When Bright Minds Struggle: Twice-exceptional, Giftedness and Mental Health

What if the problem isn’t the person—but the misunderstanding of their strengths?

Exploring how high potential and emotional depth can be misread as disorder—and how to support gifted and twice-exceptional individuals with compassion and clarity.

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If you're here, you might be someone who has always felt a little different. Or you're parenting a child who doesn't quite fit the mold. Maybe they (or you) are bright, curious, intense, and full of potential—but also anxious, misunderstood, frustrated, or even burned out.

It can be confusing. How can someone so intelligent, so perceptive, be struggling this much?

Often, the very traits that make someone exceptional are the same ones that lead to overwhelm, disconnection, or emotional pain—especially when their environment doesn’t understand or support them.

This is the paradox of giftedness, and especially of twice-exceptionality (2e): high cognitive ability paired with other neurodivergent traits, learning differences, emotional intensity, or mental health concerns. And too often, these individuals are misdiagnosed, pathologized, or dismissed.

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What Is Twice-Exceptionality?

Twice-exceptional individuals are gifted—and also have one or more additional challenges. This might include ADHD, autism, anxiety, depression, sensory sensitivities, or a history of trauma. These individuals often live in a world where their strengths and struggles mask each other. Their intelligence may hide their difficulties. Their difficulties may overshadow their strengths.

What they need isn’t more pressure to "live up to their potential." They need support that honors both their complexity and their capacity.

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What Gets Missed

Gifted and 2e individuals often:

• Struggle with anxiety, but are told they "worry too much."

• Lose interest in school or work, but are called lazy or oppositional.

• Become perfectionistic, critical, or emotionally reactive, but are labeled difficult.

• Seem withdrawn, intense, or out of sync socially, but are overlooked because they “function well enough.”

These experiences can lead to years of internalized shame, self-doubt, and the sense that something is wrong with them—even when they are functioning in environments that don't reflect their strengths or needs.

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How I Work Differently

I don’t begin by asking, “What’s wrong?” I begin by asking, “What’s your story?” From there, we explore your strengths, what’s getting in the way, and what might be possible.

In my work with gifted and 2e individuals, I aim to understand the whole person—not just their symptoms. I listen deeply, examine their developmental and educational history, consider cognitive patterns, emotional intensity, and family dynamics. I draw on my background in child, adolescent, and adult psychiatry; integrative medicine; psychotherapy; and personal experience.

I collaborate with families, schools, and other professionals. I look for fit, not just function. For meaning, not just metrics. For potential, not pathology.

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A Path Forward

If something in this resonates, you are not alone. Giftedness is real, and so are the struggles that come with it. But support is possible—and hope is not out of reach.

Whether you're a parent, an adult seeking clarity, or a provider looking for someone to help your patient take the next step, I invite you to explore this work further.

We don’t have to fix what isn’t broken. We can understand it. Honor it. And help it grow.

For more information on 2e / twice-exceptional / giftedness click here.

When we begin to see the full picture, what once looked like struggle is more clearly seen as a strength.

If this resonates with you or someone you care about, I invite you to reach out.