Diagnosed as an Adult: Relief, Grief and Making Sense of the Past
Some people read their assessment report in one sitting. Others leave it in a drawer for weeks. Some feel a lot at once, and some feel surprisingly little. All of these are common, and none of them is the wrong way to take the news.
This article is for adults who have been diagnosed with autism, ADHD or both, and are somewhere in the weeks or months since. You might have waited years for an assessment, or it might have happened quite quickly. You might have been fairly sure of the outcome, or it might have caught you off guard.
When people come to see me after a diagnosis in adulthood, one of the first things they often say is that they have mixed feelings. That's a fine place to start. You don't need to have it sorted before you talk about it.
A note on the words I've used. I've said "diagnosis" because it's the word most people search for. For some people it feels like confirmation of something they already knew. For others it's an official label they're not sure about yet. I've also said "late", although it may not feel late to you. And I've mostly written "autistic" rather than "person with autism", because many autistic adults prefer it. In our sessions, your words are the ones that matter.
When things start to make sense
For some, the first thing that comes is relief. Things that never quite added up start to fit: why school was so tiring, why some jobs felt impossible while others came easily, or why some friendships always seemed like harder work than they should be. There can be comfort in having a reason.
Relief doesn't always come straight away, though. You might notice it weeks later, or in small moments, like reading something written by another autistic person or ADHDer and recognising yourself. Or it might not come in the way you expected. Some people feel flat or numb after a diagnosis, and that's a common response too.
Grief for the years before
Alongside relief, many people describe a sense of loss. You might find yourself thinking about how things could have gone with the right understanding earlier, at school, at work or in relationships. Some people feel sad for a younger version of themselves who was struggling and didn't know why.
Grief isn't only something that follows a death. It can follow other kinds of loss, including the loss of a life you might have had. It can come and go in waves, and it can happen alongside relief without cancelling it out.
Anger, and not knowing where to put it
Some people feel angry after a diagnosis. That anger might be aimed at a school that didn't notice, a professional who suggested something else, or family who didn't see it. Sometimes it's aimed inwards, at the years spent trying harder or blaming yourself.
Anger can be confusing, especially if it's about people you love, or people you're also grateful to. You don't have to decide who was at fault, or whether anyone was. In counselling, you can talk about anger openly, without needing to tidy it up first.
Doubting the diagnosis
It's common to second-guess a diagnosis once the report is in your hands. You might wonder whether you described things accurately, or whether you're "autistic enough", or whether your ADHD is "real" compared with people you've seen online. Some people worry others will think they're following a trend.
These doubts can be stronger if you've spent years coping, or being told you were fine. Managing on the outside and struggling on the inside can both be true at once. If shame or self-doubt have been part of it for you, I've written about adult ADHD, self-worth and emotional impact. Your doubts don't have to be settled before you can get support.
Who am I now?
A diagnosis can lead to a lot of looking back. Some people start to notice how much they've been masking: hiding or adjusting the way they naturally talk, move or react so they fit in. Others start to wonder which of their habits and preferences are really theirs.
Some people also look back at times they called depression or exhaustion and wonder whether it was burnout. Low mood and burnout can overlap, so it's worth speaking to your GP if you're worried about either. This looking back can be unsettling, and it can also bring some freedom. There's no rush, and there's no right answer about what to keep and what to change.
When it's both
Some people are told they're autistic and have ADHD at the same time. Others get one diagnosis and then, months or years later, the other. Autism and ADHD can occur together, and some use AuDHD to describe this.
A second diagnosis can shake up how you'd started to understand the first. The two can seem to pull against each other, like needing routine but finding it hard to keep one. If this is you, you're welcome to bring all of it. There's more on my autism counselling and ADHD counselling pages.
The practical questions
A diagnosis can also bring practical questions. Do you tell your family, and how? Do you tell your employer, and what might change if you do? What support is out there? If you have ADHD, you might also be thinking about medication. These questions can feel pressing, especially if other people are asking before you've had time to think.
You don't need to have the answers straight away. For information about support at work and after a diagnosis, the National Autistic Society and ADHD UK are good places to start. Questions about medication are for your GP or prescriber. In counselling, we can look at what these decisions mean to you, what worries you about them, and what feels right, at your own pace.
If you'd like to reflect
If you'd like, here's one question you could try. It's best at a calm moment, not when you're already tired or overwhelmed. Give it a minute or so. You don't need to write anything down unless that helps.
What's one thing that makes a bit more sense to you now?
If you notice racing thoughts, a heavy or numb feeling, or a sense of shutting down, that's a sign to stop. You can come back to it another day, or not at all. Afterwards, it can help to do something familiar that brings you back to the present, like making a drink, holding something with a texture you like, or spending a few minutes on an interest. If you'd rather not try it at all, that's fine too. Even reading this far is enough.
How counselling can help after a diagnosis
I work in a person-centred way, which means you're treated as the expert on your own life. You decide what we talk about, whether that's grief, anger, the practical questions or something else. There's no homework, and there's no expectation that you should feel a certain way by a certain point. There's more about how I work with autistic and ADHD clients on my neuro-affirmative therapy page.
I know talking about feelings can be hard, particularly if you've been asked "how does that make you feel?" and not known what to say. We don't have to start there. We can look at what you're thinking or what's coming up for you in a more factual way, use a comparison or one of your interests if that helps, and take as long as you need. In my room, the lighting and temperature can be changed, eye contact isn't expected, and there are things to keep your hands busy. I also offer shorter sessions if sitting for longer is uncomfortable.
Autism is one of my main areas of interest and training. My training includes Working with Autism with Counselling Tutor, and the Self-Determination Model of Therapeutic Support for Adults with ADHD with BACP. You can see the full list on my credentials page. You're welcome here, exactly as you are, whether or not you've worked out how you feel.
Making sense of it
There's a lot in this article, and you don't need to hold on to all of it. If it helps, here are the main points to take away:
Relief, grief, anger, doubt or feeling very little are all common after a diagnosis in adulthood. They can come in any order, or not at all.
Grief for the years before a diagnosis is a real kind of loss.
Doubting a diagnosis is common, and it doesn't need to be settled before you get support.
Practical questions like who to tell can wait until you're ready.
You don't need to know how you feel before you start counselling.
If you'd like to talk things through, I offer a free 15-minute telephone consultation. It's a friendly, no-obligation way to see if it feels like the right fit. We can talk about what's brought you here and whether you've had counselling before, and I'll explain how I work so you can decide. I offer sessions face to face in Manchester, by video and by telephone. When you're ready, you can get in touch through my contact page.
If things feel like too much, please speak to your GP. If you need urgent help with your mental health, you can call NHS 111 and choose the mental health option, or use NHS 111 online. Samaritans are available any time, for free, on 116 123. If you're in immediate danger or can't keep yourself safe, call 999 or go to A&E.
