Self-Diagnosis vs. Professional Diagnosis for ADHD and Autism

The Evolving Nature of Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a moving target that changes almost every decade, reflecting the shifting priorities and understanding of neurodivergence in a predominantly neurotypical society. Historically, it has been used as a tool to classify those who do not fit rigid definitions of societal normalcy. As recently as 50 years ago, mainstream psychiatry recommended shock treatments and lobotomies for neurodivergent individuals, with the primary objective being to neutralize the perceived threat or disruption to neurotypicals rather than to support neurodivergent people themselves.

Overdiagnosis in the 90s and 2000s

During the 1990s and 2000s, Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) were heavily overdiagnosed. These conditions were often used as blanket explanations for unwanted behavior or to push for higher academic performance in an increasingly standardized education system. It was not uncommon to see long lines at school nurse offices after lunch as elementary and middle school students queued up for their afternoon doses of Ritalin, with little regard for whether medication was genuinely necessary.

Medication Disparities Between ADHD and Autism

Many patients and caregivers are surprised to learn that there is no specific medication designed to treat autism. Instead, antipsychotic medications are often the only recommended medical course of action, reserved for the most severe and uncontrollable behavioral issues. This lack of treatment options leads many individuals to seek an ADHD diagnosis instead, as it provides access to a variety of medications—though their effectiveness is mixed, and there remains no long-term cure.

Changing Diagnostic Criteria and Scientific Integrity

Diagnostic criteria for ADHD and autism evolve far more rapidly than those for conditions with confirmed biological causes and treatments. This has led many to question whether neurodivergence should be classified as an illness at all. For instance, someone diagnosed with Attention Deficit Disorder (ADD) or Asperger’s Syndrome 20 years ago may now find that those diagnoses no longer exist. This continual shifting in terminology and categorization naturally raises concerns about the scientific integrity of neurodivergence diagnoses.

The Former Mutual Exclusivity of ADHD and Autism

Until recently, an individual could not be diagnosed with both ADHD and autism according to the DSM-IV. This changed with the DSM-5, but previously, a doctor who had already diagnosed a patient with one condition could not diagnose them with the other. As a result, many individuals sought an ADHD diagnosis instead, particularly as the inattentive and combined subtypes of ADHD were broad enough to encompass a wide range of neurodivergent traits.

Financial Barriers to Diagnosis

Receiving an official diagnosis costs money, and mental health services are often deprioritized in standard U.S. health insurance plans. Even when a diagnosis is obtained, individuals may face increased health and life insurance rates, as well as other bureaucratic inconveniences, despite not receiving any meaningful cure or treatment in return. The financial burden of diagnosis alone can deter individuals from seeking professional evaluation.

The Validity of Self-Diagnosis

Autism, by its very definition, involves a condition of self-focus and self-direction, making self-diagnosis particularly common. Many autistic individuals may feel reluctant to seek advice from medical professionals, especially when they know that no meaningful treatment exists. Both self-diagnosis and professional diagnosis hold validity, though many individuals prefer to use the term "neurodivergent" over specific labels like ADHD or autism. This allows them to avoid rigid classification, especially given the evolving nature of diagnostic standards and the potential for their diagnosis to become obsolete in the future.