Posts in category: Dating Tips, Guide and Advice

Vaping THC oil involves heating the oil and inhaling it through a vaporizing device like a vape pen or e-cigarette. Many healthcare providers are concerned about the health-related effects of this THC product type.

Marijuana use carries many risks, including addiction. Keep reading to learn more about the risks of THC oil, how to spot the signs that someone you know might have a marijuana addiction, and how you can get help with addiction, withdrawal, and recovery.

Overview of THC Oil

THC is the main psychoactive compound found in marijuana and the substance that produces intoxication effects. In addition to its psychoactive effects, THC is also believed to impact pain, mood, and other feelings. It creates these effects by impacting cannabinoid receptors in the brain.

While some states have legalized the medical and recreational use of marijuana and marijuana products, it is still illegal according to federal law. Marijuana use in any form also comes with short-term and long-term health risks.

Risks of THC Oil

Research suggests that vaping THC oil, especially oil that contains vitamin E acetate, can be particularly harmful to the lungs. Vitamin E acetate, which is regularly added to THC when preparing it for use in e-cigarettes and vaping devices, is especially harmful when it’s inhaled.

In 2019, the dangers of vaping came to light. In September of that year, health officials began investigating an outbreak of a severe lung disease associated with vaping and e-cigarettes. By December, 2,561 cases of the lung disease, often referred to as e-cigarette or vaping use-associated lung injury (EVALI), had resulted in hospitalization or death.

Vaping THC oil just once can significantly impact your lungs. A study in the Journal of the American Medical Association found that first-time and infrequent users of marijuana were more likely to experience adverse reactions from vaping THC oil.

This study’s authors suggest that the negative impacts of this THC ingestion method are largely due to the enhanced delivery of the oil. This was evidenced by participants having more pronounced effects and experiencing significant impacts on their motor skills and cognitive abilities.

Marijuana concentrates, such as those used in vaping, also have incredibly high THC levels—up to four times as high as those found in top-shelf marijuana. This may also explain why their effects are more enhanced. Research suggests that some forms of THC oil contain THC levels up to 70%, compared to 30% in dried flower forms of marijuana. Regularly using such products increases the risks of cognitive impairment, dependence, psychosis, and withdrawal symptoms.

Other Risks of Vaping THC Oil

There are a number of other risks that have been associated specifically with marijuana use. Among them are:

Longer-lasting side effects of marijuana use include learning, memory, and sleep issues. People who use marijuana repeatedly over time may also experience effects such as:

• Increased risk of addiction
• Increased risk of chronic cough
• Increased risk of schizophrenia (if a genetic risk also exists)
• Learning and memory issues

Signs of THC Oil Use

How do you know if someone in your life might be vaping THC oil? Signs of marijuana use can include:

• Being drowsy during the daytime
• Having bloodshot eyes
• Inability to judge time
• Increased cough or wheezing
• Increased hunger for no apparent reason
• Lack of focus or inability to concentrate
• Secretive behavior
• Trouble with coordination
• Unusually talkative
• Vaping devices or oils in their possession or in their room
• Weird, unexplained smells (some THC vaping oils are flavored, resulting in a variety of scents)

Marijuana vaping use is on the rise, particularly in certain age groups. For instance, the number of college-age students who’ve vaped in the past month increased from 5.2% to 14% in just two years’ time. A 2022 study adds that the number of teens vaping cannabis in the last 30 days increased seven-fold from 2013 to 2020.

Other Concerns About THC Oil

There are a couple of misconceptions surrounding both THC and vaping.

THC Is Not the Same as CBD

Some people confuse THC with CBD (cannabidiol), another cannabinoid found in the cannabis plant. However, it’s important to note that CBD oil and THC oil impact the body in completely different ways.

One notable difference is that while THC has psychoactive properties, CBD does not. As a result, CBD does not make you intoxicated. CBD is also believed to work with other receptors in the body to produce an overall feeling of well-being.  

There are also legality differences. As of April 2024, 38 states, three territories, and the District of Columbia have approved the use of marijuana for medical purposes. As of November 2023, 24 states, three territories, and the District of Columbia have approved marijuana for recreational use.

Conversely, the 2018 Farm Bill removed hemp (of which CBD oil is a derivative) from the definition of marijuana, making it legal federally as long as it contains 0.3% THC or less.

Vaping THC Is Not Safer Than Smoking It

It is a common misconception that vaping is less risky than smoking. A 2018 Gallup Poll found that most Americans believe that vaping is less harmful than smoking, with 40% of the respondents indicating that marijuana was “not too” harmful. Some think this because vaping involves inhaling vapor rather than smoke. The issue is that there isn’t enough research to support this belief.

Other health experts warn that vaping marijuana may even damage the lungs more so than smoking or vaping nicotine. This doesn’t mean that vaping nicotine is safe, but that vaping THC oil is thought to create a greater amount of lung damage.

A study published in Addiction adds that while vaping nicotine may be safer than smoking cigarettes, the same may not hold true when it comes to marijuana. In fact, additives like vitamin E acetate may make this delivery method even more dangerous than smoking marijuana, putting the person’s lungs at a greater risk for injury.

Tolerance, Dependence, and Withdrawal

If you vape THC oil regularly, you may develop a tolerance, potentially through the way cannabis creates neuroadaptive changes in the brain. Vaping THC oil can also lead to a substance use disorder.

The National Institute on Drug Abuse (NIDA) estimates that between 9% and 30% of people who use marijuana develop some sort of substance use disorder. Also, people who begin using marijuana before they turn 18 are four to seven times more likely than adults to develop cannabis use disorder.

Addiction

The National Institute on Drug Abuse shares that cannabis use disorder can turn into a marijuana addiction if the usage of this drug cannot be stopped even when it interferes with various aspects of your life. This could include causing issues at work, school, or home.

Additionally, because some confuse dependence with addiction, it is unclear exactly how many people may be addicted to marijuana. Though, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that one in 10 people using marijuana will develop an addiction.

Withdrawal

People with a history of long-term marijuana use (including vaping THC oil) may experience mild withdrawal symptoms if they stop. These include:

Symptoms such as these can make it difficult to quit using marijuana. Though they are typically mild, if they are bothersome or severe, talk to your healthcare provider. They may be able to help.

How to Get Help

Several options exist for people who want help with their marijuana use. Ones that seem to provide the best outcome include:

• Cognitive behavioral therapy, which includes learning how to identify and correct behaviors, resulting in better self-control and the resolution of issues contributing to drug use
• Contingency management, which is a form of behavioral therapy that involves monitoring certain behaviors and instituting rewards if a specific positive behavior occurs, or rewarding a lack of the behavior if that is the desired outcome
• Motivational enhancement therapy, which helps promote motivation within the individual to change, and to engage in treatment

At this time, no medications are FDA-approved to treat cannabis use disorder, but research is ongoing for several options that may help by relieving issues related to stress, anxiety, and trouble sleeping.

Recovery from THC Oil Use

In addition to exploring your treatment options, it can also be helpful to enlist support resources as you recover from an addiction to THC oil. Options include:

• Choose how you will quit: There are two main options for quitting marijuana use: gradual tapering or cold turkey. Tapering your use can minimize withdrawal symptoms, but quitting cold turkey may be an option if you don’t think you can reduce your use gradually on your own.
• Join support groups: Joining a support group for marijuana addiction can be an excellent source of encouragement, information, and strength. 
• Find distractions: Look for ways to cope with drug cravings such as finding distractions. Engaging in hobbies or spending time with friends are strategies that can help take your mind off cravings. Exercise has also been shown to be an effective way to deal with marijuana cravings.

The Couples Quiz

Sometimes, it can be hard to tell how your relationship is going from inside of it. If you’re wondering how healthy your dynamic really is, take this free relationship quiz to find out:

Who Is This Couples Quiz For?

This couples quiz is for anyone who is questioning their relationship dynamic and wants to know more about the characteristics of healthy and unhealthy relationships.

It can help you better understand your feelings about your relationship and determine whether you might benefit from reaching out to a mental health professional, such as a couples therapist, to discuss your concerns. Each question on the test relates to feelings and behaviors associated with romantic relationships.

What To Know About Relationships 

Relationships, romantic and otherwise, are social connections we need for a healthy life. Research shows that having healthy relationships boosts mental and physical health. On the other hand, unhealthy relationships can have a negative impact on mental and physical health. 

Unhealthy relationships typically cause more conflict and create stress. These relationships can have subtle signs of unhealthy patterns or clear signs of being toxic or abusive. Having an unhealthy relationship doesn’t always mean you should dissolve it. Sometimes unhealthy behaviors and dynamics can be addressed with the help of a mental health professional. 

Healthy romantic relationships don’t just happen, they are created
with mutual care, effort, and intention. By communicating openly and
vulnerably, demonstrating care and consideration for each other, and
being willing to adapt to changes and work through challenges
together, your love relationship can grow and thrive.

—
IVY KWONG, LMFT

Signs of a Healthy Relationship

Healthy relationships have some key elements in common. 

Trust

The ability to trust a partner is important to any relationship. Learning to trust comes from our early relationships, such as those with our caregivers during childhood. Research suggests that attachment style influences trust. Two people who trust each other are more likely to have a healthy relationship dynamic.

Respect

Respect should be mutual, meaning both parties have the same regard for the other person’s needs as they do for their own. They value their partner and demonstrate that by how they treat them. People in a healthy relationship show respect by listening, observing each other’s boundaries, being kind to each other, and being supportive.

Honesty

Both you and your partner should be able to share your thoughts, feelings, and beliefs honestly. Honest discussions between partners help build a strong relationship.

Ability to Solve Problems and Resolve Arguments

No relationship is perfect, and we all get into disagreements. In a healthy relationship, partners are able to work through issues without insulting each other or being cruel. They can come up with a solution by focusing on the situation or behavior instead of picking at each other.

Good Communication 

Communication is one of the core elements of a healthy relationship. One study found that a negative communication style was more likely than stress and personality to predict a couple’s likelihood of getting divorced. When partners can express themselves and talk through issues, they are more likely to have a lasting relationship.

Individuality 

People in healthy relationships are able to be loved and appreciated for who they are and do the same for their partner. Each partner should still be able to be themselves. Neither should have to give up relationships with friends or family for the partnership. 

Sexual Bond

Sexual compatibility and getting consent are also important for a healthy relationship. Partners who are matched with a similar sex drive and preferences and those who are able to communicate their sexual needs are more likely to have an enjoyable sex life. 

Signs of An Unhealthy Relationship 

Some signs of an unhealthy relationship are more noticeable than others. It can be hard to recognize subtle signs, especially if you’re in love with someone. 

Control

If one partner is exerting control over the other person, it’s not a healthy relationship dynamic. The controlling partner may be manipulative or use intimidation to prevent the other from doing things or seeing people. 

Poor Communication 

Good communication is key to a healthy relationship. Partners who aren’t able to communicate effectively with respect, honesty, and clarity are less likely to be able to solve problems and work through difficult issues.

Lack of Trust

When one or both partners don’t feel they can trust each other, it’s an indicator of an unhealthy relationship. Lack of trust could lead to hiding things from the other person or accusing them of behaviors, such as cheating.

Violence

Physical violence, such as hitting or shoving, and sexual violence, such as forcing someone into a sexual act without consent, is both unhealthy and abusive behavior.

Not all unhealthy relationships are abusive, but all abusive relationships are unhealthy.

Feeling sad at night can be a symptom of major depression. You might also feel depressed at night because you are dwelling on past events, or because of something simple like too much nighttime light exposure or a disruption in your sleep-wake cycle.

As one of the most common mood disorders, major depression can develop in anyone, at any age, at any time. Feelings of sadness or depression that occur at night can lead to insomnia, anxiety, and feelings of isolation and hopelessness.

Learn more about why you may feel sad or depressed at night, and what you can do to feel better.

Causes of Feeling Depressed at Night

There are several factors that can cause your mood to change at night. Some of them you may be able to adjust, while others are more challenging to manage.

Rumination

People with depression often ruminate, or repeatedly mull over past events and issues that concern them. You may spend hours trying to make sense of past events or imagine them having a different outcome. Since depression makes you likely to focus on negative events, rumination can fuel feelings of depression and anxiety. It’s usually a major cause of nighttime depression symptoms.

Not surprisingly, you tend to be more prone to rumination when you’re alone and free from distractions, which for many of us tends to be at night.

Though rumination is normal, it can be extremely unhealthy, particularly if it’s causing or worsening depression or anxiety.

It may be helpful to take note of the specific things you’re ruminating about before you go to bed. For instance, some people get sad or depressed the night before work because their workplace is a negative environment or they don’t get any satisfaction from their job. Dreading waking up in the morning because you know you have to work can take a mental and emotional toll.

Nighttime Light Exposure

There have been numerous studies on the link between exposure to light at night and depression. One study published in the American Journal of Epidemiology showed a correlation between low-level bedroom light exposure during sleep and developing depression symptoms in older adults, though light exposure was more than likely not the only cause.

The risk could be even higher for younger people, since their eyes are more sensitive. It’s still unclear how exactly light and depression are related, but it’s possible that being exposed to even a tiny amount of light during the night interferes with your sleep cycles, which in turn interferes with your mood.

Circadian Rhythm Disruption

Multiple studies have shown that when your circadian rhythm, or internal sleep clock, is disrupted, your risk of developing depression or worsening symptoms is higher. Circadian rhythm disruption can occur as a result of jet lag, working the night shift, and increased light exposure at night, among other factors.

In general, it’s best to be awake and active during the day and make sure you get the best quality of sleep you can at night.

Chronotype

Do you consider yourself an early bird, a night owl, or somewhere in between? How long and when you sleep at night is called a chronotype. One study on the link between chronotype and depression looked at 32,470 females who were, on average, 55 years old and did not experience depression. They each categorized their chronotype: early, intermediate, or late.

Of these women, 2,581 ended up with diagnosed depression across a follow-up period of four years. The women who identified as early birds had a 12% lower risk of developing depression than the intermediate women, while the night owls had a 6% higher risk. The results showed that the more strongly a woman identified as being a night owl, the higher her likelihood of developing depression.

This study doesn’t show that being a night owl causes depression. But the fact that there are multiple studies indicating a link between chronotypes and depression means that more research is warranted, especially regarding genetic and environmental influences.

Loneliness

Feelings of loneliness can cause sadness at night. You may feel more lonely at night if you lack social companionship outside of work or school. Spending evenings alone can cause worsening feelings of loneliness.

Loneliness is a risk factor for major depression. People with depression may self-isolate, which can increase feelings of loneliness. It is even possible to feel lonely when you are with friends and family.

Symptoms of Major Depression

Major depression causes severe symptoms that interfere with your mood and daily activities. Nighttime feelings of sadness aren’t always associated with major depression, but they can be.

Major depression usually involves other symptoms besides just feeling sad at night. If you’ve experienced some or all of these symptoms for the majority of the day, almost every day, for the past two weeks or more, and they aren’t getting better, you should see a healthcare provider.

• Sleep issues, such as sleeping more than normal or difficulty getting to sleep or staying asleep
• Eating more or less than you normally do
• Weight loss or gain
• Losing interest and/or pleasure in activities you once enjoyed
• Lack of energy
• Difficulty engaging in normal tasks of daily living such as brushing your teeth or bathing
• Headaches, stomachaches, or other pain that doesn’t respond to treatment and has no obvious cause
• Irritability
• Feeling sad and/or anxious
• Feeling hopeless
• Crying
• Restlessness
• Feeling isolated or lonely
• Feeling worthless, guilty, or helpless
• Difficulty concentrating
• Suicidal thoughts or attempts, or thinking about death

Depression and Sleep

Insomnia is a risk factor for depression. People who have difficulty sleeping are more likely to have depression, and people who have both depression and insomnia are more likely to have severe depression that is more difficult to treat. 

Trouble sleeping can affect your mood and cause increased feelings of sadness even when you are not depressed. When you feel sad at night, that can even lead to worsening insomnia. 

Coping With Nighttime Sadness

These strategies may help you break the cycle of nightly negative thoughts and curb nighttime depression symptoms.

Create Positive Thoughts

Participating in a hobby that you enjoy, such as writing, playing an instrument, drawing or painting, and meditation or prayer, can help create positive thoughts. Try to fill your mind with positive things so there’s no room for the negative thoughts to creep in and occupy space.

Problem-Solve Negative Events

People who ruminate tend to not only replay events but also engage in thoughts such as, “Why does this always happen to me?” and “What’s wrong with me that I can’t cope?” These types of thoughts lead to feelings of helplessness.

Instead of letting your mind go to those places, wait until you’re thinking clearly and identify at least one step you can take to overcome your problems. This can even be something as simple as calling a friend to try and brainstorm a solution. This mental interruption and proactive action can help you regain power over the situation and feel less helpless.

Build Self-Esteem

What are you good at? What do you enjoy? Think of some ways to build up your sense of self-worth, such as trying a new type of exercise, starting a new hobby, picking up that musical instrument you used to play, or taking a night or online class in a subject that fascinates you. Feeling good about yourself and what you’re accomplishing helps keep rumination at bay.

Practice Good Sleep Hygiene

Set yourself up for sleep success as much as you can.

• Don’t go to bed until you’re really tired. This gives you less time to start thinking about your problems and the negative events in your life. If you aren’t sleepy, try reading a book or magazine until you are.
• Keep your room dark. Make your bedroom as dark as possible to help prevent disruption to your sleep during the night. Try room darkening shades or blinds and don’t leave the TV on at night.
• Minimize your exposure to screens before bed. Turn off screens and electronics a minimum of two hours before bed to help maximize your sleep time. Exposure to the blue light emitted from screens right before bed can interrupt your sleep and lead to a poorer quality of sleep as well.

How Depression at Night Is Treated

There are many different routes you can take to address nighttime depression. Most likely, you’ll benefit from finding a combination of strategies that fit you and your lifestyle. Start by visiting a doctor or mental health professional.

They will advise you on next steps and come up with a treatment plan, which will likely involve therapy and lifestyle changes. If you have a diagnosis of depression, a doctor may also prescribe medication to help.

Therapy

A popular therapy method for treating depression is cognitive behavioral therapy (CBT). With CBT, a therapist helps you address things like rumination and negative thoughts with self-help strategies. Rumination-focused CBT is specifically geared toward helping patients with rumination, though studies are still being done on its effectiveness.

For instance, if each night you’re dreading the next day at work, you could set a goal to research other jobs you might like better. Sometimes taking small steps to solve the big problems that are weighing you down can improve the sadness that you feel at night.

Medication

If you are diagnosed with depression, a doctor may recommend taking medication alongside attending therapy to treat your symptoms. Common medications for depression include selective serotonin reuptake inhibitors (SSRIs) such as Celexa (citalopram) and Lexapro (escitalopram). SSRIs work by increasing serotonin in the brain, which helps regulate mood.

Lifestyle Changes

There are some changes you can make to your everyday routine to help decrease the sadness you feel at night and even improve your sleep quality. For instance, regular physical exercise can boost feelings of well-being, reduce stress, and lead to better sleep.

Eating a well-balanced diet can also help improve depressive symptoms, combined with other lifestyle choices like exercising and following a sleep schedule.

Though a sound bath may seem like a “new age” concept, the practice of healing bodies through sound is technically thousands of years old with deep roots in cultures across the world. A sound bath is a meditative experience where those in attendance are “bathed” in sound waves. These waves are produced by various sources, including healing instruments such as gongs, singing bowls, percussion, chimes, rattles, tuning forks, and even the human voice itself.

This “spiritual, cleansing music” varies according to place and culture, but it can be as simple as chanting an om following your yoga session or as complex as an hour-long experience in a dedicated space with a sound practitioner.

The music doesn’t have a catchy melody or rhythm like you’d experience at a rock concert or symphony. Instead, it’s a carefully selected wash of instrument and voice with notable resonance and overtones.

What Happens During a Sound Bath?

During the sound bath, participants lie on their backs—sometimes referred to as the Savasana position in yoga—for the entire experience, adds Christina Resasco, a sound healing practitioner and yoga therapist at Saffron & Sage in San Diego, California.

The sound healing practitioner facilitates the experience, and sometimes the entire group participates with chants, mantras, or rolling oms. A guided experience like this generally lasts anywhere between 15 and 60 minutes.

After a sound bath, participants may be advised to move slowly when transitioning to a seated position. Other advice after a sound bath ends can include staying hydrated, getting rest, and staying relaxed.

What Does a Sound Bath Do?

“The general intention of a sound bath is to create a state of harmony in the listener by using sound to clear discordance from the participants’ energy fields. Among the benefits are relaxation, an increased sense of well-being, expanded awareness, and access to inner visionary experience,” says Seth Misterka, co-founder of the Crystal Sound Bath in Los Angeles.

In addition to helping the body relax, some healing sound practitioners argue that sound baths can potentially foster physical healing. Miller likens the experience to acupuncture.

“If you go to an acupuncturist, you likely have energy blocked somewhere that the practitioner helps unlock. The sound bath is similar, but you’re using frequency and vibration instead of needles,” Miller says. “At Naturopathica, we’ve seen people have specific areas of their body where they can feel things loosening up or they feel pain literally going away.”

“Sound therapy is deeply rooted in science and based on the principles of quantum physics and sacred geometry. There are hundreds of clinical trials and peer-reviewed white paper studies on the healing properties of sound,” adds Resasco. “In fact, Western medicine uses sound waves on a daily basis in the form of ultrasound technology, which can be used to break up kidney stones among other things.”

Who Shouldn’t Do a Sound Bath

With the exception of “counter-indicators,” or those who shouldn’t participate—such as someone who’s had a concussion—the experts we spoke to say that sound baths are great for any person who’s interested in experiencing one.

“This is the beauty of sound baths,” says Resasco. “They are for everyone at any stage of their lives. Since you are lying in Savasana (or supported Savasana) the entire time, you don’t need athletic ability or flexibility to participate. In fact, sound baths are very beneficial for pregnancy, prehab and rehab, old and young, or people who are experiencing disease, illness, and trauma.”

Miller agrees, saying, “For a lot of people, it’s much easier to let go in a sound bath versus traditional meditation. I recommend people go when they feel like they need it. Ideally, you’d come every week, but especially when you’re experiencing overwhelming thought patterns or stress.”

Arguably, the best part is that you don’t have to do anything but show up in comfortable clothing and receive the sounds around you while lying peacefully. 

How to Experience a Sound Bath

Sound baths exist in brick and mortar locations across the country, and there are even “pop up” sound baths you can seek out that occur in parks, churches, and other communal spaces.

Resasco also highly recommends a 1:1 sound bath experience, especially if you have a specific injury (physical or otherwise) that you want to target. She says, “The different frequencies of sound healing instruments such as tuning forks and crystal singing bowls, affect different organs, emotions, illnesses, diseases, chakras and trauma. Having a sound therapy session personally tuned to your needs is a game changer.”

You also have the option of purchasing sound healing instruments, or using your own voice, to create a sound bath at home. However, Resasco notes that you may find it easier to enjoy the experience if you’re being guided by an expert.

For a happy medium, consider listening to a sound bath recording. Misterka offers several on his website and a number of sound bath apps also exist.

“Ultimately, a sound bath is a subjective experience and you can try out different sound baths to see what works for you,” says Misterka. “Ideally you should feel that the musician offering a sound bath has positive intentions of wellness, love, and healing. It is a unique experience that can’t really be compared to other therapies and potentially a wonderful supplement to any healing or wellness program.”

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both noted as neurodevelopmental disorders in the DSM-5, however, contemporary perspectives emphasize that they’re just different neurotypes from what is considered neurotypical. Even so, neurodivergence can lead to challenges, though neurodiversity reflects a variety of strengths among humanity.

While approximately 10% of the population has ADHD, some research has shown that 40% of autistic people have ADHD, with other studies suggesting that the rate may be closer to 70%. Conversely, while 2-3% of people are autistic, 20-50% of those with ADHD are also autistic.

In this article, we discuss the connection between ADHD and autism and how these diagnoses present when they co-exist.

How Are Autism and ADHD Connected?

As the statistics above indicate, people with ADHD are significantly more likely to be autistic compared to those who do not have ADHD, and vice versa.

However, before 2013, the Diagnostic and Statistical Manual of Mental Disorders indicated that an individual could not meet the diagnostic criteria for both diagnoses. Despite this requirement, the comorbidity rate of diagnosing both autism and ADHD was 45% at this time.

Despite the overlap, though, current research indicates that ADHD and autism are distinct, separate diagnoses rather than one neurotype on the same spectrum.

Potential Complications

Due to symptom overlap, autistic individuals who also have ADHD might have more difficulty receiving an accurate diagnosis.

Many diagnostic scales emphasize symptoms—more commonly referred to as traits or characteristics—as they tend to manifest when the individual only meets the criteria for autism or ADHD rather than both diagnoses. So a unique combination of symptoms that may not neatly fit into just one diagnostic “box” can be overlooked or misunderstood.

Even though an autistic person is more likely to have ADHD than someone who is not autistic, and someone with ADHD is more likely to be autistic than someone who does not have ADHD, professionals often only assess for one diagnosis at a time.

If you have one diagnosis, it may be beneficial to request testing for the other if you feel that your existing diagnosis does not fully describe your experience.

Sometimes, autistic people with ADHD may have difficulty functioning in a world created for neurotypical brains. Sensory issues and executive dysfunction can make many daily tasks challenging. If you are struggling, look into what support services might be available to you.

Diagnosing AuDHD

ADHD and autism can both be diagnosed by specifically qualified medical and mental health professionals. Although many people have both diagnoses, providers may not evaluate for both unless you request it. A qualified evaluator will use a variety of diagnostic tools when determining if someone meets the diagnostic criteria for ADHD, autism, or both.

Most psychological evaluations for any diagnosis will include a diagnostic interview, during which they will ask several questions about history, symptoms, mental health, and traits that might be consistent with ADHD or autism. Since neurodevelopmental diagnoses like ADHD and autism occur from birth or early childhood, this interview will likely include questions about early developmental years.

Diagnosing ADHD

Measures commonly used to diagnose ADHD include:

• Conners Rating Scales: There are Conners forms for ages 2 to 6 (Conners Early Childhood), 6 to 18 (Conners 4), and 18+ (Conners Adult ADHD Rating Scales). Depending on your age, there are self-report and observer rating scales that yield information about your symptoms and how closely those traits correlate with the diagnostic criteria for ADHD.
• Tests of Sustained Attention: Many different attention tasks exist, such as the Test of Variable Attention. These tasks require an individual to demonstrate their ability to focus on a task.
• Behavior Rating Inventory of Executive Functioning (BRIEF): There are child and adult versions of this form, which assesses the individual’s ability to break down large projects, complete tasks, and sustain attention.

Diagnosing Autism

Measures used to diagnose autism include:

• Autism Diagnostic Observation Schedule. This test utilizes a series of tasks, which the evaluator uses to assess thought processes, behavior, and communication style for consistency with the diagnostic criteria for autism.
• Autism Spectrum Rating Scales. This observational form takes data from parents and teachers or childcare professionals to determine if a child’s behaviors are consistent with autism. It does not have a self-report form.
• Monteiro Interview Guidelines for Diagnosing the Autism Spectrum. This structured interview gathers history and current information about adults to determine if they meet the criteria for autism.

Depending on your presenting concerns, an evaluator might also complete a cognitive assessment (also known as an IQ test). Some autistic people or those with ADHD have learning difficulties, and the IQ test may provide valuable information about how to support your learning.

They may also administer screeners for various other mental health issues, like anxiety or depression, that can co-occur with autism and ADHD.

Support for People with AuDHD

Since the world is not set up for autistic and ADHD brains, many people with either or both diagnoses need support for daily living, work, finances, or other areas. Traditionally, “treatment” for autism and ADHD has emphasized making the person act or appear neurotypical rather than supporting their needs. This has led to increased burnout and trauma symptoms and is increasingly discouraged.

These organizations offer more information on supporting autistic people with ADHD or for finding support regarding your own diagnoses:

• The Autistic Self-Advocacy Network: Created by and for the autistic community, ASAN provides educational information about autism and advocates for autistic-affirming policy changes.
• Neuroclastic: This online non-profit organization elevates autistic voices and stories as well as advocates for a neurodiversity-affirming world.
• CHADD: This organization provides information and community support for people with ADHD and their loved ones.
• ADDitude Mag: This magazine and blog provides medically accurate and community-based information about ADHD.

Rather than encouraging autistic people with ADHD to hide their traits, support looks like creating environments where their needs are met without having to hide or mask. Listen to community members, and make decisions about support based on what autistic and ADHD folks say is helpful to them.

As you read this, you may hear the words “spoken” in your head. That little voice is your inner monologue, also referred to as your inner voice, inner speech, or your self-talk. Research has shown a great deal of variation in how often people experience their inner monologue, with some people not having this experience at all.

Keep reading to learn more about what an inner monologue is and its prevalence (spoiler: researchers disagree on this topic). We also explore how people without an inner monologue think. Finally, we examine why some people may lack an inner voice, along with the pros and cons of both having it and not.

What Is an Inner Monologue?

Many people’s internal experience includes a verbal quality that comes across as a monologue. This inner monologue uses language, but the individual doesn’t need to move their mouth or be heard to form the words that are central to it.

This private speech is addressed only to ourselves and is something we feel like we can “hear.” One’s inner monologue is complete with tone and inflection, even though it’s not audible.

Inner Speech Dimensions

Research has indicated there are three dimensions to inner speech:

• Condensation, or how concise or verbose your inner monologue is. In some instances, one’s inner voice may be descriptive and talkative, with self-talk that includes whole sentences and paragraphs. In others, it may only use a single word or fragments of a sentence.
• Dialogality, or whether you’re thinking in one or multiple voices. Sometimes we may only hear one voice in our head, such as when we tell ourselves things we need to remember or encourage ourselves before tackling a difficult task. But other times, we may think in multiple voices, such as when we anticipate future conversations by imagining what we and the other person will say, or when we have an internal debate in which we think of several different perspectives at once.
• Intentionality, or whether you’re deliberately using your inner monologue. In some cases, such as when we want to practice an upcoming presentation, we may intentionally employ our inner monologue. However, in other cases, such as when our mind wanders, our inner monologue may be active even though we didn’t make a conscious decision to use it.

How Prevalent Are Inner Monologues?

This is a question without a concrete answer. The reason is because inner monologues are extremely difficult to study. After all, no one can peer into another person’s mind and see exactly what and how they’re thinking.

As a result, researchers have come up with different ways to study inner monologues. Some of these have included self-report surveys and experience sampling. In the latter, research participants are asked to keep diaries or take part in interviews in order to provide open-ended data about their inner experiences.

In short, these different ways of investigating inner monologues have led to inconsistent results. As a result, researchers have come up with different answers to the question of how prevalent they really are.

Some scholars have suggested that everyone has an inner monologue, and it never stops during waking hours. Others posit that some people lack an inner speech, adding that even people who do have this experience vary widely in terms of frequency throughout the day.

Discrepancies in Prevalence

For example, Hurlburt estimates that between 30% and 50% of people frequently experience an inner monologue. His research using Descriptive Experience Sampling has indicated that most people don’t experience their inner monologue all the time, and many go through large parts of their days without experiencing it at all.

On the other hand, researchers using different research methods have concluded that the frequency of inner speech is much higher. One study suggests that people experience it 75% of the time.

How Do People Without an Inner Monologue Think?

For those who have an inner monologue, it can be hard to understand how people think when they don’t have this experience. However, research has shown people generally think in five different ways, only one of which involves an inner monologue.

Those ways of thinking are:

• Inner speech: Our inner monologue in which we speak words in our mind.
• Inner seeing: Imagining an image in our mind that doesn’t match what we’re seeing in reality. For example, you might conjure an image of a place you want to vacation.
• Unsymbolized thinking: Thinking but without employing words, images, or other symbolic methods of communication. For instance, you might go through the motions of brushing your teeth without consciously envisioning or telling yourself to complete each step.
• Feeling: Consciously considering your emotions. For example, you might acknowledge that you’re feeling overjoyed after getting good news.
• Sensory awareness: Idly thinking about one sensory aspect of the environment while not thinking about others. For instance, on a windy day, you may feel the wind and notice the way it makes your clothes blow around you, but instead of thinking about that, you focus your thoughts on how cutting the wind feels on your hands.

Why Do Some People Lack an Inner Monologue?

Research on why some people lack an inner monologue is in its infancy and, therefore, there are no firm answers to the question of why some people may not experience this phenomenon. One study found that people with aphantasia, an inability to see visual imagery in one’s mind, also had weak or completely absent inner monologues, which the researchers labeled anauralia.

The opposite was also true, with people who could conjure vivid visual imagery also tending to experience a vivid inner monologue. However, more research is needed to understand why the inability to see visual imagery would impact whether one has an inner monologue and vice versa.

Pros and Cons of an Inner Monologue

An inner monologue has been found to have benefits across a wide range of domains, including planning, problem-solving, self-regulation, self-reflection, emotion regulation, and perspective-taking. One’s inner monologue can also be a source of motivation, instruction, and positive self-reinforcement.

On the other hand, for some people, self-criticism is a regular feature of their inner monologue. This is a major drawback of inner monologues, and studies have found critical self-talk is associated with lower self-esteem and more frequent automatic negative statements about the self.

The other ways of thinking that don’t involve an inner monologue, outlined above, likely have benefits and drawbacks as well. However, more research is necessary to understand what they may be.

As you navigate divorce, having questions and concerns about your friendships is common. Recent divorcées may be anxious about being left out of couples get-togethers or being seen differently by their old friends. “Individuals who recently split off from their spouses can be concerned about how their social interactions will be impacted as a result of their new situation,” shares Michelle English, LCSW, co-founder and executive clinical manager at Healthy Life Recovery.

Concerns like these are totally valid, but you have some power in this situation. Divorce can impact your friendships, but it can also be an opportunity to take stock of who you can genuinely trust.

Why Friendships Often Change After Divorce

“It’s hard not to feel betrayed when a friend stays close to your ex,” says Shari Leid, a mindset coach, friendship expert, and national speaker at Imperfectly Perfect Life. “Suddenly, you question if you can confide in them without worrying that they will share your thoughts with your former spouse.” Worse yet, you may wonder if the friend is discussing you with your ex behind your back, Leid says.

There’s no denying that divorce tends to reshape your friendships, especially the friendships you and your ex shared. Kiana Shelton, LCSW, a therapist with Mindpath Health, agrees that divorce can have an overall strong impact on your friendships. But how much of an impact it has depends in part on your friends themselves, including how they perceive the situation and their own emotional maturity, she explains.

Divorce can often illuminate which of our friends are “keepers” and which may not be the best match for us.

“Many divorced individuals often note that during this journey, there is a real discovery of who their ‘true friends’ are,” says Shelton.

The Importance of Friendships in Post-Divorce Healing

Divorce is a time of crisis, and having a supportive network is essential to getting you through this period. “Knowing who is supportive vs. unsupportive is critical in ensuring you have a safe emotional space for processing grief, navigating new routines, and maintaining a sense of connection,” says Shelton.

What’s the best way to figure this out? According to English:

• Loyal, supportive friends are “those who empathize, do not engage in gossip about your life, do not pry into what is currently a sensitive topic, and remain loyal through the stages of your life.”
• Disloyal, non-supportive friends tend to “distance themselves, take the side of your former partner, and say hurtful or unfair things to you that sabotage your recovery instead of encouraging you to see the bright side.”

How to Rebuild or Strengthen Friendships After Divorce

Figuring out how to manage your friendships after divorce can be tricky. Here are some expert tips:

Managing Inconsiderate Friends

Navigating the friends you share with your ex can get sticky at times, and sometimes your mutual friends will be less than considerate. English advises recent divorcées to share their feelings and requests with their friends as openly as possible.

“For example, you can say, ‘I understand that you have a good relationship with both of us, and I do not take that lightly; however, I would kindly ask that everyone be considerate of me during this period,’” she recommends.

Encourage Mutual Friends to Remain Neutral

It’s not always possible, but when it is, it’s best if your mutual friends try to remain as neutral as possible at this time. “Encourage these friends to remain neutral while reassuring them that neutrality entails and does not equate to betrayal,” English advises.

“When you see someone who is beginning to be overly enthusiastic in telling tales with respect to your ex, you can politely tell them, ‘I’d prefer not to talk about what [ex’s name] is doing at the moment.’”

Accept That You May Lose Some Friends

Leid is a recent divorcée herself and has found that having a clear-eyed view of her friendships—and accepting her friends for who they are—has been pivotal. “After finalizing my divorce this past year, after 27 years of marriage, I knew going into the divorce process that I would lose some friends,” she says.

She explains that she made a conscious choice not to dictate who her friends should or shouldn’t keep in their lives, and to simply observe which friendships remained strong and authentic, realizing those were her true friends. “Fortunately, most of my friendships withstood the divorce and even became closer friends, while others faded naturally,” she shares.

Restoring or Making New Friends in a New Chapter

For many people, divorce is a time when you can also reconnect with old friends—and when you are ready, add some new friends into the mix.

English shared some tips for this period of friendship renewal:

• Be mindful that restoring a friendship after a divorce takes time and effort.
• Consider contacting friends you’ve lost touch with to share that you’d like to rekindle the friendship.
• For friends that you’ve been in touch with but would like to stay in touch more often, start by texting them simple questions like “How are you doing?” every once in a while to show you care and would like to connect more often.
• Keep in mind that making new friends can be scary, but it can also be fun as you get more comfortable putting yourself out there.
• Consider attending hobby clubs, sporting activities, or community social events; online friendship apps like Meetup or Bumble BFF can be helpful too.
• If you’re a parent, it can be helpful to have friendships with other single parents who may understand your children’s needs so that you don’t feel sidelined when you need to focus on them.
• More importantly, focus on friends who understand what it means for you to be a parent and a friend and who can support you in this momentous life transition.