Clinical Misfits

What happens when you're experiencing very real neurological symptoms, but medicine can't explain what's causing them?

In this episode of Clinical Misfits, Dr Mary explores functional neurological disorder (FND), a term used to describe neurological symptoms that can include changes in sensation, speech and movement, paralysis and seizure-like episodes. She questions the language historically used to describe these experiences and what happens when unexplained symptoms are too readily dismissed as psychological or “all in your head.”

Dr Mary considers the relationship between these symptoms, the autonomic nervous system and trauma, particularly for neurodivergent people whose lives may include experiences of bullying, rejection, chronic illness, pain and other forms of trauma. She also discusses approaches used to manage symptoms, from medication and trauma therapies to sensory regulation, movement and other forms of self-care.

Throughout the episode, Dr Mary returns to a simple principle: when medicine doesn't yet have an explanation for someone's neurological symptoms, that uncertainty shouldn't become a reason to blame or disbelieve the person experiencing them.

Produced for the Autistic Culture Podcast Network.

🎧 Clinical Misfits is available on Spotify, Apple Podcasts, and all major platforms.

🌈 Celebrate autistic voices with early access, ad-free listening, and our full archive at AutisticCulturePlus.com

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Hosted on Acast. See acast.com/privacy for more information.

For many neurodivergent people with complex chronic illness, the barriers they experience at school or work aren't only neurological or psychological. So why are accommodations so often approached as though they are?

In this episode of Clinical Misfits, Dr Mary explores the relationship between dysautonomia, neurodivergence and the need for school and workplace accommodations. She questions whether current assessment processes adequately recognise physical symptoms such as fatigue, brain fog, dizziness, pain, sensory sensitivities and difficulties regulating heart rate, blood pressure and body temperature.

Dr Mary looks at how dysautonomia might be recognised and investigated in healthcare, and argues for greater involvement from medical professionals when determining the support someone needs. She also discusses practical routes towards better quality of life, from physical and occupational therapy to nutrition, movement and other forms of ongoing support.

Produced for the Autistic Culture Podcast Network.

🎧 Clinical Misfits is available on Spotify, Apple Podcasts, and all major platforms.

🌈 Celebrate autistic voices with early access, ad-free listening, and our full archive at AutisticCulturePlus.com

🌐 Visit www.autisticculturepodcastnetwork.com

📲 Follow us on Instagram: @autisticculturepodcast

Hosted on Acast. See acast.com/privacy for more information.

Clinical Misfits returns for Season Two with a deeper, more conversational approach to the connections between neurodivergence and complex chronic illness.

In this episode, Dr Mary revisits ideas explored in Season One before turning her attention to hypermobile Ehlers-Danlos syndrome (hEDS), dysautonomia and their relationship with neurodivergence. She explores the potential role of chondroitin sulfate in connective tissue and the nervous system, including its involvement in structures surrounding nerve cells known as perineuronal nets.

From there, Dr Mary considers how differences in synaptic pruning could influence the way neurodivergent nervous systems process and retain signals. Using pain and the body's autonomic response as an example, she explores a possible connection between neurological development, heightened nervous-system responses and the complex physical symptoms experienced by many neurodivergent people.

Produced for the Autistic Culture Podcast Network.

🎧 Clinical Misfits is available on Spotify, Apple Podcasts, and all major platforms.

🌈 Celebrate autistic voices with early access, ad-free listening, and our full archive at AutisticCulturePlus.com

🌐 Visit www.autisticculturepodcastnetwork.com

📲 Follow us on Instagram: @autisticculturepodcast

Hosted on Acast. See acast.com/privacy for more information.

In the final episode of Clinical Misfits, Dr Mary discusses some genetic conditions that account for a lot of the physical, mental, psychological and behavioural characteristics, present in varying degrees in the majority of neurodivergent people. These are largely due to defects in collagen!

Collagen is a major structural protein throughout the body and nervous system. In the majority of cases, this causes organs, blood vessels, bones, muscles, tendons and ligaments to sag. The result may be weakness in many organs and structures, including throughout the gastrointestinal, musculoskeletal, respiratory, reproductive, urinary and nervous system. 

Oh wait! That's pretty much the whole person! Want to know how this works? Dr Mary has some good information in this episode!

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🌐 Learn more about the network at AutisticCulturePodcastNetwork.com

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In Episode Three of Clinical Misfits, Dr Mary explains about how the autonomic nervous system and the immune system provide a protective net over the entire person. 

As with the endocrine system, discussed in the last episode, coordination of activity has to be very tight to pull this off. If either system is dysregulated, both are and the body is left vulnerable. Worse, the immune system may attack the nervous system causing serious, debilitating disease. Or, the nervous system may trigger exaggerated immune responses to any number of environmental stressors that are not true physical threats to the body. 

The symptoms are familiar to us Clinical Misfits.

Also in this episode, Dr Mary discusses how masking autistic traits undermines the Clinical Misfit's immune system, contributing to the physical illnesses that present in late-stage burnout.

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In Episode Two of Clinical Misfits, Dr. Mary describes each of the major endocrine (hormone) systems of the body and the myriad ways that dysregulation of the autonomic nervous system can affect their function, and vice versa.

She explains how the communications among a person's thoughts, senses, emotions and experiences affect and are affected by a person's hormonal balance at any time. When the autonomic system is dysregulated, the endocrine systems cannot function normally. This can result in all the signs and symptom of hormone gland disease, when the glands themselves might be completely healthy.

The result is true illness that cannot be identified using standard medical testing.

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Dr Mary Sims is an AuDHD (autistic with attention deficit hyperactivity disorder, and some overlap with obsessive compulsive disorder) who has both dealt with neurodivergent patients in crisis and been one herself.

In Episode One of Clinical Misfits, Dr Mary describes in detail a unique way to identify neurodivergent people who are approaching or in the middle of burnout, who she calls Clinical Misfits. She emphasizes a gestalt approach to diagnosis, looking for patterns, in true autistic style, rather than focusing on specific organ systems, or parts of the body, and the afflictions thereof.

The episode recommends a thorough examination of all parts of a person's life, looking for numerous vague symptoms, in many different categories, that have characteristics commonly seen in neurodivergent people in crisis. Below are links to materials that may be helpful.

Clinical Tools

List of Podcasts that are helpful to neurodivergent people facing burnout:

• Autistic Culture Podcast
• Beyond Six Seconds
• Meet My Autistic Brain
• Divergent Conversations/ Divergent Insights

Webpages dedicated to caring for neurodivergent people in affirming, non-ableist ways: Allbrainsbelong.org

If you know of other resources, please contact Dr Mary: [email protected]

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What if healthcare understood neurodivergence differently?

Welcome to Clinical Misfits, a podcast exploring neurodivergent health, medicine, and clinical understanding through an autistic cultural lens. Part of the Autistic Culture Podcast Network.

Hosted by Dr Mary Sims, a neurodivergent neurologist who is AuDHD herself, the series combines lived experience and medical expertise to explore the physical, neurological, and systemic realities of neurodivergence.

From burnout and the autonomic nervous system to hormones, genetics, and immune system interactions, Clinical Misfits challenges assumptions and offers new ways of understanding neurodivergent health.

🩺 Subscribe now to hear future episodes.

🌈 Celebrate autistic voices with early access, ad-free listening, and our full archive at AutisticCulturePlus.com

🌐 Learn more about the network at AutisticCulturePodcastNetwork.com

Hosted on Acast. See acast.com/privacy for more information.