The heartbreaking truth about ADHD and autism we still don’t understand

Imagine spending years being told you’re too sensitive, too disorganised, too difficult, too emotional. Imagine knowing that you’re struggling, but not understanding why — and, perhaps most painfully, feeling that the people around you don’t understand either.

For many people with ADHD or autism, this can be the reality long before they have a diagnosis.

New research has revealed just how heavy the emotional cost can be. More than eight in 10 people with ADHD (83%) and autistic people (86%) say they have struggled with their mental health over the past decade. Across the UK population as a whole, the figure is 53%.

Those numbers are striking. But perhaps the more heartbreaking question is what sits behind them.

Because the problem isn’t simply that we don’t talk about neurodiversity enough. It is that we still don’t always understand what it can feel like to live with it.

‘All that time masking takes a toll’

For someone who has spent years trying to appear as though everything is fine, the relief of finally understanding themselves can be enormous. So can the grief for all the time spent believing there was something wrong with them.

Dr Elena Touroni, consultant psychologist and co-founder of The Chelsea Psychology Clinic, says that neurodivergent conditions have been “massively underdiagnosed for years”.

“All that time masking, without understanding that your challenges have been caused by a condition, takes a toll on someone’s mental health,” she says.

Masking can mean consciously or unconsciously hiding traits, developing elaborate coping strategies or pushing yourself to behave in ways that feel exhausting simply because they appear “normal”.

And even now, when awareness of ADHD and autism is greater than ever, another problem is emerging.

Touroni says that “unfair scepticism” is causing anxiety for some people with autism and ADHD, who fear they will not be believed or understood.

That creates a cruel contradiction: people are being encouraged to understand neurodiversity, while some of those living with it are still having to justify their experiences.

We’re talking more — but are we listening?

The findings form part of new research from The Chelsea Psychology Clinic looking at how the UK’s mental health has changed over the past 10 years.

And there are signs of progress. Around one in five UK adults report a formal diagnosis of depression (21%) or anxiety (20%). When people who have self-diagnosed are included, those figures rise to 27% and 31%.

We’re also becoming more willing to seek help before reaching breaking point. Twelve per cent of people with mental health difficulties now seek support preventatively, rather than waiting for a crisis — more than double the 5% reported a decade ago.

But talking isn’t the same as feeling heard. That becomes particularly clear when the research looks at different generations.

Among Gen X adults who had struggled with their mental health in the previous month, 42% had told nobody. For Gen Z, despite growing up in a world where mental health is discussed much more openly, 35% had also kept their struggles to themselves.

Perhaps that tells us something important about the limits of awareness. We can teach people the language of mental health. We can fill social media with messages telling us it’s OK to ask for help. But if someone has spent their life believing their difficulties are a personal failing, saying “I’m struggling” can still feel impossibly vulnerable.

The diagnosis can be an answer — but also the beginning of a new conversation

For some people, discovering they are autistic or have ADHD provides an explanation for a lifetime of experiences that never quite made sense.

It can help someone look back at their childhood, relationships, education or career with a new understanding.

But it can also bring difficult questions: Why did nobody notice? Why did I spend so long thinking I was failing? How much of my life have I spent pretending? Those questions deserve compassion, not judgement.

And perhaps this is the part of neurodiversity we still need to understand better. A diagnosis isn’t simply a label. For some people, it is the first time their experiences have been given context.

The challenge now is to make sure that understanding doesn’t stop with the person receiving the diagnosis. Because being understood by yourself can be life-changing. But being understood by the people around you can be, too.