The Harsh Reality of “High Functioning”

The term “high functioning” is the bane of neurodivergent (NDs) with lower support needs. It’s a brutal process trying to understand or explain how I successfully achieved all the things I previously did — Masters Degree, high stress international job — and then, after burnout, struggling to do a fraction of what I did before. My brain has effectively said, “No more.” I realize now, after a very late diagnosis (of autism spectrum disorder, or ASD), I wasn’t successfully functioning as much as I was forcefully masking — suppressing who I was and ignoring or pushing through all kinds of injurious scenarios to survive as a quasi neurotypical. In the long run, it results in Complex PTSD for the neurodivergent. At some point everything becomes traumatic. 

This is the danger in using the term “high functioning”. 

Neurodivergence does not wax and wane — it is a permanent state, and the degree of functioning varies from day to day, hour to hour depending on the context, environment, and physical or mental health reserves at our disposal in the moment we confront the demands of adult living. The level of functioning never rightly fits categorization as high or low. 

This matters for those who have a diagnosis and is absolutely central to an understanding of those who require accommodations to work or need access to disability benefits to survive. The access and entitlement to these supports is too reliant on the traditional medical model to articulate, which is a huge disservice and, in some cases, enormous injustice to the neurodivergent communities forced to rely on them. The traditional medical model is barely competent at explaining and treating physical diseases or acute or chronic injuries; it fails dismally in apprehending, diagnosing or treating the fluctuating, variable symptomology — psychological, cognitive, and physical — of those who are neurodivergent. It is insulting and traumatizing to have to rely on this cacophony of medical incompetence to secure the bare minimum supports needed to function to the best of our ability. 

“High functioning” is in the eye of the beholder, it is the furthest thing from truth.