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Over or under-diagnosis: does it matter? 

The debate around neurodiversity is a relatively new, but a polarised one. On one hand, many people are finally getting diagnosed after years of doubting themselves, and the image of what neurodiversity “looks like” – beyond a hyperactive child – is evolving.  

However, there is a firm camp of people that insist that the diagnoses have become too common, and that we’ve become far too tolerant of people saying they’re neurodiverse. Social media has everyone self-diagnosing, they say, and it’s all! Gone! Too! Far!  

Hadley Freeman recently claimed in her Times column that everyone now wants to diagnose themselves with one condition or another, and as part of this, are all rushing to claim that they’re neurodiverse. Reading this, you’d be forgiven for thinking that everyone is self-diagnosing and self-medicating. But is this really the case – is everyone claiming to be neurodiverse? Or is there something else at play here?

Over-diagnosis isn’t the problem – we’re just more aware of it  

Once again, a noisy online debate has obscured the real issue: despite increased awareness, there is still very limited support for those who’ve been diagnosed, particularly for adults.  

Those claiming everyone is suddenly neurodiverse usually forgot how common neurodiversity is – 1 in 7 people in the UK (over 15% of the population) are neurodivergent. While Hadley decries the impact of social media on people’s apparent keenness to over-diagnose themselves, in reality, it’s given people more information, tools, and confidence to advocate for themselves and seek a diagnosis. 

Improved research has also led to better understanding of what neurodiversity looks like, and how it intersects with race, gender and sexuality. This more nuanced view has helped create a more diverse, productive conversation around how to support neurodivergent individuals, but there is still a lot of progress to be made, both in terms of awareness in the wider world, and support.  

So, what can we do? I’m by no means the authority on this, but with neurodiversity becoming a more prominent issue, and people needing to advocate for themselves more, here are a few things that have helped me on my journey.  

Accept there are different routes to diagnosis – and at different life stages.  

I was at the ripe old age of 25 when I first suspected I had ADHD, after my boyfriend shared an anecdote about having to re-read the same pages constantly, because he struggled to absorb it. This took me aback, because I thought this was something everyone experienced, but I pushed it to the back of my mind. Then, not to prove Hadley Freeman’s point, I saw a TikTok about ADHD symptoms in adult women. Something I had never even considered suddenly blared into full focus in front of me, shifting my perception from “That’s just how everyone thinks” to “This is how I view the world.”  

Be prepared for inconsistency, and learn to advocate for yourself 

It’s a classic trait, but it’s true: whether it’s a lack of focus, or general comprehension, being neurodiverse often means you’re a natural talent at some things, and struggle to wrap your head around basic concepts of others. Neurodiverse individuals are often misunderstood, or face challenges at work, because they don’t “show the right skills”, or “fit” the right image.  

A lot of the time, situations like these come from a lack of understanding. Don’t be afraid to stand up for yourself, and show those around you – both in your work and personal life –   what you need. Whether it’s having different places to work around the office, or an accountability buddy to help you keep on top of daily tasks, there’s many ways you can help make your working life easier.  

On the other hand, if you’re neurotypical, make sure you’re creating a space where neurodiversity can be talked about, and isn’t taboo – your friends and colleagues should feel empowered to share their experiences, and be able to speak up if they see something that isn’t right.  

Be kind to yourself 

It’s clear to me that Hadley did not speak to many (or any) neurodiverse people before writing this article. Yes, neurodiversity brings many strengths, including a uniqueness of thought, creativity and talent. However, those claiming that people are jumping on the bandwagon of saying they’re neurodiverse don’t understand that while it’s becoming easier to learn how to navigate a world that wasn’t built with neurodiversity in mind, it’s rarely easy. 

Part of being kind to yourself is finding the advantages in your neurodiversity, so I’ve put together a few of my own: 

  • I remember small, seemingly unimportant details, which helps people feel valued when, 5 years later, I can remember the name of their childhood dog, their favourite subject at school, or their usual coffee order. 
  • I’m passionate, so when I’m interested in something, I will move heaven and earth to get it done – and my sense of determination (or bone-headedness, depending on who you ask), gives me patience to try things again and again, even when they don’t work out. 
  • I’m observant – my mind goes at a million miles an hour, so I often spot things that other people don’t. This helps me be a more sensitive friend, colleague and manager, and helps others open up when they feel seen or heard.  

Know when to walk away 

“You don’t look like you have ADHD…” 

“Oh, but that’s just what you’re like – that’s not ADHD?  

“Did you really have trouble focusing at school?” 

These are just a few of the many questions I’ve received, both in my personal and work life, when telling someone I have ADHD. There aren’t many other conditions out there where people would feel comfortable openly questioning someone else’s condition, but I know my experience is far from being a rare one.  

It’s hard to say it, but some places just aren’t built with neurodiverse individuals in mind, and struggle to include them. Whether it’s subtle or overt, sometimes you need to evaluate whether a certain situation is doing you more harm than good, and when it might be time to remove yourself from it. Saying no is just as important as advocating for yourself, or supporting other colleagues. 

Accept the unexpected 

Life isn’t always fun when it’s regimented and homogenous, so learn to embrace the differences and the unexpected. We still need more awareness around the complexities of neurodiversity and the diagnosis process. Minimising growing neurodiversity to people “self-diagnosing” or “jumping on the bandwagon” only trivialises the issue and stunts progress. If you’re neurodiverse, and you hear someone talking about overdiagnosis, don’t let them stop you getting help, or advocating for yourself.  

On the other hand, if you’re neurotypical, and your first reaction when someone shares their neurodiversity with you is to question it, check yourself, and ask yourself why that might be. It’s not their job to “prove” their medical history to you.  

We all have our individual journeys to go on with this. A happy workplace, or a happy life, is one where people feel safe in their differences, support each other, and find the humour in it along the way.

Cover image credits: Harvard Health  

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