In July 2023 I was diagnosed with Combined Attention Deficit Hyperactivity Disorder. For the first time in my life, everything made sense. I had never realised that the constant internal restlessness I lived with was hyperactivity. I did not know it could present this way, but it is common in women and girls.

I had not planned to start medication. The clinician used a simple comparison that stayed with me. If I were deficient in B12, would I take supplements? Of course I would. ADHD involves differences in dopamine regulation in parts of the brain such as the substantia nigra, ventral tegmental area and hypothalamus. Yet I hesitated, believing I had managed for 34 years without any medication. I worried medication would dull the parts of me that made me driven. I did not want to feel numb or altered.

Looking back, I wish I had understood this sooner. I had not been myself for a long time. The impact of coercive control had stripped away many of the traits I once valued in myself.

Rejection Sensitivity Dysphoria

The clinician who assessed me also believed I experienced rejection sensitivity dysphoria. After researching it, so much of my life suddenly aligned. My childhood, my friendships, my fear of criticism and the intense emotional pain triggered by perceived rejection all made sense.

Understanding RSD helped me recognise why I felt so compelled to help someone who was harming me, why I feared losing him, and why the emotional impact of his behaviour was so severe. It is not weakness. It is a recognised pattern linked to neurodivergence.

When Abuse Is Dismissed

On 21 December 2023, a police officer with more than 25 years of service told me, “Some relationships are just bad, not all are abusive.” It was the second time he failed to act on a disclosure, despite a documented history of controlling behaviour.

This is the reality many victims face. Coercive control is often invisible to those who do not understand it. Dismissal from professionals can be devastating.

Understanding Coercive Control

Professor Evan Stark describes coercive control as being taken hostage. The victim becomes captive in an unreal world created by the abuser, trapped in confusion, contradiction and fear.

Emotional abuse is not always shouting or threats. It can be sarcasm, dismissiveness, character attacks, subtle put downs and constant button pushing. It often stems from the abuser’s insecurities and their need to create a hierarchy where they are always right and you are always beneath them.

Gaslighting Tactics Survivors Should Know

Gaslighting is one of the most damaging tools of coercive control. Survivors often recognise the behaviours long before they have the language for them.

Common tactics include:

• Blatant lies told with confidence to destabilise your sense of truth
• Denial even when presented with evidence
• Using what matters most to you as ammunition
• Gradual erosion of your confidence over time
• Occasional praise to keep you off balance
• Creating confusion so you rely on them for clarity
• Projection, accusing you of what they are doing
• Turning others against you to isolate you
• Questioning your sanity to undermine your credibility
• Claiming everyone else is lying so they become your only “truth”

Recognising these tactics is essential for breaking the cycle.

Socioeconomic Disadvantage

Socioeconomic disadvantage significantly affects mental health outcomes. Children growing up in disadvantaged households are two to three times more likely to develop mental health disorders. When low socioeconomic status persists, the lifetime risk increases further. Improvements in household income and stability can reduce this risk, showing how strongly parental circumstances shape a child’s mental health (Misirliyan et al., 2023).

Resilience in Children

Resilience is shaped by a child’s personal qualities, their relationships and the wider systems around them. Children adapt best when their environments are safe, predictable and supportive. The focus should be on improving the child’s environment rather than expecting the child to become more resilient in the face of adversity (Misirliyan et al., 2023).

A Personal Reflection on Diagnosis and Stigma

When my son was diagnosed with ADHD at the age of five, I began researching everything I could. I did not expect to see myself reflected in the information. By the time I reached 32, I felt overwhelmed by different aspects of my life, particularly my home environment. I went to my GP hoping she would look beyond the surface.

Before she prescribed antidepressants, I explained that I did not believe I was experiencing depression. I suspected undiagnosed ADHD. The stigma I had carried for years disappeared the moment she responded with understanding. She referred me to an adult ADHD service, and for the first time I felt seen.

Years later, my diagnosis has strengthened my belief that correct identification of neurodiversity or mental health conditions is essential for appropriate support. Too many adults hide their struggles until everything collapses. If we recognised these challenges earlier in childhood, we could create a far more positive future.

Embracing Neurodiversity

Children thrive when they are understood. When we reassure them that there is nothing wrong with them, and that their differences are simply part of who they are, we help them build identity rooted in strength rather than shame.

Some of the world’s most talented artists, musicians, authors and innovators are neurodivergent. Their challenges would be far less daunting if society accepted that difference is not deficiency.

Embracing neurodiversity enriches our communities, workplaces and culture. Recognising different ways of thinking enhances creativity and innovation. Seeing conditions such as autism, ADHD and dyslexia as natural variations encourages acceptance and supports advocacy for the strengths associated with neurodivergence (Doyle, 2020).

This shift is reflected in the growing number of specialist services and programmes designed to support neurodiverse individuals (LeFevre‑Levy et al., 2023). Advocates and thought leaders continue to drive this change, reinforcing neurodiversity as an essential aspect of human diversity (Johnson and Ahluwalia, 2024).

Different is not less.

Research and Evidence

Research from the Evidence‑Based Practice Unit at University College London highlights the importance of school interventions. Community interventions are also crucial. These efforts improve mental health outcomes for children and young people (UCL, 2023).

A systematic review by University College London found a clear association between academic pressure and adolescent mental health problems. These problems include anxiety and depression. This reinforces the need for public health approaches that address academic stress (Stearea et al., 2023).

A scoping review exploring how children and young people perceive mental health emphasises the importance of developing a shared language. When children understand the difference between everyday challenges and issues that require support, outcomes improve significantly (Beckman et al., 2023).