And what the Age of Diagnosis got wrong!
There is a lot of fear mongering around people identifying with autism and ADHD as labels. It’s been going on in the media for a while now, but it’s been amplified with the recent publication of the book ‘Age of Diagnosis’. The author questions the rising diagnosis rates, particularly of people who are perceived as ‘mild’ when it comes to autism and ADHD, and reduces neurodivergent masking to ‘something we all do’ during an RTÉ interview discussing her book.
No questions that the needs of neurodivergent people varies a lot, including how disabling people’s experiences are. However, it doesn’t help anyone when this issue positions autistic people against each other into a culture war styled argument, based on perceived functioning labels. Function labels are a reductive method of examining neurodivergence, and have been discussed at length. Some key issues that come with functioning labels include.
- People’s needs fluctuates across lifespan
- People labeled as ‘high functioning’ are often denied support.
- People labeled as ‘low functioning’ are often denied agency.
- The ideology of functioning labels were used by Nazi’s to decide which autistic people were and were not ‘high functioning’ enough to avoid sterilization and the T4 euthanasia programme.
(Czech 2018, ASAN 2021, Purkins, 2017, Kapp, 2023)
Although there was a lot I disagreed with in the RTÉ interview, the one that had the most significant impact on myself was the commentary on ‘mild autism’ and masking. Yes, most people mask to some extent when navigating the world e.g. putting a smiling face when working in a customer service role. What makes neurodivergent masking different is how we often have to mask our real selves to a higher degree during social interactions and in public, because we are still a long way from being fully accepting of difference on a societal level. We don’t just pretend we’re happier than we actually are for a few brief interactions to go more smoothly. We often are masking our interests, our natural way of communicating, while also trying to decode social and neurotypical norms during interactions (Something most people don’t need to do). It’s exhausting, and we do it to prevent further discrimination and for our personal safety. During my peak masking days, I couldn’t even fully unmask at home. The only break I had from masking and actually could be myself was in my bedroom alone.
It is not typical for most people to mask to this extent, the reasons we mask to this level is because of the ableism neurodivergent people face in a neurotypical world. The consequences for us if we do not mask in public or during social interactions are a lot more severe compared to neurotypical people who may only need to do it once in a while.
Diminishing neurodivergent masking to such a degree is highly dangerous due to the associations with suicidality. Anecdotally this is something neurodivergent people have been aware of for a while, and research is just starting to recognise the associations between autistic people masking and increased suicidality (Pérez-Arqueros, 2025). There’s nothing mild about masking contributing to suicidality. The last thing we need is health professionals jumping to this conclusion without considering the full picture.
Also a quote shared online from the ‘Age of Diagnosis’ book stated
“It is only anecdotal, but the lack of palpable life improvements for people diagnosed with either ADHD or autism is something that concerned me many times as I interviewed people for this book. Of the scores of people I spoke to, all of whom were adults, all perceived their lives to be better off thanks to a diagnosis. Every person welcomed the diagnosis into their lives. But almost all had left their job, dropped out of education”
Often neurodivergent people are pressured into conforming to norms when it comes to work and education. We struggle to live life in a neurotypical way and often suffer as a result. Not knowing why can be extremely difficult, and for many people who discover their lifelong neurodivergence in adulthood it can be a huge relief. As a result many of us experience validation that there was a reason why we struggled in ways that most other people don’t, often we just feel like failures before then. As a result, many people adjust their lives to better meet their needs as neurodivergent people and for some this will mean leaving their current job or dropping out of education. Often it becomes clear that once we become aware of our neurodivergence, the life we were living isn’t sustainable to maintain, and we need to rethink how we live our lives.
What appears to be missing from this quote is the concept of burnout, and more specifically autistic burnout. Autistic burnout is still a relatively new concept which seeks to explain the exhaustion autistic people experience from living their lives as neurotypical people do (Raymaker et al., 2020). The chronic exhaustion that comes from masking can last months and even years. Although this is primarily understood through the lense of autistic burnout right now, individuals can experience burnout for ADHD related reasons too (Attention Deficit Disorder Association, 2024)
People will often struggle to meet their basic needs for a long time as a result. If we don’t quit the things (or at least significantly reduce the amount of time we spend doing them), then it is inevitable we’ll experience burnout. By normality’s standards, this is seen as a ‘failure’, when in reality the neurodivergent people interviewed for the book are likely avoiding more significant problems later on, and figuring out how to live in a way that compliments their neurodivergence, and not work against it. There appears to be a lack of consideration for the burnout neurodivergent people experience, and the author’s take appears to be incredibly biased against neurodivergent people trying to figure out the best way to live the rest of their lives.
Most neurodivergent people will seek a diagnosis in adulthood when they are really struggling and needing answers. That’s why I certainly did. Although I don’t agree with how deeply autism and ADHD are pathologised, I do find having the language to describe my experiences in the world incredibly helpful. Prior to knowing about my autism and ADHD, I was still given many labels for being different, most of them were a lot more sinister then autism and ADHD and deeply stigmatising. Having my autism and ADHD confirmed was beneficial for me as it allowed me to understand the negative labels people threw my way over the years weren’t accurate at all, and it said a lot more about them, than me by choosing to describe my differences in such an awful way.
I decided not to read the full book ‘Age of Diagnosis’, as I do not want the author to earn royalties from my money or borrow the book from the library (as authors also earn money this way in the UK). It’s a bestseller so no doubt the author is making a decent amount from the book. Seeing from what other neurodivergent people have shared from this book, it seems to me the author only confirmed her own views by writing this book, and failed to grasp the other side of the coin and how her words do not reflect the realities for a lot of late discovered neurodivergent people.
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You can also support the blog by purchasing my book ‘Young Autistic and ADHD: Moving into adulthood when you’re multiply neurodivergent’.
References
Sarah Boon 
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