Guide
Before You Get Tested
A pre-assessment companion for adults thinking about neurodivergent testing. What to prepare, what to ask, and how to make sure the assessment you pay for actually gives you something useful.
See the guideAbout · Neurodivergence & giftedness
The adults who pass every test and pay for it daily.
Late-diagnosed AuDHD, giftedness, and twice- or thrice-exceptional profiles. You’ve had a whole life of being the person everyone else thought was fine, and a private list of everything that fine has cost you. Most of the work I do here is with people who got missed by every system they grew up in, and who’d like to stop paying for that now.
Who comes to me here
Names you may have already been given.
You’ve probably been handed a stack of labels by now. Maybe anxiety at some point, depression for sure, possibly burnout. One therapist wondered about complex PTSD. A coach called it perfectionism. Someone, eventually, said attachment issues. Maybe one of those names has fit better than the others. Maybe none of them ever really did.
A fair number of the people I work with in this area find that a late diagnosis of autism, ADHD, or both, with or without giftedness on top, explains the tiredness better than any of the earlier labels. Others find that the neurotype alone doesn’t fully explain what’s going on, and it sits alongside attachment work or moral-injury work to tell the whole story.
Your diagnosis isn’t something I’d assume, and neither is whether you need one. What I do is help you read the whole picture, neurotype included, so you can figure out what’s actually going on.
Recognition patterns
Some of the things most often described in the first session.
The specifics are different for everyone, but the shape tends to be familiar.
You can perform well in public and come home wrecked in a way nobody around you understands.
You were the gifted kid, the quiet one, the easy one, and something about that description now feels like a bill coming due.
Small-talk is physically draining. You can do it, but it takes a full afternoon to recover from.
You notice patterns, tones, inconsistencies, and subtexts other people seem not to register, and you have been told this is too much.
You are either late because time is slippery, or you are twenty minutes early because you refuse to be late.
Sensory inputs most people filter, you do not. Strip-light offices, perfume, certain fabrics, a particular register of voice.
You have had at least one period that looked, from the outside, like burnout, and felt, from the inside, like something older.
You have done therapy. Possibly a lot of therapy. There is a specific piece that never quite got reached.
Recognizing yourself in a few of these doesn’t mean you’re neurodivergent. Lots of people experience pieces of this for other reasons. What matters is whether the whole pattern has been read together, by someone who knows what to look for, rather than picked apart symptom by symptom.
The 2e and 3e question
Twice and thrice exceptional.
Twice-exceptional (2e) means you carry giftedness alongside a neurotype like autism or ADHD. Thrice-exceptional (3e) means all three. These profiles often get missed because the traits end up covering for each other inside a standard assessment: the giftedness hides the struggle, and the struggle hides the giftedness. The official test score comes back average, or normal, or inconclusive. The person walks away with nothing, when what’s actually happening is they’re running three operating systems at once and paying the energy cost of translating between them all day.
I don’t administer diagnostic assessments myself, but I can help you read the pattern and figure out whether a formal assessment is worth pursuing, and with whom. If you’d like a pre-assessment guide before having that conversation, the Before You Get Tested guide walks through what to prepare, what to expect, and what to ask whoever is doing the assessment.
How I think about this
On labels, wiring, and what changes when conditions change.
A lot of people think of giftedness, ADHD, and autism as neurotype. Giftedness isn’t a DSM category. ADHD and autism are. I believe in a spectrum of how minds function. I also think the DSM is an attempt to sort messy human experience into clean boxes, and the boxes are useful for awareness and integration, but not necessarily always the whole truth. The lived experience and symptoms of BPD and autism overlap, and so do plenty of others. Comorbidity and misdiagnosis are a real clinical problem. What I care about, more than the label, is where the mismatch lives between someone’s origins (the lived experiences until today) and wiring (their needs, their pace, their strengths, the way they actually work), the environment they’re in, and the ideal version of the world if they were to design it.
Once awareness arrives, and the conditions get designed around that wiring instead of against it, things can change. The complexity of giftedness stays, and so do the creativity of ADHD and the systems thinking of autism. The challenges can shift. The wiring is the same wiring, but built around instead of worked against, and a lot of what looked like disability quiets down. For some people, this goes far enough that they wouldn’t meet diagnostic criteria anymore.
In gifted adults the difference between life with the masking on and life with the masking off tends to be especially big. There’s more load to come off, because there was more raw capacity holding the mask up to begin with. When the giftedness finally gets seen and built around instead of worked around, what’s left can look much less like the diagnostic picture you started with. The wiring is the same. The conditions it’s running through are not.
The work
What sessions usually focus on.
Three threads, usually at the same time. The first is understanding what your body and mind have been doing, and what they’ve been expected to handle in environments that weren’t designed for them. The second is grieving, because a late diagnosis is rarely just relief. It’s also the name for what you’ve been doing to yourself, for decades, to get through. The third is working out what unmasking actually looks like for you specifically, which tends to be harder than the newer literature makes it sound.
The pace isn’t fast, but it isn’t endless either. The goal isn’t to become a different person. It’s to stop spending so much of yourself on being a version your environment can handle, and to build a life shaped around the one you actually are.
Related
Other places to go from here.
Essay
When you try other glasses
On late diagnosis and the feeling of recognition that shows up when a pair of glasses finally fits.
Read the essayWant to figure out what has been going on?
A first conversation is free, informal, and takes about thirty minutes. Get in touch and I’ll get back to you within 3 business days.