Note: this is Part 1 of a 2-part article
When Gifted Individuals Need to Make Choices: Issues, Conflicts, and Resolutions
Gifted individuals often have problems managing their family’s and friends’ reactions to their giftedness, finding a school that promotes their development, establishing relationships in which to share it, and creating a career path that will allow their potential to be realized. Gifted individuals also have trouble controlling creative frenzies or reactions to success and failure. They also have trouble managing certain parts of their gifted personalities:
- passionate engagement,
- the need for independence,
- tendencies toward overreaction, and oversensitivity.
These are essential for high levels of creative work, but they also need to be modified when engaging in social or intimate relationships. Gifted polymaths, individuals with multipotentiality, can have difficulty choosing a particular domain in which to develop expertise.
For some gifted individuals, educational adjustments, coaching, counseling, and various forms of cognitive/behavioral therapy can succeed in addressing the more straightforward aspects of these problems: circumstances can be improved; more appropriate relationships can be found; family dynamics can be shifted; and critical thinking can be used to make important decisions.
When and Why Standard Assessments and Interventions Often Fall Short
However, when problems persist, it can be a sign that a set of deeper psychological or emotional issues may be operating. Often, these dynamics exist at a subconscious or unconscious level, making it hard to employ conscious cognitive and behavioral interventions. Without a more comprehensive assessment that uncovers and examines these issues and points the way toward addressing them, serious psychological symptoms, including anxiety, depression, mood swings, and self-defeating behavior, can develop alongside the more obvious areas of dysfunction.
The Role of Early Psychiatric Consultation and the Use of Psychotropic Medication
After new information from different assessments and new interventions fail to make a difference, a sense of pessimism sets in. This is often the beginning of a downward psychological spiral.
Gifted individuals may slowly become convinced that their problems and symptoms are rooted in primary neurological or biological defects or deficits. Now the very qualities, especially the noncognitive intuitive ones that were once thought to be the remarkable traits of being gifted, are experienced as “neurodivergent” liabilities or disabilities.
Unable to use their capacity to see beyond the ordinary (clairvoyance), the immediacy of intuitively arriving at answers to complex problems now actually seems irrelevant.
Feeling more and more hopeless, all aspects of giftedness begin to be disavowed. Precocious accomplishments that were once a source of pride and self-esteem are now considered “flukes,” and the whole idea of being gifted can be seen as a self-indulgent fantasy.
When Psychiatric Consultation and Psychotropic Medication Become an Emergency
The tipping point, when a psychiatric consultation and the use of psychotropic medication become an urgent necessity, is reached when psychological symptoms of anxiety, depression, mood swings, and self-destructive behavior become immobilizing.
Suicidal ideation can creep into everyday thinking, and thought experiments about techniques for self-harm become preoccupations. Now gifted individuals and their friends and family worry that, in addition to their other problems, they have developed a genuine psychiatric syndrome or a pathological personality disorder.
Sadly, psychiatric consultation and psychotropic medication often become last-ditch efforts to forestall a full-blown psychiatric crisis. Employed earlier, these interventions might have stopped this downward, destructive path and helped avoid needless suffering and time wasted (Schatzberg & DeBattista, 2024).
The Psychiatric Consultation and the Proper Use of Psychotropic Medication
As the crisis deepens and dysfunction spreads across all aspects of life, some gifted individuals can accept that they are, in fact, out of control. Critical thinking allows them to set aside their fears of being misunderstood, misdiagnosed, or overmedicated. They can accept, for the time being, that their need for help is more important than their need for independence.
The most immediate goal of psychiatric consultation and assessment is to place the symptoms into an accurate diagnostic category, formulate how specific underlying psychological factors have caused the symptoms, stabilize the symptoms, and restore basic levels of emotional, cognitive, and executive functioning.
Judicious use of psychotropic medications often plays an important role in this early stage of these processes (Peterson, 2019).
The ultimate goal is to help a gifted individual reconnect with giftedness in positive ways so they can reclaim their identity as a gifted individual and proceed on their unique developmental path.
The first step in the assessment process is to determine whether the symptoms and dysfunctional behavior are caused by medical illnesses, the side effects of prescription medications, or the use or abuse of recreational drugs.
Part 2 of this article releases in May 2026…
References
Peterson, A. L. (2019). Psych Meds Made Simple: How & Why They Do What They Do. Mental Health@Home Books.
Schatzberg, A. F., & DeBattista, C. (2024). Schatzberg’s manual of clinical psychopharmacology. American Psychiatric Association.
Webb, J. T., Amend, E. R., Webb, N. E., Goerss, J., Beljan, P., & Olenchak, F. R. (2005). Misdiagnosis and dual diagnoses of gifted children and adults. Great Potential Press.
This article is an updated 2026 version of a 2018 article written by Dr. Grobman, published by Gro-Gifted.
Jerald Grobman, MD, is a board-certified psychiatrist, Distinguished Fellow of the American Psychiatric Association, and a graduate of Tufts University School of Medicine. For over 40 years, he has specialized in the assessment and psychotherapy of gifted adolescents and adults in private practice. His writings, seminars, and presentations are widely used within the national and international gifted community. At SENG conferences, he has led workshops and advanced training for therapists on giftedness, including underachievement and the inner experience of gifted individuals.
