Overdiagnosis or Overdue Recognition?
Years long waiting lists sent me to a private clinic, but I still have questions...
For years, I struggled with social awkwardness, chronic forgetfulness, and a frustrating habit of accidentally getting drunk all the time, and then one day, someone mentioned ADHD and Autism and a little voice in my head gasped, Maybe that's it!
That was a few years ago now. I was diagnosed Autistic and ADHD in 2020, and life got better as I began to understand myself. But then I read articles like this one in The Standard, which suggests that self-diagnosing via the internet is akin to WebMD-ing a headache and deciding it’s brain cancer, and I find myself questioning things all over.
Are we witnessing an explosion of overdue recognition, or have we just collectively discovered that the human condition is, at its core, an ADHD/Autistic experience?
Is ADHD the New Black?
The article brings up something that always makes me uncomfortable: the idea that ADHD and Autism are simply trendy diagnoses, hot-swapped into cultural relevance like a noughties fashion revival. Apparently, in the 18th century, gout was the must-have affliction for the upper classes (it came with a free powdered wig), and in the 2000s, bipolar disorder had its moment in the diagnostic sun. Now, ADHD is in, and Autism, too, due to all the hyper-corrective work of advocates insisting it’s a superpower, perhaps, or - according to the article - because of high status out Autist tech billionaires.
If this is a trend, it's not the most enjoyable one. Who would bother spending years on a waiting list, spaffing hundreds for private assessments, or being dismissed by GPs with bizarre questions that showcase a total lack of understanding? Getting an official diagnosis involves paperwork, waiting, and, in many cases, a professional gently explaining that being bad at emails doesn’t necessarily mean you’re neurodivergent.
I knew that if I relied on self-diagnosis, I wouldn’t take it seriously - I’d always assume I was just making excuses for my own incompetence. So I paid for a private assessment, which sometimes feels like the adult equivalent of getting a teacher to give me a sticker. Or maybe that episode of Peep Show where Marc puts an extra star on Jeremy's life coaching certificate after he fails the course.
Even with a trained professional spelling it out for me, I still find myself doubting my diagnosis. Did I fix the test? Was I subconsciously leaning into my own (at that time very noisy) narrative of suffering and terminal uniqueness?
Was I just looking for an explanation for why life has always felt slightly harder than it seems to be for other people? But then, if so, is there anything wrong with that?
The TikTok Problem
Ah, TikTok. The great democratiser of information and misinformation alike. The article rightly points out that social media is full of self-diagnosis content, where relatable lists and 30-second clips convince thousands of people that they must, at the very least, be neurodivergent-adjacent. But a lot of those videos exist because traditional diagnostic routes have failed so many people.
The NHS waiting list for ADHD/Autism assessments is stretching into the next decade, so what are people supposed to do in the meantime?
For decades research and diagnostic tools have had such a specific focus that whole generations of women and people of colour were left undiagnosed.
The sudden oh, wait, me too? moment happening now feels less about trendy labels and more about finally having language for experiences that were previously dismissed as personality quirks or moral failings.
The ‘Everyone Is Autistic’ Panic
The article raises the idea that if diagnoses keep rising, soon everyone will be considered neurodivergent. After all we talk about a spectrum. But maybe that’s not the crisis some people fear it is. Our definitions of “normal” were always too narrow.
The issue isn’t overdiagnosis, it’s that we built a society that doesn't accommodate humans.
And if people are recognising themselves through these conversations and finding tools to navigate life better, then isn’t that probably a good thing?
I paid for a private Autism diagnosis in the end, because I needed to know and I knew self-disgnosis wasn’t going to cut it. I needed proof - to myself, if no one else - that I wasn’t just lazy, forgetful, or weird. But, I still doubt it sometimes. I probably would have doubted, even if I had waited and been tested by the NHS. Though of course, it's possible I wouldn't have been diagnosed by them, had I waited.
(So that's basically £700 down the toilet…)
Even with my cognitive loop da loops, having a name for the way my brain works (or let's be real, doesn't) has helped me be kinder to myself, day-to-day.
I know there is something I'm not getting about this debate and I'm hoping that soon someone is going to explain it to me. But until then I'll be happier living in a world where people are getting answers - even imperfect ones - than one where we’re left to struggle in shame-drenched silence.
Chelsey Flood is the author of award-winning novels Infinite Sky and Nightwanderers, and a senior lecturer in creative writing at UWE. She is currently working on a book about the connection between undiagnosed neurodiversity and addiction + her first domestic noir
I don't think there's anything that you're failing to understand about the debate. The debate doesn't exist in any real sense. It's one of many that has been manufactured, from thin air, to support another entirely manufactured idea that there's an ongoing and important culture war going on in society.
Hundreds of separate factions on the front lines fighting each other to the death for splintered definitions of themselves where only one group can be right and everyone else is definitively wrong. Where no one is allowed to have any common causes, values, or humanity. They must pick an identity from a very limited 'spectrum' lol. A fractured and chaotic mass othering.
Blinded by mustard gas we marched forward through muddy fields pock marked with craters where the heavy artillery had fallen driven by the big lie - It is sweet and fair to die for one's claim to tell the world of their neurodivergence 😂😂
It's been done deliberately to keep people at odds with each other and distracted in meaningless arguments in order to divert people's attention from real problems that aren't being addressed and actually do have an effect on their lives. I believe Steve Bannon coined the term "Flooding the zone," which is a part of it, but that would be more accurate with the additional of a small modification to "Flooding the zone with shit."
As it happens, it's also perfect for generating clicks and views that drive engagement towards monetised accounts and platforms on social media. Every click and outraged comment being fed back into an algorithm to determine what pushes our buttons so more of the exact same shit can be fed back to us over and over and over again in our own little echo chambers of self righteousness.
It's a tried tested and developed technique that is both the most lowest common denominator nonsense and extraordinarily stupid but simultaneously incredibly smart when it's analysed on the basis of how effective it is and is grounded within solid psychological principles. It's the lifeblood of advertising, marketing, and propaganda. No room for nuance or grey areas exists. Just shout the same things over, often accompanied by bright colours and striking imagery. It's the fruity at the local pub that's flashing lights and random sounds compels people to feed their entire weeks wage into it on a Friday night even though no one's ever seen it pay out more than a fiver in 15 years.
Unless there was something dodgy about the assessment process you went through or the qualifications of the psychiatrist who diagnosed you, then there is no debate, Chel.
Here's a quick test if any of these things ever start to make you question that you just blagged the entire thing and these people might be right. Was your assessment like this -
Did you head out in the dead of night, under cover of darkness, disguised by a fake nose, glasses, and moustache. Cap tilted down to cover your face, and a hoodie pulled tight to your head. Furtively scanning the area for surveillance in order to meet up with a mysterious stranger down a shady alleyway somewhere?
Did you make a quick hand off of a large sum of money comprised of non consecutive bills in exchange for a crumpled document pulled from inside their overcoat labelled Autism and ADHD. Then stealthily conceal it in your left sock and hastily set off in opposite directions?
Or was it more like mine -
I can provide a full psychiatric report. Detailing exactly what tests were used and where I clearly met the criteria set out in both the DSM5 and the ISD-11 for severe ADHD.
I can prove the medical validity of those tests and the diagnostic criteria set out in the two medical diagnostical statistical manuals, which are the standard for psychiatrists in both the US and Europe, respectively.
Not that it is in any way necessary for me to prove them or that doing so myself would add anything worthy to the science. Much smarter people than me who've worked in those fields of expertise for years have already done that and have been doing it for decades.
Not only is it another example of people treating medicine and science like it's some kind of finger food buffet they can pick and choose from purely on the basis of what they like and don't. It makes a mockery of the fact that -
(The condition is recognised under the Equalities Act of 2010 (Disability Discrimination Act).
If it's just a blag, why did they have to have in-depth details of my development from infancy onwards? Why did I provide supplementary evidence in the form of school and behavioural reports from the age of 5 to 16? Why did I provide them with details of every single interaction I've ever had with the police and the circumstances surrounding them? Why did I hand over as much of my medical records from the age of 16 to age of diagnosis as I was able to get access to? Why did I have to explain my entire adult life past that point and provide specific examples from all of it?
The problem with the article you linked is that it purposefully confuses two separate things. The triangle shape goes in the triangle shaped hole. The square goes in the square shaped hole. They're trying to force the square shape through both holes.
Sure, bring in a couple of genuinely qualified people to speak about what ADHD and Autism actually are to legitimise it, but then go on and conflate that information as if it's the same thing as some lost teen* searching for an identity posting 90 second TikTok videos talking about how ADHD they are or "OMG I'm so manic and delulu today!" Where it concerns Bipolar.
Why do that? It's two different topics, both might make for an interesting conversation, but you can't use the Trumpian Weave in order to make them one thing. That makes you either a disingenuous and illegitimate journalist, a good old-fashioned grifter, or someone who's deliberately trying to stigmatise people with genuine conditions by sowing doubt that they even exist.
They can get themselves to fuck with the superpower stories too. When you were a kid no one would ever ask if you could have the ability to fly, to become invisible, to have super strength, or to be a super disorganised mess, or achieve super crippling anxiety issues? Which would would you choose and why? Because it's so fucking ridiculous to consider things that way, that even the 7 year old boys discussing it in the playground can recognise it.
In terms of the diagnosis, I was referring to the assessment process for earlier. That one was ADHD specific, and I can provide a copy of it to anyone. I'm not going to, but I would for you if you were ever genuinely doubting your own diagnosis and it was upsetting for you. Rather than writing and publishing the piece for the interest of others and offering them some support.
I enjoyed it, by the way, and as you can see from this mess, it obviously did make me think about the issues you wrote about.
The NHS assessment I went through for Autism spanned at least a 4 month period. Required a lot of written info from myself and my mum. For her to take part in an interview with them and for me to go through 3 or 4 separate interviews before all accumulated evidence was presented for consideration to a team of qualified mental health workers, psychiatrists, and people who specialised in Autism. They found that I didn't have that, but all reached the conclusion that I almost certainly had ADHD, but within NHS guidelines, they weren't able to give that formal diagnosis at the end of an Autism specific assessment.
Which led to the private assessment taken for ADHD. The people who follow you will be largely aware of the problems with waiting times. Lack of resources. Potential for misdiagnosis due to incompetence or lack of time, missing evidence, etc, that leads people to go the private route for certain things, even when it stretches already strained finances to do so.
Given how recent news cycles have been affecting me. I have a little reluctance in posting to the Internet at the moment as I'm aware that I've not been particularly stable, which makes me question my own opinions, and I'm not sure there's any room left on the Internet for it anyway. Superhans might be able to swing that for me with the internet people, though x
*I feel like I understand these kids a lot more nowadays, despite some of my initial confusion when that brand of identity politics first started popping. I don't dislike or blame them for anything as a group, but I wrote a similarly lengthy rant about that somewhere the other week.