Let’s talk about something that comes up in therapy rooms more and more… women discovering in their 30s, 40s, even their 50s, that they are autistic, or have ADHD, or both!! The sensational media headlines will have you believe that there is an epidemic increase in ADHD and Autism, and overdiagnosis…. But this is actually more likely the result of women starting to feel comfortable to share their story and feel seen for the first time in decades.
Often this process happens sideways. A woman might bring her child to get assessed, as they aren’t coping well at school. The report comes back, and somewhere around page four Mum starts recognising herself… on every single page.
All of a sudden… the puzzle pieces click…. and the realisation sets in.
Relief and grief tend to arrive together, usually with a bit of anger tagging along (sometimes more than a bit…). Then comes the question that almost always follows: “If I’ve been getting help for anxiety for years… how did nobody notice??”
Why autism and ADHD in women are so often missed
Here’s the thing… much of the early research into autism and ADHD was built around boys. So the picture most of us grew up with was the disruptive kid at the back of the class, or the boy who knew every train timetable by heart. That picture shaped who got referred, assessed and diagnosed for decades.
Girls and women can look quite different. Their intense interests are often socially acceptable ones, like animals, books or people. Hyperactivity can live entirely inside the head, a brain that simply will not switch off at 2am. And the girl working twice as hard just to keep up?? She gets praised for being conscientious!!
BUT… there’s a bigger piece to this puzzle.
Masking and the hidden cost of fitting in
Masking (you might also hear it called camouflaging) is the work of hiding or managing neurodivergent traits to fit in. Rehearsing a phone call three times before dialling… copying how other people laugh… forcing eye contact… or even being aware internally of how long eye contact is held for… holding it together beautifully at work, then falling apart in the car park.
Many women become incredibly skilled at it. The catch is that masking is exhausting, and research consistently links long-term camouflaging with anxiety, depression, low self-worth and burnout.
It also hides the very traits a clinician would need to see to make a diagnosis. Clever brains, hiding in plain sight!
Misdiagnosis, and what gets treated instead
By the time a woman receives an adult autism or ADHD diagnosis, she has often collected quite a list of other labels along the way… generalised anxiety, depression, borderline personality disorder, chronic fatigue, sometimes an eating disorder. Some of those may well be accurate and sit alongside her neurotype. Others are really describing the fallout of living in a world designed for a different nervous system.
When treatment is aimed at the wrong target, women can walk away believing they’ve failed therapy too.
How neuro-affirming therapy sees things differently
This is where neuro-affirming therapy really comes into its own… it takes a woman’s experience at face value, and builds the work from there.
Burnout is recognised as burnout. Autistic and ADHD burnout is a deep, whole-body depletion that builds after years of masking and coping beyond capacity. The focus moves to rest, recovery and lightening the load, at a pace that actually feels doable.
Sensory needs are respected. If fluorescent lights, crowded shopping centres or scratchy clothing labels genuinely cause pain and overload, the answer is rarely to push through. Together we look at how to shape the environment around what she needs to function and feel safe and comfortable in her environment.
Executive function gets practical support. When a woman with ADHD worries about forgetting an appointment or missing a deadline, she’s usually drawing on a lifetime of evidence!! The work becomes building systems and supports that suit her brain, with a big dose of self-compassion along the way.
What a late diagnosis can open up
A diagnosis doesn’t change who someone is. What it can change is the story she tells about herself… all those years of being “too much”, “too sensitive” or “not trying hard enough” can finally be understood in a kinder way.
Many women describe a stretch of grief afterwards, for the younger version of themselves who struggled without an explanation. Others feel real freedom in setting down a mask they didn’t even know they were wearing. Both are completely normal, and both deserve the space they need.
Unmasking, identity and self-advocacy
Once the everyday load starts to ease, there’s room for the bigger picture… who she is now, with this new understanding of herself.
This part of the work might include:
- Exploring safe, gradual unmasking in relationships and at work
- Making sense of the diagnosis and what it means for her identity
- Strengthening self-advocacy at work, with health professionals and within families
- Understanding how neurodivergence runs through the family, and parenting in a way that works for everyone’s brains
And the room itself matters!! A therapy session should never feel like one more place where masking is required.
Frequently asked questions
Can autism or ADHD be diagnosed in adulthood?
Yes, absolutely. Adults can be assessed for autism and ADHD at any age. Assessment usually involves a detailed developmental history, standardised questionnaires and, where possible, input from someone who knew you as a child.
What if I think I have ADHD and want to explore medication?
If ADHD seems likely and medication is something you’d like to consider, the most direct path is to see your GP for a referral to a Psychiatrist, who can assess, diagnose and prescribe. A Psychologist can still be a wonderful support alongside this, helping with strategies, burnout recovery and making sense of the diagnosis.
Can a Psychologist diagnose ADHD or autism?
Yes. If medication isn’t something you want, a Psychologist with the right training can assess and diagnose both ADHD and autism. Your Psychologist can even be a great starting place, as they can complete some initial screeners to help start the testing process and work out the best path to take.
Why are women diagnosed with autism and ADHD later than men?
Early diagnostic criteria were based mostly on boys, girls often present differently, and many become very skilled at masking. Together, these mean women are frequently missed or misdiagnosed for years.
What is autistic burnout?
Autistic burnout is a state of physical, emotional and cognitive exhaustion that builds after long periods of masking and managing demands beyond capacity. It can look a lot like depression, but recovery usually needs rest and a lighter load.
What is neuro-affirming therapy?
Neuro-affirming therapy is an approach that respects autistic and ADHD ways of thinking, feeling and sensing, rather than trying to make people appear neurotypical. It focuses on sensory safety, burnout recovery, gradual unmasking and self-advocacy, adapted to how each person’s brain actually works.
Support in Milperra, Oran Park, Narellan and via Telehealth
If parts of this story feel familiar, you don’t have to work it all out on your own. Our Psychologists offer neuro-affirming support from our clinics in Milperra, Oran Park and Narellan, and via Telehealth across NSW. They can support women exploring a late diagnosis, recovering from burnout, or living with the anxiety and exhaustion that years of masking can bring.
Every person’s situation is different, so a Psychologist can talk through what may suit you.
Whenever you’re ready, call our friendly team on (02) 7907 3964 or book an appointment online.
Renata Wosik
Director and Principal Psychologist, RWPsychology
BA Psych., Post Grad Dip Gen Psych., Grad Dip Clinical Leadership & Clinical Supervision
MAAPi | ANZAED Credentialled Eating Disorder Clinician & Supervisor
