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The interplay between mental health and neurodiversity
Client Background
The client was a British man in his late 30s who, despite coming from a background of significant family wealth that negated the financial need for employment, had built a respected reputation in the wellness industry as a nutritionist and yoga practitioner. Growing up in a family of generational wealth and affluence, he was raised with high expectations of perfection and adherence to traditional values. While currently in a long-term relationship, he had no children and faced strained dynamics with his extended family, who struggled to understand his neurodiversity.
Internally, he grappled with feelings of inadequacy and confusion stemming from his late diagnosis of ADHD and Autism two years ago. These conditions left his with prolonged periods of misunderstanding, self-blame, and anxiety. While mild depressive episodes tied to unmet familial expectations affected his self-worth.
His private family GP, familiar with Harbor’s reputation for discretion and neurodiversity-informed care, referred him for treatment.
Presenting Challenges
The client presented with a unique and complex interplay of neurodiversity and mental health conditions. Diagnosed with ADHD and Autism late in life, he had spent years struggling with self-blame and a lack of understanding about why he felt so different from those around him. This also led to the development of anxiety, exacerbated by sensory sensitivities and a history of social rejection. He often found himself overwhelmed in social situations and struggled to maintain meaningful connections. Mild depressive episodes were tied closely to his struggles with identity, unmet familial expectations, and feelings of isolation. Growing up in an environment with perfectionist expectations significantly impacted his self-worth.
This perfectionism, combined with executive dysfunction, impacted his professional and personal life. Despite his passion for nutrition and yoga, he found it increasingly difficult to manage his personal endeavours effectively. Within his family, a lack of understanding about neurodiversity meant that he struggled to set and maintain boundaries, often feeling pressured to conform to traditional family expectations.
Given his family’s significant social standing and influence, he required a highly confidential and tailored approach to treatment that avoided the impersonal nature of traditional in-clinic environments.
Tailored Treatment Plan
To address the complex interplay of the client’s neurodiversity and mental health challenges, Harbor designed a phased, six-week treatment programme that combined medical, therapeutic, and more ‘holistic’ interventions tailored to his needs.
Weeks 4-6: Consolidating Progress and Family Integration
- Psychotherapy and Yoga: Sessions continued at the same frequency, reinforcing the client’s ability to manage stress, build resilience, and embrace his neurodiverse strengths.
- Family Therapy: Weekly sessions were introduced to involve his extended family and partner. These sessions provided tools for improving communication, fostering mutual understanding, and setting healthy boundaries to support his long-term recovery.
- Recovery Manager Activities: Daily support continued, with the integration of structured activities to prepare the client for a successful transition to aftercare.
Recognising his professional commitments, Harbor ensured flexibility throughout his treatment. Sessions were structured around his participation in his personal work and remote consultations that he wanted to continue running. He resided in a luxurious central London property designed for sensory-friendly living, and free access to his mobile phone and visits from close family and friends were curated to ensure safe connectivity.
Week 1: Initial Stabilisation and Psychoeducation
- 24/7 Recovery Manager Support: There was a desire to build a strong rapport, and so the client and recovery manager engaged in daily walks, allowing them to establish trust, plan for future therapeutic activities, and ensure emotional stability.
- Consultant Psychiatrist: 5 sessions within the first week to provide comprehensive medication reviews and neurodiversity-informed mental health support.
- Psychotherapy: 3 sessions during the first week, with an initial focus on psychoeducation. These sessions helped the client gain a clear understanding of his ADHD and Autism diagnoses, exploring how they had shaped his experiences, relationships, and self-perception.
Weeks 2-4: Integration of Holistic Therapies and Continued Support
- Yoga Therapy: Introduced 3 times per week. These sessions focused on mind-body alignment, addressing sensory regulation and emotional balance while incorporating mindfulness techniques.
- Recovery Manager Activities: Daily walks continued alongside ad hoc movement classes, including spin sessions and hot yoga at a local gym, supporting both physical wellbeing and sensory modulation.
- Nutrition Integration: Recognising the client’s passion for nutrition, he began collaborating with his private chef to prepare 1 meal per week on Sunday afternoons. This activity supported his recovery while nurturing his interests.
- Consultant Psychiatrist: Sessions reduced to 3 times per week as the client stabilised and adapted to his therapeutic routine.
- Psychotherapy: Continued at 3 times per week, with an emphasis on unpacking the impact of neurodiversity on family dynamics, self-worth, and executive functioning. Practical coping strategies were introduced to help him manage sensory sensitivities, perfectionism, and social overwhelm.
Addressing Underlying Factors
The treatment plan tackled the deeper causes of the client’s challenges. Therapeutic work explored the impact of growing up in a high-pressure, perfectionist environment while reframing family expectations and providing help on navigating unresolved conflicts. Clinicians focused on re-establishing his identity beyond familial expectations and societal norms, helping him embrace his neurodiverse traits as assets rather than limitations. Yoga and mindfulness became essential components of this process, blending gentle movement with structured self-care practices. Strategies for managing stress, sensory sensitivities, and social overwhelm helped him regain control of his life and relationships.
Confidentiality and Discretion
Confidentiality was rigorously maintained throughout his residential treatment, given the prominence of his family in society.
Harbor ensured that he had 24/7 security at the property and when travelling to external locations, and all staff working with him signed comprehensive NDAs. The one-patient-at-a-time model ensured the client received undivided attention in an environment free from exposure, allowing him to fully engage in his recovery.
Resolution and Recovery
Over the course of his treatment, the client developed greater self-awareness and acceptance of his neurodiverse identity.
Tailored strategies for managing sensory sensitivities and social triggers reduced his anxiety levels, while his renewed confidence enabled him to excel further in his personal endeavours.
Family therapy sessions helped him build stronger relationships with his extended family, improving communication and fostering mutual understanding. Focused therapy with his partner also addressed misunderstandings stemming from his neurodiverse traits, strengthening their bond.
Aftercare and Long-Term Support
Following his residential treatment, weekly psychotherapy sessions and biweekly psychiatric consultations provided ongoing support, while practical strategies helped him navigate professional and social triggers. These sessions also focused on helping him organise his professional commitments to better align with his strengths and energy levels.
Family education sessions equipped his relatives with a deeper understanding of neurodiversity, and a group therapy session upon discharge prepared them to support him transition back to daily life.
And ongoing collaboration with his private GP ensured seamless continuity of care.
The Outcome
By addressing the complex interplay of mental health and neurodiversity, Harbor provided him with the tools and support needed for lasting transformation. With ongoing care and a renewed sense of identity, he continues to navigate his personal and professional life with greater ease and fulfilment.
