Navigating Neurodivergence: Do I Need a Diagnosis?

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A guide for those wondering about neurodivergent assessment for adults in the UK

Have you been thinking that you might be neurodivergent? Perhaps you’ve read some books, done some research or seen some Tiktok or Youtube videos that resonate with you. Maybe you’ve spent a long time just wondering and now you’re ready to consider the next stage.

In this article I’ll try to answer some questions you may have such as “how do I go about getting diagnosed in the UK?” and “do I need a diagnosis to know that I am ADHD or autistic?” or “what if I’m wasting everyone’s time?” or even “why would I want a label?” and hopefully also provide you with an idea of the support you might need or wish to have during this process.

Please note that the information in this article is correct to the best of my knowledge at the time of writing. Please check all information before making decisions about your health or wellbeing.

What is neurodivergence?

Neurodivergence is a term used to describe someone who thinks, acts or behaves in a way which diverges from societal “norms”. So this includes autism, ADHD, dyslexia, dyspraxia, dyscalculia. It also includes conditions such as OCD, Tourette’s, Epilepsy and personality disorders. For the purposes of this article I’ll be talking mostly about autism and ADHD as these are the most common things I get asked about as a specialist neurodivergent therapist.

When I first realised I might be neurodivergent, as is common with a lot of us, I did a deep dive into all things autism and ADHD. It very quickly became my intense interest (in itself probably an indicator!) and I constantly reflected on this to the point where I couldn’t think of anything else. If this sounds familiar then you might have come to the stage where you wonder what is next.

What are my Options?

In the UK our diagnostic process for both ADHD and autism is sadly quite outdated, with assessments for adults still being based on those originally created for children, and often with boys in mind (it was originally thought that autism and ADHD usually only presented itself in young boys). We know far more about this now (see my ADHD in women article for example) but in my opinion, a lot of the assessment processes haven’t caught up yet.

This doesn’t mean however that it isn’t a valid thing to seek diagnosis – far from it. In many instances, a diagnosis can unlock support systems, accommodations and benefits that otherwise would sadly not always be available to you. For example in schools, colleges and some workplaces, a diagnosis is still necessary to access accommodations. Thankfully this is not always the case and there are some very supportive workplaces and institutions that will provide support based on the individual’s needs rather than their diagnoses.

Sometimes a neurodivergent person may feel that they want the validation of a professional agreeing with them about what they already feel. And sometimes we may just feel we need that “piece of paper”. These are totally valid reasons.

And I ought to say that of course decisions over whether to seek a diagnosis or to self identity vary and fluctuate, you might feel that you don’t need a diagnosis for years and then decide to seek it out at a later point.

But if you are at the stage you want to consider these options then please read on for an explanation of your various choices.

Diagnosis

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So, you’ve decided to look into a diagnosis for either autism or ADHD – what now?

Well in the UK there are two routes to diagnosis, one is free and provided through the NHS, and one is going privately. I’ll take you through both routes but please note that areas of the UK can differ in their providers and it’s always best to do your own research on what is available. Please also note that this process I’m describing is for adults although there is a similar route for under 18s.

Both of these routes usually require an initial screening type test so it can be worth looking at these ahead of time to give you an idea. Please note that as mentioned above, these screenings can be quite difficult to answer but they will give you a general idea. The website Embrace Autism has some autism screening tests that are quite easy to access. ADHD UK has an adult ADHD screening tool also. (Please note these are just suggestions and I do not have any affiliation with or take responsibility for content on these sites.)

NHS – £Free route

You can seek an assessment through the NHS in the UK for free by firstly seeing your GP and asking to be referred. You are likely to need to explain why you think you might need an assessment and may be asked a few questions. It might be helpful to take a long the results of the screening tests mentioned above, and any other notes you may have made,

If your GP refers you to the ADHD or autism service in your area there is likely to be a long wait for assessment. At the time of writing in Kent, my local area, the waiting lists are estimated to be over a year by the NHS, the reality reported to me is up to 3 years for an autism assessment and similar for ADHD. For children it’s a similar story.

There is another option via the NHS in England. The Right to Choose route is where you have a right to choose a different provider than your local one, provided they provide assessments somewhere within England via the NHS. As many autism and ADHD assessments are now carried out online this means there are more options for you. Many private providers are also providing a service via the NHS under the right to choose system. It is worth asking about this although as people become more aware of this option the waiting times are increasing here too.

Private Route

Another route for an assessment is the private route. This is an often costly route with assessments costing anywhere from £500 – £2000 for ADHD and Autism assessments. However the plus side is there is much less of a wait for these.

Private providers of assessments vary greatly across the UK. They can be carried out in person or online and I would suggest that you research different providers in your area and ask questions around what they offer.

Medication

Image of different sizes and shapes of pills on plain white background

For some people a diagnosis (particularly for example for ADHD), can allow you to try out stimulant or other medication. This is a very personal decision but, if you want to go down this route and if you have gone private for your diagnosis, most providers will require you to pay for private prescriptions which can be upwards of £80 a month for the time you are titrating. (Titration is the name given to the period of time when you are trialling the medication to see what dosage works best for you). Once you are settled on a medication, providing it is working for you, there is the possibility of applying for “Shared Care” with your GP. This means that you will still need to pay for a private medication review every year with your provider but the NHS will cover the cost of your medication meaning you pay the NHS prescription charge each month.

If you have gone the NHS route then usually the medication, if agreed upon, will be paid for via the NHS, again leaving you to pay the usual NHS prescription fee unless you are exempt.

What Will It Feel Like To Get A Diagnosis?

Once you have a diagnosis it can be a real mix of emotions and it can be hard to know what you do with that piece of paper now you have it. My diagnosis, what now? article may give you some helpful insights.

What If They Say I’m Not….

You may well have considered the possibility that the results of your assessment could mean that the relevant professional doesn’t give you a diagnosis. This also comes with it a range of confusing feelings.

Even if you didn’t meet the criteria for a diagnosis, that doesn’t mean that you are definitely not neurodivergent. If you still feel that using the neurodivergent lens to view your world resonates, then I would encourage you to continue to do this. There is no reason why you can’t self identify as neurodivergent despite a professional not diagnosing you (see below). Remember these assessments are often very limited in their scope and not all practitioners are well versed in how ADHD or Autism presents in anyone other than young boys. See my ADHD in Women article for more on this.

Self Identification – An Alternative

A hand reaching out and pointing at a mirror showing its reflection

Many neurodivergent people self identify and believe they don’t need a diagnosis or a label to feel comfortable with that identity. Due in part to prohibitively expensive private assessments and long waiting times on the NHS, self identifying as neurodivergent is becoming more and more common.

This is also possibly the case as many people recognise that the assessments currently on offer are very much based in the medical model and wish to find a more affirming alternative. The Neurodiversity paradigm (or model) promotes the idea that neurodivergence is just a natural form of human variance s0 difference is to be celebrated (rather than it being disordered) which is why I think lots of us turn towards this as a preferred identity and framework.

If you would like to learn more about the neurodiversity paradigm, about neurodivergence or self identification, I would suggest turning to social media to see what other people are saying about this. The neurodivergent community has a strong voice online and by reading about this from the people who are experiencing it, you can get a much better sense of this.

A Heads Up

It is very common when going through this process to start to doubt yourself and your reasons for seeking a diagnosis, or self identifying. It’s quite normal to occasionally feel like an imposter, and to swing between being convinced you are neurodivergent, to thinking that you are making it all up. Part of the reason for this is the stereotyping and ableist views around autism and ADHD – you may have internalised a lot of this and it comes out as doubts. Just be aware that it can be a bit of a roller coaster ride so make sure you have people around you who will support you, whether that’s a therapist or a friend or family member.

Therapy and should I see a Neurodivergent therapist?

Whether through a formal diagnosis, or a process of self identification, the benefits to discovering you are neurodivergence can be huge.

Building self-awareness is often the key factor here, and by seeing your history, ways of thinking and your relationships through a neurodivergent lens, you can start to understand yourself in a way you never have before. This newfound information and help you achieve a sense of acceptance with yourself, identify your needs and learn how to express them. With the help of a counsellor or therapist you can learn how to manage your emotions, release some of your anxiety, and have realisations about your life you never thought possible.

I always say it’s not necessary for your therapist to have gone through everything you have to be able to help you. But it can be helpful to see someone who is naturally on your wavelength. My articles on the Benefits of Seeing a Neurodivergent Therapist? may give you some insights here. Another article that might be helpful is Therapy and Neurodivergence.

TL/DR: If you need a diagnosis to be able to access support at school, work, or to access medication or benefits for example then I would suggest that you seek a formal diagnosis (whilst being aware of the limitations and frustrations of this process). There are two ways to do this in the UK, the NHS route and the private route. There are limitations to these both. However, if you are happier with exploring this on your own, or with help from supportive, affirming professionals or family/friends, then perhaps self identifying is for you.


Amy is a counsellor specialising in neurodivergence and the founder of Newglade Counselling. She has created a team of neurodivergent counsellors who work online and face to face around Canterbury, Kent. Amy is the creator of the popular Neuro Cards and other therapy resources. Amy also provides parent support sessions, clinical supervision and delivers training in therapy and neurodivergence. For more information about our services contact us here.

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