Being an alphabet souper: Living with neurodivergence and co-occurring challenges

Reading time: 5 minutes

Have you spent most of your life carrying experiences that few people ever see? If you’re autistic, ADHD, chronically ill, or some combination of all three, there’s a good chance you already know what that feels like.

You live with a dozen intersecting realities—sensory sensitivities, executive dysfunction, fatigue, chronic pain, mental health conditions—and yet you’re constantly asked to condense all of that into one simple explanation. A label. A sentence. Something that fits the narrative people already expect to hear.

That’s why I use the term “alphabet souper.”

It’s my shorthand for a life shaped by diagnosis codes, misunderstood symptoms, and invisible struggles. It refers to the long string of acronyms many of us carry: ADHD, ASD, HSD, POTS, MCAS, IBS, C-PTSD, etc.—and more. Each one might explain a single piece of our reality, but none tell the full story. And most of the time, no one even asks.

Being an alphabet souper means living with neurodivergence and co-occurring challenges, while constantly being expected to explain it all in a way that’s easy for others to understand.

We become experts at this. Not because we want to. Because we’ve had to.

The Pressure to Be Legible

When you’re an alphabet souper, you quickly learn that complexity makes people uncomfortable. Most of the world is calibrated for simplicity. Single diagnoses. Clear causes. Easy fixes. But alphabet soupers don’t fit that mold.

Instead, we live at the intersection of multiple systems that don’t work the way they’re “supposed to.” Our experiences don’t follow a single diagnostic narrative. We might be managing sensory overwhelm, executive dysfunction, chronic illness flare-ups, social anxiety, and trauma, all in a single afternoon.

And yet, when we speak about our reality, we often feel pressure to streamline it. To reduce it to something legible. Something people will recognize. Something that sounds familiar enough not to raise eyebrows or questions we’re too tired to answer.

So we adapt. We learn to talk about our conditions in bite-sized chunks. We avoid going into detail. We measure our words against other people’s attention spans and comfort levels. We edit our stories because we know what happens when we don’t.

The more challenges you carry as an alphabet souper, the more invisible labor goes into appearing “manageable.” This is about more than masking. It’s about shaping your whole presence around what others can emotionally or intellectually tolerate.

Masking Runs Deeper Than People Think

When people talk about masking, they often imagine it as something surface-level: suppressing stims, mimicking facial expressions, mirroring tone. But for many of us living as an alphabet souper, masking runs far deeper.

We mask pain. We mask confusion. We mask the crashing of multiple internal systems while calmly nodding through a conversation. We become fluent in scripting—even basic interactions—because improvising takes energy we often don’t have.

And the longer we mask, the harder it becomes to remember what’s underneath.

Being an alphabet souper means juggling neurodivergence and co-occurring conditions that interact in unpredictable ways. Maybe it’s brain fog from POTS, overlaid with executive dysfunction from ADHD, while also managing the social load of masking autistic traits. On paper, we might look “functional.” But the cost of looking that way is rarely visible to others, and often invisible even to ourselves.

Masking becomes muscle memory. We’ve done it for so long, it can feel automatic. Expected. Sometimes even praised.

But here’s the truth: that praise is hollow. Because it usually comes from people who don’t see the after-effects. They don’t see the crash after we’ve held it together for too long. They don’t see the shutdowns, the flares, the hours lost trying to regulate. They see us as “resilient”, but they never asked what it cost.

For an alphabet souper, masking isn’t just about fitting in. It’s about managing other people’s reactions so we don’t lose support, credibility, or connection. And that’s a heavy ask, especially when you’re already carrying so much.

Complexity Isn’t a Defect

In a world that rewards neat categories and predictable narratives, being an alphabet souper often feels like you’re doing life wrong. You’re neurodivergent and you’re also navigating chronic illness, trauma, sensory processing differences, mental health struggles, and no one seems to know what to do with all that at once.

You get responses like, “That’s a lot,” or “Have you tried yoga?” You see the subtle wince when you bring up yet another acronym. You notice how people start to disengage when your story doesn’t have a simple ending or a tidy explanation.

There’s a widespread belief—sometimes unspoken, sometimes very loud—that if you have too many issues, you must be exaggerating. Or dramatic. Or maybe even difficult. But complexity isn’t a personal failing. It’s just reality for many of us.

Being an alphabet souper means that no single diagnosis explains everything, but each one adds to the picture. It’s layered. And those layers influence how we experience the world, how we communicate, how we move through each day.

But complexity makes systems freeze up. Medical professionals don’t know which part to treat first. Friends don’t know how to respond. Coworkers stop inviting you to things.

And so, out of self-protection, we start to censor. We pick the “most relatable” diagnosis to talk about and leave the others off the list. We say we’re “just tired” when we’re in full autonomic dysregulation. We avoid bringing up that a food sensitivity triggered a three-day spiral because it sounds too strange, too much.

We internalize the idea that to be supported, we must be simple.

But being an alphabet souper means embracing complexity, because denying it costs us more than anyone else. Denying it keeps us alone.

A Thousand Small Losses

Grief isn’t always loud. For an alphabet souper, it’s often subtle, cumulative: an echo that builds over time.

It starts with the doctor who dismisses your symptoms because your tests came back “normal.” The therapist who focuses on one diagnosis but ignores the others. The friend who changes the subject when you try to explain what a flare day really feels like.

None of these are big moments on their own. But together, they form a pattern. A long trail of interactions where your reality was too complex, too inconvenient, or simply too misunderstood.

When you’re an alphabet souper, the losses add up: the connection that fizzled out after you were “too honest”; the job interview that went silent after you disclosed; the look someone gave you when you tried to explain how everything overlaps—how your sensory overload makes your GI symptoms worse, which then spikes your anxiety, which makes your executive dysfunction spiral.

You learn not to go there, because you’ve learned most people don’t want to know.

You start skipping details. Leaving things out. Not mentioning the acronym you just got added to your file. That information, after all, could cost you in social currency.

Every time you withhold a part of your story, there’s a loss. A missed opportunity for understanding. A part of yourself that stays hidden.

And the hardest part? Even when you’re surrounded by people, you can feel deeply alone. Because no one sees the full version of you. Few people have stayed long enough—or listened closely enough—to hold your whole story.

That’s the ache many alphabet soupers carry: the longing to be known and believed, without having to shrink their truth to fit someone else’s comfort zone.

Final Thoughts

If you’ve ever felt like your story had too many moving parts to explain—if you’ve ever watched someone’s eyes glaze over as you tried to name what you’re carrying—you’re not alone. You’re likely an alphabet souper, navigating a world that doesn’t know how to hold the weight of complexity without trying to simplify, fix, or ignore it.

Being an alphabet souper means you’ve had to become your own translator, advocate, and interpreter, often in spaces that demand silence or performance over truth. That’s exhausting. And you deserve better.

You deserve to take up space with your full story, and not just the parts that are easy for others to digest. You deserve support that doesn’t disappear when the list of challenges gets longer. You deserve to say, “I’m struggling,” without having to earn that struggle’s legitimacy.

And above all, you deserve to be known without having to be explained.

Are you an alphabet souper too? Have you ever had to simplify your truth just to stay connected or believed?