Image: A diagram showing the relation between different neurodiverse conditions, created by the late Mary Colley, who founded the now retired charity DANDA (the Developmental Adult Neuro-Diversity Association)1
January 2025 |
16 minutes
We are here to cover some common questions about alcohol and neurodiversity. Is drinking riskier? Can hangovers feel worse? How does alcohol impact and is this different to neurotypical people? Answering these important questions and more - Neurodiversity UK founder, Jack Norwood, speaks to Alcohol Change UK.
Neurodiversity is a concept. It's the first positive word to describe people who have been classed as having neuro- developmental conditions, which include ADHD, autism, dyspraxia, dyslexia, Tourette's syndrome, and others, whilst also recognising these not as deficits but rather different ways of thinking and experiencing the world. In contrast, neurotypical refers to individuals whose brain functions, behaviours, and ways of processing information align with what is considered typical or standard in society.
The reason neurodiversity is a positive word is because it really emphasises difference rather than focusing on impairments. It’s seen as a response to the ‘medical model of disability’2, which focuses on impairments, treatments and cures - whereas neurodiversity is based on the ‘social model of disability’2. This is the idea that it’s society that places the barriers to people taking part through its rules, regulations, and structures. The other reason neurodiversity is a great term, is because very rarely do people have ADHD or autism on its own. It's much more likely that people will have a range of different conditions, so it's much easier to say that someone's just neurodivergent and to think of it as more of a spectrum and a continuum.
A helpful way to explain neurodiverse conditions is through the metaphor of learning to drive. When someone first learns to drive, they must consciously think about every action: shifting gears, positioning their hands on the steering wheel, using the pedals, and checking mirrors. Over time, these actions usually become automatic, and driving no longer requires conscious effort. For neurodivergent individuals, specific areas of unconscious learning - where skills or behaviours typically become automatic - can be more challenging to develop and requires more mental effort.
The areas affected vary depending on the neurodiverse condition. For example, individuals with ADHD may find it harder to develop automatic processes related to executive function, such as planning, prioritising, and focusing. Those with dyslexia may struggle with unconscious learning related to reading and language processing. In autism, challenges often involve social skills and interpreting social cues. These specific difficulties form the basis for the different neurodiverse labels.
Globally, 15% of people are neurodivergent. Within that, 10% of the population are dyslexic. 1% are autistic, and between 4-5% have ADHD. However, it's very common for people to have more than one condition, and in particular for people with autism to have ADHD as well and vice versa.
What about neurodiversity and alcohol?
Neurodivergent people can experience alcohol differently to neurotypical people and this can happen in a range of ways. There are some extra risks when it comes to drinking for neurodivergent individuals, for example, individuals with ADHD are more vulnerable to harmful drinking, with up to 43% developing an alcohol-use disorder over the course of their lifetime3.
It’s important to mention, not all these experiences will be relevant to all neurodivergent people. For some people, these experiences will really resonate, and for other people they might not.
Obviously, all neurodivergent people are different, however, for example for people with ADHD, alcohol can make impulsivity worse. This can increase risk-taking behaviour when drinking. This can be particularly relevant for young men when they are together - they might do very risky things because they might find it funny and may be more likely to get in accidents or injure themselves.
Additionally, social anxiety is common for people with neurodiversity. Neurodivergent individuals will sometimes ‘mask’ in social situations, which is where they’re having to manually think about what body language and social signals they’re giving off. Masking is linked to sensory processing, it’s listening and deciphering conversations, it’s knowing how honest or intense to be in a conversation. You could describe it as when someone is almost trying to ‘act’ neurotypical, or trying to blend in. However, masking also uses up a lot of energy, it can use up all of a person’s energy and can leave people exhausted the next day. Leaning on alcohol as a coping mechanism for anxiety in social settings can also lead to excessive drinking4.
Neurodiversity can also affect emotional regulation, people may experience very intense emotions, finding it difficult to manage. If you imagine someone is masking the whole time trying not to let frustration or anger out, when they're drunk this can be harder to control as their fuse can be a bit shorter.
Alcohol can disrupt sleep quality and routine, which can make everything worse. Anxiety can be an issue too, lots of neurodivergent people suffer from anxiety anyway and that is something that can be made much worse when dealing with anxiety during a hangover.
For neurodivergent individuals, hangovers can really upset their whole routine and functioning. Some neurodivergent people can have limited energy and less resilience, so hangovers can really affect them. If they already are using so much energy just to function on a day-to-day basis, it means that the physical and mental health effects of hangovers can be experienced more intensely compared to neurotypical people. Hangovers may exacerbate issues with insomnia which are already very common among, for example, people with ADHD.
Some neurodivergent people also describe that they are ‘peopled out’ after socialising, and this can lead to what’s described as ‘a double hangover’. So, you're dealing with the hangover, but then you've also got the hangover from socialising and masking which uses a lot of energy. With this in mind, learning what helps recovery and what you need to do for self- care when you're hungover can be more important for neurodiverse people.
There is a small cohort of neurodivergent people that don't feel like they get hangovers at all, which can also be an issue. Neurodiversity can include sensory processing difficulties, and this can mean that someone is overwhelmed with their senses, but in other cases, it also can mean that they fail to notice their senses.
How you feel inside your body is called ‘interoception’. People with autism can be particularly prone to struggling with interoception, e.g. failing to notice feeling unwell, or being in pain, etc. Some neurodivergent individuals don't feel hungover because they struggle to feel what is going on inside their bodies. The issue with this is that people need to rest when they are hungover, but a neurodivergent individual may not register this need and act on it with the necessary self-care steps.
Some people can use alcohol to self-medicate, where they are using it to help them sleep, using it to feel less stressed, or perhaps to change how they feel. This again can tie into feelings of frustration and impulsivity that are common with ADHD. This can be quite relevant, especially where access to support comes in, or lack thereof, for example access to medications and treatment. Self-medicating with alcohol can be problematic, because although it might make someone feel slightly better in the short term, in the long term it's a slippery slope and it can lead to dependency.
When we think about mental health, we're only as strong as our coping strategies and sometimes, we can develop things called ‘maladaptive coping strategies’ (coping strategies that provide short term relief but lead to negative outcomes). There's been a huge cohort of people that have discovered that they had ADHD through addiction services, because they have used alcohol as support to cope with their symptoms. They've used alcohol as a maladaptive coping strategy, and it can be hard to stop this.
Yes, absolutely, because the individual feels the need to replace the feelings that alcohol is giving them with something else. This is why medication can be so important in these cases. ADHD medications for example may provide those feelings of calm and can alter that default restless state that a person might be experiencing. A sense of community can also be really helpful for neurodivergent individuals cutting back on their alcohol use. And that's why I think things like the Dry January® challenge is a really good initiative because people can do it together.
Lots of neurodivergent people have said that they are ‘all or nothing’ with alcohol. For them to have a small night out and just drink a little bit can be really hard to do. Quite often what they'll do is either drink a lot or have nothing at all. The other way that it's riskier is that people find it hard to stop. I've had ADHD people tell me that they feel like they can't go home early, because if they're drunk, they're really excited and the idea of just going home is really boring. This can really affect daily life, if you’re so hungover and tired because you’ve been out all night it takes a really big toll.
Approximately 30-40% of individuals with ADHD engaging in heavy drinking display patterns of binge-drinking1. This all-or-nothing mindset can sometimes make stopping alcohol consumption altogether easier than moderating it.
There are strengths in neurodiverse behaviours which can help in stopping from leaning on maladaptive coping strategies too. Embracing hobbies or special interests can serve as a healthy distraction from alcohol. When neurodiverse individuals find what they’re good at and passionate about, it can lead to a more fulfilled life and reduce the need for alcohol as a coping mechanism.
Neurodivergent people often possess what is referred to as ‘spiky profiles of intelligence’5. This means their abilities can vary widely across different domains. For example, while a neurotypical person may have a consistent level of capability in areas like performance, memory, and comprehension, a neurodivergent person might excel dramatically in one area, such as creative thinking or scientific problem-solving, while facing challenges in others such as time management or completing routine tasks. This is a unique characteristic that makes neurodiverse individuals specialists rather than generalists. Thriving in areas they are passionate about can improve mental well-being and reduce the need to turn to alcohol as a coping mechanism.
Equally, neurodiverse individuals are often incredibly driven and determined when they believe in something. This can make them more focused on achieving goals, including reducing or stopping alcohol consumption if it aligns with their values or interests.
A diagnosis for neurodiverse conditions normally requires a formal assessment. If you are an adult in the UK, a good first step is to speak with your GP about any symptoms you’re experiencing. They should then refer you for assessment, and you will be put on an NHS waiting list. For ADHD and Autism, where current assessment waitlists are extremely long, there is a second option called NHS ‘Right to Choose’. If you are based in England under the NHS, you now have a legal right to choose your mental healthcare provider and your choice of mental healthcare team. The website ADHD UK has a list of right to choose providers. As a third option, for those who can afford it, you may consider a private assessment. However, this can be expensive and may not be accessible for everyone.
For individuals looking for further support, a good option is support groups. On the Neurodiversity UK website, there’s a community directory of support group events. If you are specifically looking for online support groups for ADHD, ADHD Aware and ADHD UK both offer excellent options. For those seeking in-person groups, platforms like Meetup and Eventbrite are great resources for finding local gatherings.
It can be helpful to join a support group and meet other neurodivergent people, as seeing yourself reflected in others can be incredibly validating. Support groups can also reduce feelings of isolation or loneliness and provide an opportunity to meet inspirational and interesting people!
Neurodiverse conditions such as ADHD rarely come on their own. Jack Norwood, the founder of Neurodiversity UK, explains that he is neurodivergent, with ADHD, dyslexia, dyspraxia, and autism. Through his extensive work, Jack has dedicated nearly 15 years to supporting neurodivergent individuals, offering coaching, and running peer support groups.
Visit the Neurodiversity UK website to learn more about how they support the neurodivergent community through peer support groups, coaching, training, and raising awareness to create a more inclusive society.
Sources
1) What is Neurodiversity - ADHD Aware
2) The Medical VS Social Model of Disability
3) Alcohol use disorders and ADHD - ScienceDirect
4) The anxious amygdala: CREB signaling and predisposition to anxiety and alcoholism - PubMed
5) Neurodiversity at work: a biopsychosocial model and the impact on working adults - PubMed
