More and more people, of all ages, are being diagnosed with neurodevelopmental disorders like ADHD and autism. This increase has been especially noticeable in adults in recent years. Some think the pandemic even pushed more adults to finally get diagnosed. For example, prescriptions for ADHD medicine went up a lot from 2018 to 2022, especially for women and people in their 20s and 30s.
Even though conditions like bipolar disorder might not show up until adulthood, the signs of neurodevelopmental disorders like autism and ADHD usually start in childhood. The official guide for diagnosing mental health conditions (DSM) says a diagnosis should only happen if symptoms were there in the first ten years of life. But many adults – even those who now realize they had clear signs as kids – weren't even considered for autism or ADHD until they were adults. So, why were their early symptoms missed, downplayed, or ignored?
For many, becoming an adult and having less structure from parents and teachers made their symptoms go from annoying to really hard to manage. The support kids get can hide their learning or social struggles, sometimes all the way through high school. Sometimes, symptoms don't just become more obvious over time; they can actually get worse. For instance, early bipolar episodes tend to be milder and easier to treat. If mania in teens or young adults isn't treated, later episodes are likely to be harder to handle. So, worsening bipolar symptoms can be a tough situation: they can mess up someone's life, but their increasing severity might be what finally leads to a diagnosis.
Gender also plays a big role, especially for women, who are more often diagnosed with neurodevelopmental disorders later in life. People often think of autism and ADHD as "boys' disorders." Autism is almost four times more common in boys, and ADHD is almost twice as common. This is partly because early research focused mainly on boys, and their symptoms shaped how we understood these conditions. It's not just about bias; it's also about what symptoms are easy to see. The symptoms more common in boys – like hyperactivity in ADHD or intense, specific interests in autism – are usually easier for adults to notice. Girls, on the other hand, tend to have more internal symptoms, like trouble paying attention. Autistic girls are also more likely to "mask," meaning they try to act neurotypical to fit in, which can make their symptoms easier to miss or ignore.
People diagnosed late might feel bad about themselves, but it's not always the case. One study found that women with undiagnosed ADHD had lower self-esteem than women without ADHD. Another study showed that people diagnosed with autism as kids felt better about themselves than those diagnosed as adults. Untreated bipolar disorder can cause big swings in self-esteem, with the lowest points during depression.That lack of self-worth, starting in childhood and lasting into adulthood, can look like depression or anxiety to others. In fact, it's very common for adults to be diagnosed with depression or anxiety before they're diagnosed with ADHD, autism, or bipolar disorder. Often, people diagnosed late realize that "depression" or "anxiety" doesn't fully explain what they're going through. Even if their mood improves, the main underlying problem – often the stress and feeling inadequate caused by the undiagnosed disorder – is still there.
Without a clear reason why things feel so difficult, some adults with undiagnosed ADHD, autism, or bipolar disorder become very self-critical and feel ashamed.Research shows that most adults who are newly diagnosed feel a sense of understanding, relief, and gratitude. However, they might also feel frustrated, disappointed, angry, or sad about the years they went undiagnosed. Studies on late diagnoses of autism and ADHD found that 30 to 50% of people had negative emotions, like regret for lost time, along with the positive feelings. It takes time to adjust, but many people diagnosed late, especially those who get therapy or other treatments, feel they make progress faster than expected.
Some people diagnosed late find it really helpful to have a therapist who also has the same diagnosis, which is becoming more common for therapists to share. This can be especially true for autism. Whether someone is neurodiverse or not, good therapists should understand the challenges faced by adults diagnosed late but also recognize and celebrate their strengths. Most importantly, a diagnosis can finally give someone permission to be their true self. Bulluss explains, "Now, I can focus on making real connections with people who like the same things I do, instead of trying to fit in with social rules I didn't understand. I can build a life that fits me, rather than trying to be someone I'm not."
