When I tell people that the focus of my health coaching work is with neurodivergent adults, especially Autistic and ADHD folks, I get a range of responses. Most often, there's that awkward shutting down of conversation when people hit a topic they don’t know much about and don’t want to ask. Other times, people light up, recognising the huge rise in people identifying as neurodivergent, and the big need for support. Then there are people (usually those who recognise these traits in themselves) who don’t see the value in neurodivergent identities at all, saying, “Isn’t this just part of the normal range of human behaviour? Why pathologise it?”
And you know what? I completely agree. Both with the idea that these traits exist widely across the human population, and that we don’t want to pathologise them. If that was all a label like this indicated, I’d reject it too. Many people whose minds likely work in these ways are getting on with life just fine, finding their own ways of doing things without needing to identify as neurodivergent. That’s awesome! If they’re supported in what they find challenging and appreciated for their strengths, that’s what matters.
But far too many adults who share these traits have been labelled in more damaging ways. Their traits have been misunderstood or dismissed as signs of being rude, lazy, over-sensitive, or subjected to a million other unhelpful judgments throughout their lives. They haven’t found a way of living that works for them because they haven’t had the right support or understanding of their needs. For these people, a neurodivergent label (whether through self-identification or clinical diagnosis) can be a turning point. It can explain years of confusion and open up new ways of living that lead to much better wellbeing. That’s where the value of a neurodivergent identity comes in.
A Pathological History
Historically, the Western understanding of autism and ADHD has been deeply rooted in pathology. Traits that we now recognise as neurodivergent have always existed. You don’t need to dig far into history to see that these ways of being have always been a part of humanity.1
In the early days of autism research, there was an understanding that Autistic traits ranged from a personality type that was more withdrawn or focused on particular interests to more obvious developmental delays and behaviours that were seen as distressing.2 But as time went on, especially with the development of the DSM, the focus became narrower.3 Diagnostic criteria for both autism and ADHD were based largely on observable behaviour - how different someone (usually a child) acted compared to their peers. The assumption was that these differences indicated a cognitive deficit. In other words, “You’re behaving differently to what we expect, so something must be wrong with you.”
Instead of supporting people to live well with their differences, the focus was on changing behaviour, often through behavioural interventions or medication, to make neurodivergent kids look more like neurotypical ones. Success was measured by how little someone stood out - whether they could suppress the traits that made others uncomfortable.
A Bit of My Story
For a long time, I wrestled with my own sense of being different. I’d always had some struggles - the frustration of people saying one thing but doing another, social dynamics that felt so fraught, existential crises, periods of depression, difficulties managing life-admin, starting and dropping out of different study paths. As an adult, I began carving my own way - finding self-compassion, advocating for myself, and defending the idea that everyone’s needs are different. That’s what eventually led me into pastoral support work, helping others foster their own self-compassion amidst struggles and experiences that were often uniquely theirs.
But even then, maintaining a secure sense of self was a battle. I often felt judged, like I didn’t fit others’ expectations. I swung between a self-protective, defiant stance of “I’ve got lots to offer, but I’m just misunderstood!” and a nagging worry that maybe something was irreparably flawed about me.
Then, in my 30s, I discovered that many of my own struggles and strengths lined up with the experiences of other late-identified Autistic and ADHD women. It was a lot to process. On one hand, it was massively validating - finally, reassurance that I wasn’t imagining that I didn’t fit into neurotypical norms! But on the other hand, it sent me into a bit of a spiral. Did this mean everything I’d been defending was actually proof that something was wrong with me?
It took time to process all this, but I eventually found a more helpful understanding. I realised that I wasn’t actually learning anything new about myself. I’d been describing these particularities my whole life and, within the context of a supportive and accepting family, finding ways to live that worked for me. The difference now was that I no longer felt the need to defend myself or hold onto that inner turmoil. I could let go of the need for others to understand me and find peace in just knowing this is just the type of brain and nervous system I have. This new understanding also gave me the chance to connect with others who “got” me in ways I hadn’t experienced before. For me, embracing a neurodivergent identity meant deeper compassion for myself and a sense of belonging with a community that shared my experiences and ways of being.
The Neurodiversity Paradigm
This brings us to a neurodiversity-affirming way of understanding autism and ADHD, which challenges that old pathological lens. This shift in understanding has largely been driven by neurodivergent adults who grew up with those deficit-based labels and are now saying, “That’s not how we see ourselves.”4
The difference between seeing neurodivergence as something to be understood and affirmed, rather than something to be fixed, feels personal to me. I remember, during the time I was first coming to terms with my own neurodivergence, a friend was diagnosed with ADHD. They were looking forward to starting medication because they thought it would make them “normal.” They were hopeful, excited that they could finally stop struggling and just fit into what others expected. Hearing this really upset me - not because I was against them seeking support, but because the idea of aiming to fit neurotypical norms hit me hard. I wanted to be accepted and appreciated for who I was, not for how well I could conform. Was that really too much to hope for?
Of course, as my friend soon found out, that’s not how the medication works. While it can be incredibly helpful for managing some challenges associated with ADHD (and I fully support people exploring this), it doesn’t change our brain wiring or erase our experiences. That moment really highlighted the difference between a pathologising approach and why I’m so passionate about a neurodiversity-affirming approach. It’s about accepting who we are, not trying to make us fit someone else’s expectations.
The neurodiversity paradigm recognises that these traits don’t point to disorders to be fixed, they’re just part of natural human variation. It prioritises understanding how neurodivergent people experience the world, not how we appear to outsiders. It acknowledges that some of our difficulties arise from environments that assume a fairly narrow range of “normal” ways of being. And it recognises that alongside struggles, there are strengths that come with the way our brains are wired. You can’t separate the two, they’re part of the same whole.
When Diagnosis is Life-Saving
Not everyone needs a label to understand themselves. But for some, a diagnosis can be hugely valuable, especially for those whose ways of being have been misunderstood because they don’t meet the typical diagnostic criteria. Autistic and ADHD folks who are driven by social motivators like fitting in, often referred to as “high-masking,” might not show obvious behavioural differences.5 But that doesn’t mean they don’t struggle. Many high-masking Autistic or ADHD people carry other diagnoses (often related to mental health) that overlook the deeper reasons for their challenges. These folks are at much higher risk of burnout, mental health crises, and even suicide.6
Thankfully, clinical practice is slowly shifting to be more affirming. In New Zealand, updated diagnostic guidelines for both autism and ADHD now recognise the concept of masking, and how neurodivergent struggles aren’t always visible. These guidelines emphasise the importance of self-understanding, external support, and lifestyle changes tailored to our needs, recommending therapy, coaching, and other non-pathologising forms of support.
This aligns with my own experience. When I went through the autism diagnostic process with a clinician who took a more affirming approach, it was still uncomfortable to see my challenges laid bare and to be labelled with a neurodevelopmental condition. But it wasn’t about finding out what was “wrong” with me, it was about gaining clarity and validation on how my brain works and what I need. That’s why I’m passionate about this shift - it allows people to access support without feeling like they’re broken.
If It Helps…
This understanding of neurodiversity helps me support others even more effectively. I've always believed that everyone has different needs and that honouring those needs is essential. Now, I can also offer this additional perspective to help some people recognise their own needs and extend compassion to themselves. As a health coach, my clients don’t need a formal neurodivergent diagnosis, and they don’t have to use this language if it doesn’t resonate with them. Label or no label, I’ll always support whatever helps a person to best advocate for themselves, embrace their unique ways of being, and build a life that truly works for them.
You can’t go past Steve Silberman’s NeuroTribes: The Legacy of Autism and the Future of Neurodiversity to learn how understandings of autism have developed over the last hundred years, particularly in Western contexts.. The descriptions of Henry Cavendish’s obviously autistic traits, as noted by his peers in the 18th century, are a fascinating and amusing example.
While Hans Asperger's work during the Nazi regime is deeply disturbing, it’s worth noting that his observations were ahead of his time. He recognised that the behaviours associated with autism could often be distress signals best addressed through affirming support, a perspective further explored in NeuroTribes.
The DSM (Diagnostic and Statistical Manual of Mental Disorders) is the standard diagnostic manual used in the U.S. for psychological diagnoses. It plays a significant role in clinical practice and also informs practices in New Zealand.
For more on the neurodiversity paradigm, see the work of Dr. Nick Walker, whose contributions to understanding neurodiversity are invaluable.
High-masking is more common in (while not exclusive to) women and AFAB individuals, which undoubtedly explains why both autism and ADHD diagnoses have been WAY more prevalent in boys and men.
The numbers here are really dire. Research shows a significant mental health burden among autistic and ADHD individuals, particularly those who mask their traits, with 79% of autistic adults experiencing psychiatric disorders and a suicide rate seven times higher than the general population.
I love your beautiful approach to health and wellbeing - we're all so different, and no one thing works for everyone!