Medication & Treatment Options

Types of Therapy

There are many approaches to therapy, and what works for one person may not work for another. Finding the right fit - the right modality and the right therapist - can take time, and that is normal.

Cognitive Behavioral Therapy (CBT)

CBT focuses on identifying and changing unhelpful thought patterns and behaviours. It is structured, goal-oriented, and often short-term (12-20 sessions). CBT is well-researched for depression, anxiety, and OCD, but some neurodivergent people find it too rigid or feel it focuses too much on "fixing" thoughts that are actually valid responses to their experiences.

Dialectical Behavior Therapy (DBT)

DBT was originally developed for borderline personality disorder but is highly effective for emotional dysregulation across diagnoses. It teaches four skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT is particularly helpful for neurodivergent people who experience intense emotions, rejection sensitivity, or meltdowns. Many people use DBT skills without being in formal DBT therapy - the skills are available in workbooks and online.

EMDR (Eye Movement Desensitization and Reprocessing)

EMDR is a therapy designed to process traumatic memories. It involves recalling distressing events while engaging in bilateral stimulation (eye movements, taps, or tones). EMDR can be life-changing for people with PTSD or complex trauma, which many neurodivergent people have due to a lifetime of masking, bullying, and invalidation.

Acceptance and Commitment Therapy (ACT)

ACT is a mindfulness-based approach that focuses on accepting difficult thoughts and feelings rather than fighting them, while committing to actions that align with your values. Many neurodivergent people find ACT more affirming than CBT because it does not frame neurodivergent traits as problems to be corrected.

Neurodiversity-Affirming Therapy

This is not a single modality but an approach. A neurodiversity-affirming therapist works from the understanding that neurodivergence is a natural variation, not a disorder. They accommodate sensory needs, validate different communication styles, and focus on quality of life rather than conformity to neurotypical norms. We are building a directory of neurodiversity-affirming providers - check the Wiki for updates.

Psychiatric Medications

Medication is a personal decision. Some people find it essential for functioning, others prefer to manage without it, and many fall somewhere in between. There is no moral value attached to taking or not taking medication. What matters is that you have accurate information and make a choice that supports your wellbeing.

Common Types of Psychiatric Medications

• Antidepressants (SSRIs, SNRIs, etc.) - Used for depression, anxiety, OCD, and sometimes for emotional regulation in ADHD. They take 4-6 weeks to reach full effect and often require dose adjustments.
• Stimulants (methylphenidate, amphetamine-based) - First-line treatment for ADHD. Improve focus, executive function, and impulse control. Short-acting and extended-release options available.
• Non-stimulant ADHD medications (atomoxetine, guanfacine, bupropion) - Alternatives for people who don't tolerate stimulants or have contraindications.
• Anti-anxiety medications (buspirone, gabapentin, beta-blockers) - Used for generalised anxiety, social anxiety, or specific anxiety symptoms. Benzodiazepines are sometimes prescribed but carry dependency risk.
• Mood stabilisers (lamotrigine, lithium, valproate) - Used for bipolar disorder, but sometimes prescribed for emotional dysregulation in other conditions.
• Antipsychotics (aripiprazole, quetiapine, risperidone) - Used for psychosis, bipolar mania, and sometimes as augmentation for treatment-resistant depression or severe anxiety.
• Sleep medications (trazodone, melatonin, hydroxyzine) - Many neurodivergent people struggle with sleep, and medications can help break the insomnia cycle.

What to Know Before Starting a Medication

• Ask about common side effects and how long they typically last (many are temporary).
• Ask how to take it - with food? At a specific time? What if you miss a dose?
• Ask about interactions with other medications, supplements, or substances.
• Ask how long it takes to work and how you'll know if it's working.
• Ask what the plan is if this medication doesn't work - what's the next option?
• Write down the answers or bring someone with you to take notes.

Stopping or Changing Medications

Never stop a psychiatric medication suddenly, especially antidepressants, mood stabilisers, or antipsychotics. Discontinuation syndrome (withdrawal) can be severe and sometimes dangerous. If you want to stop or change a medication, work with your prescriber to taper slowly. A good prescriber will respect your wishes and help you find a safe way to make changes. If your prescriber dismisses your concerns about side effects, you are allowed to seek a second opinion.

What to Expect at a Psychiatry Appointment

An initial psychiatry appointment typically lasts 45-90 minutes. The psychiatrist will ask about your symptoms, history, family mental health, medical conditions, and current medications. They may ask sensitive questions about trauma, substance use, self-harm, and suicide. You can ask for breaks, bring notes, or have a support person with you. You are not required to answer anything you're not ready to share, though honest communication helps with accurate treatment. Follow-up appointments are usually shorter (15-30 minutes) and focus on how the medication is working and any side effects.

How to Talk to Your Prescriber

Many neurodivergent people struggle with doctor's appointments - the pressure to communicate clearly, remember everything, and advocate for yourself can be overwhelming. These strategies help:

• Write it down beforehand. Bring a list of symptoms, concerns, and questions. Hand it to the doctor if you can't find the words.
• Be specific about what you're experiencing. Instead of "I feel bad," try "I've been sleeping 14 hours a day, I've lost my appetite, and I've been crying every day for two weeks."
• Name your goal. "I want to be able to get out of bed by 9am" or "I want my anxiety to not interfere with work" gives the doctor a clear target.
• Report side effects honestly. If a medication is causing intolerable side effects, say so. There are usually alternatives.
• Ask questions until you understand. It's okay to say, "Can you explain that in simpler terms?" or "I don't understand what that medication does."

Alternative and Complementary Treatments

Some people find benefit in treatments outside traditional medication and therapy. These include: transcranial magnetic stimulation (TMS) for depression, ketamine-assisted therapy for treatment-resistant depression and PTSD, neurofeedback for ADHD, light therapy for seasonal depression, and nutritional approaches like omega-3s or magnesium for mood regulation. Research these options carefully and discuss them with a medical professional before starting. "Natural" does not always mean safe or effective, and supplements can interact with medications.

Finding the Right Therapist

Finding a therapist who truly understands neurodivergence can be challenging but is worth the effort. Look for therapists who mention neurodiversity, autism, or ADHD in their profiles. Ask in a consultation: "Are you neurodiversity-affirming?" "Do you have experience working with autistic/ADHD adults?" "What modalities do you use and how do you adapt them for neurodivergent clients?" A good therapist will welcome these questions. If a therapist pathologises your neurotype or insists on "correcting" autistic traits, they are not the right fit.

Treatment is not about becoming someone else. It is about getting the support you need to be yourself more fully. You deserve care that honours who you are.