Connections ��A Neurodiversity-Affirming Approach to Suicide Prevention

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By Jennifer Gerlach, LCSW

Before We Begin

• What I share is a single perspective based on my experiences and a survey of research

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• My perspective is one of millions

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• I trust that you also have a perspective and look forward to learning from each other

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Who are you people? ☺

Who am I and Why do I Care About This?

Everyone is Neurodiverse�Not Everyone is Neurodivergent�����Neurodiversity undermarks differences in thinking and perceiving the world

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Neurodivergent individuals have a brain that is wired differently

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Research shows that autistic individuals and ADHDers show different

“neural signatures” or patterns of brain activity when in the default mode

Neurodiversity

Sort of Like Wolves and Foxes

• In ways, being neurodivergent is like being a wolf in a world designed by and for foxes, which makes one vulnerable to
• Attenuated Stress
• Misunderstanding
• Social Isolation
• Not Living up to one’s potential

Double Empathy

• Double Empathy: The Phenomena When Individuals Struggle to Understand Each Other Due to Different Ways of Experiencing the World

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• Often When Misunderstanding Occurs We Call it a “Skills Deficit” On Behalf of the Neurodivergent Person but it’s Not

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• Neurotypical People Struggle to Understand Neurodivergent People as Much as Neurodivergent People Struggle to Understand Neurotypicals

To hide….

• Often neurodivergent people will hide their neurodivergent traits as a way to relate (masking)

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• Research shows that this masking/camouflaging behavior is linked with lower levels of self-esteem, higher depression and worse anxiety (Evans et al., 2024)

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• A person might begin to forget who they are as opposed to the mask

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• Masking makes it difficult to relate to others in an authentic way

Risk Factors

• Hopelessness and Isolation are Key Risk Factors for Thoughts of Suicide Across Populations

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• Neurodivergent People are at Heightened Risk for Social Isolation and For Struggling to Live Up to Their Best Potential in a World that is Set Up for Neurotypical Brains

A shadow, Suicide and Autism

• Autistic individuals are more than 3 times more likely to die by suicide (South et al., 2021)

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• Unlike other populations, autistic women are more likely to die by suicide than autistic men

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• A study of 185 autistic individuals found that loneliness significantly predicted suicidal ideation in this population (Hedley et al., 2018)

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And a Shadow of ADHD

• Research has shown diagnosis of ADHD to be a risk factor for suicide (Mosley et al., 2024)

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• A study of ADHDers who had thoughts of suicide and/or had attempted suicide found that those with ADHD who had imagery of death by suicide and those with higher levels of impulsivity were more likely to move from thoughts of suicide to a suicide attempt (Cleare et al., 2024).

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• Feelings of defeat and entrapment were also linked to thoughts of suicide

Authetntic Connection Saves Lives

Research has shown that in neurodivergent individuals camouflaging neurodivergent traits was associated with thwarted belongingness and suicidal ideation (Cassidy et al., 2020).

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What’s Up with Neurodiversity and the Internet?

• A qualitative study of autistic adults found that many preferred communication online expressing
• That they were better able to connect when they had more time to respond (asynchronous) (Bedford and Standson, 2009)

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• That they felt less social and emotional pressure in virtual communication

A Light and Dark Side…..

• Online Communities Can Provide Support

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• Tragically, there Are Also Communities That Encourage Self-Harm and Suicide

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• Autistic Individuals May Be Particularly Vulnerable

“I was rejected by people and I was accepted by electronics.”���- John Elder Roberson (Author of ‘Look Me In the Eye’ and neurodivergent advocate)

Neurodivergent Social Norms for Neurotypicals to Learn (We wont call them skills)

**** Note, these are broad generalizations ******

1. Eye contact is optional

2. Give a Lot of Context

3. Deep Diving on One Topic is an Excellent Way to Connect with Others

4. Headphones are Okay. Wandering is Okay. Fidgeting is Okay. Asking Someone not to wear headphones, wander or fidget is rude.

5. If you don’t say it, don’t assume people know it

6. Honesty is Paramount

7. Ask Questions, Expect Questions

8. In Most Matters, Social Hierarchy is Irrelevant

9. Zoning Out is Not the Same as Not Caring

10. Overwhelm is a Thing

10 Neurodiversity-Affirming Ways

To Improve Social Connection

And Spark Hope

1. Suspend Judgement

What works best for neurotypical brains is not always what works best for neurodivergent brains

2. Create Spaces Where it is Safe to Unmask

3. Celebrate Neurodivergent Communication Styles

4. Explore Communication Venues

5. Know that Often Individuals Are Often Able to Understand More than they Can Express

6. Engage Passions

7. Take Time to Plan for the Future

8. Focus on Social Connection Over Social Skills

9. Celebrate Individual Differences

10. Connection with Neurodivergent Peers

References

• Benford, P., & Standen, P. (2009). The internet: a comfortable communication medium for people with Asperger syndrome (AS) and high functioning autism (HFA)?. Journal of Assistive Technologies, 3(2), 44-53.
• Cassidy, S. A., Gould, K., Townsend, E., Pelton, M., Robertson, A. E., & Rodgers, J. (2020). Is camouflaging autistic traits associated with suicidal thoughts and behaviours? Expanding the interpersonal psychological theory of suicide in an undergraduate student sample. Journal of autism and developmental disorders, 50(10), 3638-3648.
• Cleare, S., & O’Connor, R. C. Understanding the relationship between ADHD, mental health and suicide risk.
• Evans, J. A., Krumrei-Mancuso, E. J., & Rouse, S. V. (2024). What you are hiding could be hurting you: Autistic masking in relation to mental health, interpersonal trauma, authenticity, and self-esteem. Autism in Adulthood, 6(2), 229-240.
• Hedley, D., Uljarević, M., Foley, K. R., Richdale, A., & Trollor, J. (2018). Risk and protective factors underlying depression and suicidal ideation in autism spectrum disorder. Depression and anxiety, 35(7), 648-657.

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• Moseley, R. L., Gregory, N. J., Smith, P., Allison, C., Cassidy, S., & Baron-Cohen, S. (2024). Potential mechanisms underlying suicidality in autistic people with attention deficit/hyperactivity disorder: testing hypotheses from the interpersonal theory of suicide. Autism in adulthood, 6(1), 9-24.

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• South, M., Costa, A. P., & McMorris, C. (2021). Death by suicide among people with autism: beyond zebrafish. JAMA network open, 4(1), e2034018-e2034018.