- Time to allow natural supplementation to work (less side effects but may take longer)
Additional Required Testing: lab work, scans, written or verbal testing or questionnaires
Required Provider Follow-up Appointments: To manage medication, review progress or new symptoms
Emotional Management of the Diagnosis: Confirmation may be difficult to accept at first
Emotional Frustration of Unexpected Diagnosis: We don’t always receive what we expect to receive
- Expectation-based individuals can feel truly traumatized by receiving different results than expected

Hidden fees of sleep debt or not sleeping (27:27)

(Physical, Mental, Emotional & Motivational Fees) As of 2006, its estimated that 50 to 70 million Americans suffer from sleep and wakefulness disorders, of which there approximately 90 sleep disorders. Sleep evaluations are the most common yet alarmingly, the most frequently overlooked and treatable disorders. Sleep debt disorders blend and mask physical, neurological, psychological and emotional causal factors that can result in incorrect or incomplete medical/mental health diagnosis. General sleep disorder symptoms include:

Excessive daytime sleepiness
- Decreased concentration, increased mood changes, low frustration and transition tolerances
Difficulty initiating or maintaining sleep
Abnormal events occurring during sleep
- Abnormal movements, behaviors, and/or sensations

Sleep research can now confidently link wide-spread and deleterious health side effects like:

Anxiety symptoms up to (GAD) generalized anxiety disorder
Increased irritability and decreased emotion/mood regulation
Increased risk of (MDD) major depressive disorder
Increased risk of high blood pressure
Diabetes and impaired glucose tolerance
Obesity (adults & children)
Increased risk of cardiovascular disease (Heart attack and Stroke)
Substance Abuse (to initiate sleep)

The consequences of the most common sleep debt deficits continue to manifest into considerable risk factors and comorbidities. These can include:

Sleep Loss
Insomnia
Narcolepsy
Parasomnias
Sleep-disordered breathing
- Snoring, apneas and hypopneas

Restless Leg Syndrome
Sleep-related psychiatric disorders
Sleep-related neurological disorders
Sleep-related medical disorders
Circadian rhythm sleep disorders

The most alarming aspect of sleep debt is that most physicians omit asking questions about sleep and neglect sleep debt and quality of sleep answers as consideration factors while treating other reported medical/mental health issues. (4) As a result, a nearly 80% of adults with sleep debt disorders remain undiagnosed. You’ll understand why we at YDSA believe in asking about sleep first.

Hidden fees of living in stagnation (34:20)

(Emotional, Mental and Physical Fees) Newton’s Law of Motion is simple. A body in motion remains in motion; a body at rest remains at rest, unless acted upon by a force. Both resting and motion are vital parts of optimal human performance. Sleep, repair and rejuvenation require a resting period within each day in order to run its functions. Once the repairs and renewal processes are complete, we are designed to initiate a new day of motion and motivation.

Stagnation is a state or condition marked by a lack of flow, movement or development. Living in stagnation means living without inflow and outflow. Stagnation can be the result of blocked input/output contributions and can look like many things:

muscle tension/injury
emotional avoidance
thought/feeling loops
trauma loops
trauma bonds

hyperactive threat-seeking behaviors and environments
hyperactive freeze-seeking behaviors and environments
refusal to learn new ideas, view points and causal information
refusal to try new foods, stimuli and relationships
refusal to resolve and release physical pain and trauma

We don’t intend to throw our lives into stagnation. It happens as a result of many smaller pauses and protections that accumulate and grow into muck and stuckness. We may feel the need to clamp down and protect ourselves physically (soft tissue/muscular restrictions), emotionally (avoidance or anger triggers), or mentally (dismissing or denying different information). This becomes a co-triggering lack of movement that leads to indecision and decision-avoidance.

Hidden fees of applying for new jobs (35:40)

(Emotional & Financial Fees) An object in motion will stay in motion unless acted upon by greater force. Once again Newton’s Law of Motion is gravitational. Once you’re in a job, you create an orbit that rotates around your internal motivations and energy stores that manages your ability to get through each day. Each day you complete an orbit, neuro-biological highways are built making it easier for you to cycle through tomorrow’s orbit with less brain power and more muscle/thought memory.

The challenge comes when you want to change the orbit of your current job and upgrade to a new, better-fitting orbit, position, company and/or industry. From within your internal powers, motivations and energy stores, you have to generate a force LARGER than the the groove of your current habits and established job.

Here’s a realist list of the ways you have to muster up the strength to improve your vocation or job:

Decide that you’re unhappy enough to make a change
Self-evaluate your current skillset and dream job
- LEARN NEW SKILLS OR GO BACK TO SCHOOL as needed (financial)
Update your resume, online resume profile(s) and coordinate with sites like Indeed
Dedicate time and space to search for industries/companies/positions fitting your experience
Navigate the online application process either through broker sites like Indeed or their direct site
Allow yourself to feel excited and hopeful, utilizing your feelings as gauges for interest levels
Respond and coordinate interview date/times
Prepare for interview with questions and basic knowledge of the company
- REMEMBER: YOU’RE INTERVIEWING THEM TOO!
Be your best self in the interview and wait for their responses.
Repeat until you’ve achieved a new job that you’re excited about.
If needed, move to be closer to the company. (financial)
Start training and learn all the new:
- Company rules, culture, pay structure, performance expectations, unique goals and challenges
- Work hours, work environment, co-workers, supervisors, lunch options, driving route…

No wonder most people wait until they’re in so much emotional or mental pain in their current job/company before making a move. Many people find the energy and motivation to tackle this mountain by throwing themselves into extreme Fight or Flight to conjure the strength, determination and urgency to change jobs.

Hidden fees of mustering extra will-power (39:19)

(Physical & Emotional Fees) When you have a particularly stressful day, you burn more of your internal resources like vitamins, energy and emotional bandwidth. While we may have the ability to conjure up extra will-power, it often comes at the cost of tomorrow’s experience.

Instead of trying to borrow tomorrow’s energy and motivation, the most effective way to create extra will-power is to nourish our physical, emotional, mental and motivational energy through food, gratitude and regenerative sleep.

Energy-Regenerating Elements

Sleep
Gratitude
Methylated B-Complex (water soluble)
Magnesium
Omega 3’s (Brain Food)
Proteins
Antioxidants + N2F2 Activation
Zinc & Copper
L-Tyrosine
GABA, L-Theanine, 5-HTP
Vitamins A, C, D, and E

Energy-Zapping Elements

Stress
Anger
Sugar
Gluten
Dairy
GMO foods
Processed foods
Preservatives
Artificial sweeteners
Bad Fats
Alcohol & Substances

Hidden fees of learning about ADHD and autism(40:53)

(Emotional & Financial Fees) Deciding to engage in learning, opening your heart and mind to consider the unknown and thoughtfully pondering how new information applies to you can in-and-of itself feel threatening. The vulnerability to admit you don’t know everything can feel weakening and submissive. It takes bravery to willingly embark on a learning journey.

Just a Few Top Recommended ADHD Books:

Just a Few of the Top Recommended Autism Books:

Hidden fees of ADHD’s RSD vs. RSE (43:32)

(Mental, Social & Emotional Fees) The dynamic polarity of ADHD can create emotional whiplash for both you and you social circles. The hairpin trigger of Rejection Sensitivity Dysphoria (RSD) can keep your threat detection system on high-alert and over-perceive comments, movements, sounds and immediate spatial spaces as threats. You can feel legitimately shattered by constructive feedback when anything less than perfect feels bad.

Contrastly, Recognition Sensitivity Euphoria (RSD) is the ability to feel highly motivated by small moments of praise. This motivation can manifest like an satiable drive to have to have perfect attendance or tackle nearly impossible feats like completing back-to-back marathon accomplishments. Or walk 10,000 steps a day so your health insurance company can give you a star in their app.

Opposite expressions may present like:

Self-perceived imperfections feel threatening vs. Self-perceived goals motivate action and rewards
Problem-solving collaboration becomes a contest vs. Independent crisis problem-solving feels validating
Listening to another’s day and feelings is triggering vs. Sharing your day in detail feels like connecting.

Hidden fees of neglecting to give or recognize praise (46:25)

(Mental, Emotional and Hormonal Fees) Remember Neuropsychologist Donald Hebb and his famous Hebbian Law. When neurons and cells fire together they wire together. Said another way, when you repeat an experience over and over, the brain learns to trigger the same neurons, neurotransmitters, neuropeptides and hormones each time.

It starts as infants. We asses our environment to determine if we feel safe, loved and wanted. If we don’t, our threat-centers activate and become our filter, our lens through which we see the world.

We grow up to think and feel in self-fulfilling loops that can look like:

Immediately doubtful, dismissive or skeptical of praise
Socially uncooperative as collaboration feels like interactions with strings attached
Constantly negative about outlook and opportunities, like trading subpar “this” for crappy “that”
Automatically motivated to mask yourself to avoid the potential for someone to find fault with you
Inability to distinguish intuition from fear

Instead of allowing your mind run away with thoughts, accusations and blame, learn to listen to the things you’re saying to yourself. Notice how you feel when you catch yourself silently ranting. Is your narrative negative?

Hidden fees of giving/receiving constant corrections (49:10)

(Social, Mental, Emotional, Vocational Fees) Have you ever know that co-worker, friend or family member that seems to search for every little thing that is/might be wrong? Have you noticed how much energy is spent proving that they are right and everyone else’s way is worse, stupid and just wrong? Do you find yourself feeling worthless and always on the defensive? It’s a viscous cycle and another example of Hebb’s Law.

Listening with a threat-center filter demands that everything in life is a threat without actually considering the input. Deflecting, blaming and shaming become your greatest skills. Neuro-biologically, we can’t defend threats and heal from injuries and stress at the same time. Pick your pathways wisely.

Repeat the behavior you want to keep. Observe and refrain from the behavior you don’t want.

Self-reflection feels like a threat; Denial and deflection feels safe
Inability to receive a compliment and/or belief positive feedback
Belief that picking up a new skill should be immediate. Respond with self-injurious inner dialogue
Mental and/or emotional thought-based self-punishment cycles
Avoids self-rewards (gravitate towards sugar or dietary dopamine triggers)
Sluggish reward recognition system (requires big jolts of positivity before allowing a positive feeling)
Lack-mentality focuses on what you don’t have instead of what you do have

Hidden rewards of self-reinvention during life crisis & change (59:22)

(Self-Esteem, Self-Advocacy and Self-Impowerment Rewards) Finding the formula that helps you break down heavy and alarming thought/feeling loops starts with recognizing when in Defense Mode (Fight, Flight or Freeze) and understanding which lens you see the world through. Learning to fire and wire your brain towards self-recognition during a crisis is the best way to take control of your experience.

Crisis creates opportunities to engage with threats again to see how much of a gain we’ve made in identifying our own threat filters. The fight-flight-freeze defense mode limits our perspective and convince us we’re right. Disarming your defense mode will lead to new thoughts and feelings like:

I can see both sides of the argument
I can see the past origins and the developmental future of improvements
There are multiple ways to get to a right or healing result
Your feelings are as valid as my feelings
I can feel when my anxieties and fears hit my panic buttons
I can observe and remain neutral; then respond differently
I can evolve the way I interact with stressful situations, thoughts and feelings

The momentum of crisis is too great to change in the moment. However crisis also paves the way to harness the power of change to fuel self-discovery and reinvention. We’ll continue to explore these topics and more!

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References:

(1) Bourg Carter, Psy.D. Sherri, 2012, March 14, Stress, Why Mess Causes Stress: 8 Reasons, 8 Remedies, www.psychologytoday.com

(2) Schaller M. The behavioural immune system and the psychology of human sociality. Philos Trans R Soc Lond B Biol Sci. 2011 Dec 12;366(1583):3418-26. doi: 10.1098/rstb.2011.0029. PMID: 22042918; PMCID: PMC3189350.

(3) NIH News, 2002, Sept 9, Stress System Malfunction Could Lead to Serious, Life Threatening Disease. National Institutes of Health Communications Office.

(4) Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 3, Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19961/