It’s one of the questions I’m asked most often, usually quite tentatively, as if the person is half expecting to be turned away: “I don’t have a diagnosis. Can I still come to you?”
The short answer is yes. You don’t need an ADHD diagnosis, or an autism diagnosis, to start therapy, and you don’t need to be certain either way. Whether you’ve been diagnosed, are on a waiting list, or are only just beginning to wonder, therapy can be a place to make sense of your experiences.
The longer answer is worth a bit more time, because the question often carries something underneath it.
Why so many people are asking
More adults than ever are recognising themselves in descriptions of ADHD and autism. Sometimes it’s a conversation with a friend, a child’s diagnosis, or something you read late at night that suddenly makes your whole life look different.
At the same time, waiting lists for adult assessments in the UK can be very long. So many people find themselves in an in-between place: fairly sure something has been going on for years, but without the official confirmation that would make it feel real.
That in-between place can be uncomfortable. You might swing between relief and doubt. “This explains everything.” Then, the next day: “Maybe I’m just making excuses.” If you’ve spent years being told you’re lazy, too sensitive, or not trying hard enough, it can be very hard to trust your own sense of what’s happening without someone else signing it off.
What therapy can offer, with or without a diagnosis
Therapy isn’t about the label. It’s about you, your history, and how you’ve come to experience yourself and other people.
Many of the things neurodivergent adults bring to therapy don’t depend on a diagnosis to be worked with:
- A harsh inner critic, built up over years of feeling you were getting things wrong
- Relationships that start well and then become confusing, painful, or exhausting
- Emotions that arrive fast and feel bigger than the situation seems to call for
- Sensitivity to criticism or rejection that can knock you off course for days
- Masking, people-pleasing, and the burnout that tends to follow
- A quiet, persistent sense of being different, and not knowing why
These experiences are real whether or not anyone has given them a name. In therapy, we can explore where they come from, how they show up now, and what might help you feel less at war with yourself.
What therapy can’t do
It’s important to be honest about this too. As a therapist, I don’t diagnose ADHD or autism, and therapy isn’t a replacement for an assessment. If you want a formal diagnosis, or want to explore medication, that needs to go through your GP or an assessment service.
What therapy can do is sit alongside that process, before, during, or after it.
If you’re on a waiting list
Waiting can be its own kind of hard. It can stir up hope, impatience, and old feelings of being overlooked. Some people find themselves holding their breath for an assessment that might be a long way off, putting their life on hold until they get an answer.
Therapy can give that waiting somewhere to go. We might look at what you’re hoping a diagnosis will give you, what you’re afraid it will or won’t confirm, and how to look after yourself in the meantime. And if a diagnosis does come, therapy can help with what follows, which isn’t always simple relief. I’ve written more about that in Late-Diagnosed ADHD: The Grief No One Warns You About.
If you’re not sure you want a diagnosis at all
That’s allowed too. Some people decide a formal assessment isn’t for them, or isn’t right for now. Some simply want to understand themselves better, without needing to prove anything to anyone.
You don’t need to have made that decision before coming to therapy. Exploring what a diagnosis would mean to you, and to the people around you, can be part of the work.
ADHD, autism, or both?
Often people aren’t sure which description fits. ADHD and autism overlap more than many people realise, and plenty of adults recognise themselves in both. This is sometimes called AuDHD.
You don’t need to work out which it is before we meet. What matters more is how your mind works, what’s hard, and what helps. We can be curious about all of it together.
What a neuro-affirming approach means
A neuro-affirming approach starts from the view that ADHD and autism are differences, not defects. Therapy isn’t about making you more “normal” or teaching you to mask more effectively. It’s about understanding how your brain, your history, your relationships, and your environment fit together.
I work relationally, so I’m especially interested in how growing up feeling different or misunderstood has shaped the way you see yourself and connect with others now. For many people, that’s where a lot of the pain lives, more than in the neurodivergence itself.
I also know this from the inside. I was diagnosed with ADHD as an adult, and making sense of it changed how I understood a lot of my own history.
Getting started
If you’ve been wondering whether therapy is for you, but hesitating because you don’t have a diagnosis, I hope this helps you feel a little more welcome.
I offer neuro-affirming therapy for adults in Colchester and online across the UK. You can read more about how I work with neurodivergent adults, or get in touch if you’d like to ask a question first. There’s no need to have it all figured out.
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