Monday, May 7, 2018

When is it more than giftedness? A psychologist's perspective

Sometimes it's not about giftedness.

Let me explain...

Many of you reading this are already aware of the misdiagnosis initiative, and know that many gifted children - and adults - are misdiagnosed as a result of their gifted traits. Asynchrony, hyperfocus, overthinking, social awkwardness, to name a few, may lead those lacking an understanding of giftedness to overpathologize and frame these traits as diagnostic of a mental health, developmental or behavioral problem. ADHD, OCD, and "on the spectrum" are some of the labels these children receive, when in fact, their behaviors may be manifestations of their giftedness.

But what about when the diagnoses are valid?

As a clinical psychologist, I have encountered situations where teens or adults have been misdiagnosed, and when problem behaviors resulted from social/emotional traits associated with giftedness, or the social ramifications of being gifted. I have also seen individuals who are gifted, but have co-occurring mental health concerns.

These diagnostic questions also arise in my work as a coach, where I consult with gifted adults and parents of gifted children. Although coaching is quite different from psychotherapy, my perspective as a psychologist remains an integral part of what I do. I still think like a clinician and take a history and listen through the "ears" of a psychologist.

Over the years, I have noticed a trend where some gifted adults or parents of gifted children, well-versed in the gifted literature, assume that their troubles are exclusively due to giftedness. And while gifted intelligence and social/emotional issues can provoke their own set of unique troubles, sometimes... sometimes... the issue is a mental health problem.

Yet, some gifted adults and families understandably hope that giftedness is the culprit. They dismiss others' warnings and comments - or their own nagging doubts. Perhaps, they needed psychotherapy years ago, or their child is more distressed than they had imagined. It's just Dabrowski's overexcitabilities - not depression - right? He just overthinks everything - he'll get over the anxiety eventually - won't he? They had hoped the problems were less serious. After all, who wouldn't want this to be true?

Remaining attuned to your child's intellectual abilities, emotional and social functioning, and interpersonal needs is much easier said than done, of course. Children have different needs depending on their developmental phase, interests, abilities, family dynamics, and unique personality. As parents, we often are vulnerable to the opinions of others - family, friends, social media, self-help authors, pediatricians, teachers, spiritual leaders. You or your child may be mislabeled, misdiagnosed, or not appropriately identified as gifted. Your child's or your own giftedness may be pathologized, or conversely, used to explain away more serious levels of distress that warrant treatment.

Take it seriously

We need to remind ourselves that children's and adult's emotional struggles must be taken seriously. We don't want to "overpathologize" and ignore how giftedness contributes to social and emotional functioning, but symptoms of distress should not be dismissed as "just a part of being gifted" or "a phase" that will pass. Unlike what you may read in online forums or hear from well-meaning acquaintances, not every ADHD diagnosis springs from corrupt physicians in bed with "big pharma." Not every diagnosis of social anxiety disorder ignores the role of giftedness in your child's heightened sensitivities. Depression needs to be treated and not just dismissed as the existential angst so many gifted teens experience.

Get help when it's needed

Trust your instincts. Listen to your gut. If that nagging voice inside tells you that something more is going on, that you or your child are more distressed, or that additional support will help you navigate a difficult period in time, get some help. Gifted social/emotional traits may shape your child's or your own interests, sensitivities, passions, and quirks, but when these cross the line into distress and psychological symptoms, please seek the support of a licensed mental health professional.


  1. Yes, this! Thank you for writing this. Sometimes pathologies are real and brushing them off as something more palatable helps no one - least of all the child.

  2. Thanks for this thought-provoking post. For me, it seemed obvious that overexcitability explained the longer story of my life, while pathological anxiety explained what I developed after my dad's sudden death, which I overthought and decided I should have seen coming and so I suddenly saw everyone else's (especially my own) impending demise coming. Others around me concurred with this assessment -- that my behavior had not been pathological before that -- which was a good sanity check. So it seems to me that overexcitability can predispose someone to anxiety or depression, but that it is not the same thing as anxiety or depression. If you have OE, you will always have it; if you have anxiety or depression, you may have developed it at a certain time, and you may get over them again. You don't have to take those as part of your "identity," which might be helpful for a reluctant sufferer to remember!

    1. Jessie, Thank you for your comments. You make such an important point - no one needs to assume depression, anxiety or any other mental health concern as part of their identity. It might be a problem someone has for a while, but something one can often overcome. Whereas giftedness sticks around! Thanks again.