Through all my years of writing about and working with HSPs, I’ve received lots of follow-up questions and comments from people trying to understand what exactly high sensitivity is all about.
For an overview, please see The 5 Defining Highly Sensitive Person Characteristics and 10 Tell-Tale Signs You Might Be A Highly Sensitive Person.
But I’m also often asked to clarify how high sensitivity is different from various disorders and conditions:
- “This sounds like autism.”
- “Isn’t this the same as sensory processing disorder?”
So I wanted to put together this quick reference guide that explains the relationship between high sensitivity and some of the most common disorders and conditions.
But before we get to it, I want to be SUPER clear that I’m not writing this to help you diagnose or undiagnose yourself. If you have questions about your health care, please consult a qualified medical provider.
This article is meant for informational purposes only so that you are better able to advocate for yourself and so that you will know what to say when “helpful” friends and family try to diagnose you with this or that disorder.
Because here’s the first important point I want to make:
HIGH SENSITIVITY IS A PERSONALITY TRAIT – NOT A DISORDER
In certain circumstances, HSPs are more likely than non-HSPs to develop various physical and mental illnesses.
However, high sensitivity itself is a personality trait that you are likely born with. It’s NOT a disease or disorder. High sensitivity actually comes with many benefits, which is likely why the trait has survived evolution.
So one can be a highly sensitive person without any physical or mental illnesses whatsoever or one can be a highly sensitive person with health issues.
But because HSPs are a minority – and in many respects function differently from the non-HSP majority – what is perfectly normal for an HSP can sometimes be mislabeled as abnormal by those who don’t understand what high sensitivity is all about.
And that’s why it’s good to know…
HOW IS HIGH SENSITIVITY DIFFERENT FROM…?
Anxiety is probably the trickiest to differentiate from high sensitivity, so let’s just tackle this one first.
Fear, worry, and stress are natural and necessary reactions to threats and difficult circumstances. We are all supposed to feel them from time to time. However, fear, worry, and stress can morph into an anxiety disorder if you kinda get stuck in that mode and can’t get out.
HSPs are more likely than non-HSPs to struggle with anxiety for a few reasons:
- HSPs have a lower stress threshold than non-HSPs, meaning their stress response system will “fire up” from less provocation, so especially if they have trauma in their past, they are more likely to get stuck in that mode.
- HSPs who do not understand high sensitivity can misinterpret their overstimulation symptoms as fear and look for reasons to be scared, which will in turn worsen their symptoms.
- HSPs who do not understand high sensitivity can become afraid of their overstimulation symptoms or of people noticing them and start avoiding certain situations that they predict will cause overstimulation.
- HSPs need more rest than non-HSPs and those who do not understand high sensitivity can label this need as “avoidance”.
- HSPs are naturally more cautious and prefer to think things through before forging ahead, which is actually one of the benefits of the trait, but can cause those who do not understand high sensitivity to label it as “overthinking” or “excessive worry.”
So on the one hand, HSPs are more likely to develop an anxiety disorder, especially if they have trauma in their past. But at the same time, it’s possible to confuse HSPs’ reactions and behavior with anxiety even when what they are experiencing is not arising out of fear and when their behavior is perfectly normal and healthy within the HSP population.
ATTENTION DEFICIT HYPERACTIVITY DISORDER
High sensitivity can be confused with attention deficit, because overstimulated HSPs sometimes act scatter-brained, overwhelmed, or distracted.
However, when HSPs are NOT overstimulated, they do not fit the criteria for ADHD at all. HSPs actually tend to be exceptionally capable of listening, staying focused for long periods of time, and conscientiously following through with tasks.
And most HSPs are the opposite of hyperactive or impulsive. Even highly sensitive high sensation seekers are typically slowed down at least some by their cautious side.
AUTISM SPECTRUM DISORDERS
There are two reasons why high sensitivity can sometimes be confused with autism spectrum disorders.
First, one possible symptom of autism is an increase or decrease in sensitivity to sensory triggers.
Second, some HSPs struggle with shyness or social anxiety, which might result in communication challenges, as is seen with autism.
However, high sensitivity differs from autism in several ways:
- HSPs always struggle with increased sensitivity to sensory triggers. In autism, sensitivities are inconsistent. Sometimes there’s an increase, sometimes there’s a decrease, and the “irritants” can vary.
- HSPs are typically highly empathetic and skilled at reading social cues, something that people on the autism spectrum struggle with. If HSPs have trouble with communication, it’s not because they can’t read other people. It’s because they fear rejection.
- HSPs don’t exhibit other common autism symptoms, such as repetitive patterns of behavior or fixating on a particular topic of interest.
Similar to anxiety, HSPs are more likely than non-HSPs to struggle with depression, especially if they have experienced trauma or excessive stress. However, behavior that is perfectly normal and healthy within the HSP population can also be confused as depression just because it differs from the majority. For HSPs, it’s normal to ruminate and process negative events more deeply than for non-HSPs. HSPs also tend to have stronger emotional reactions to both negative and positive events – meaning HSPs cry easier and their low moods might appear REALLY low.
One way to tell whether there is cause for serious concern is to pay attention to the duration of the lows. A depressed HSP is in a low mood most of the time and unable to bounce back.
POST-TRAUMATIC STRESS DISORDER
Here’s another complicated relationship!
Some of the symptoms of PTSD, such as an exaggerated startle response and frequent overarousal, overlap with typical characteristics of HSPs, so the two can be a little tricky to distinguish.
As a highly sensitive trauma survivor myself, I honestly don’t know how much of my overzealous stress response is driven by genetics and how much by trauma. I have resolved not to expend too much brain power on that though – I’ve just addressed the issue from both directions.
At the same time, there are lots of HSPs who do not suffer from PTSD. Even if you experience some symptoms that resemble PTSD, you would know that you belong in this latter group if you have not experienced significant trauma that has left you with a bunch of distressing memories.
SENSORY PROCESSING DISORDER
One of the scientific terms for high sensitivity is sensory processing sensitivity. That sounds an awful lot like sensory processing disorder, so the two get confused a lot. However, they are not the same.
Sensory processing sensitivity (ie. high sensitivity) is a personality trait. While HSPs can become overwhelmed or overstimulated by sensory information and this can at times look similar to someone with sensory processing disorder, the root cause of these issues is not the same. Sensory processing disorder is a neurological condition where sensory information is either not detected or it’s disorganized to the point that your brain can’t formulate an appropriate response.
Moreover, sensory overstimulation is just one aspect of high sensitivity. HSPs also share other characteristics: deep processing, emotional reactivity, empathy, and sensing the subtle. A non-HSP with sensory processing disorder would not recognize these traits in themselves.
WANNA LEARN MORE?
If you want to get into the nitty-gritty about high sensitivity and the conditions mentioned in this article plus many more, I recommend Psychotherapy And The Highly Sensitive Person: Improving Outcomes For That Minority of People Who Are The Majority of Patients by Dr. Elaine Aron. This book has a whole appendix devoted to comparisons of high sensitivity to every imaginable psychological diagnosis.