You do not need a diagnosis
to start.
This comes up in almost every first call, usually phrased as an apology. I think I might be autistic, but I have not been tested. I was told I had ADHD as a kid but nobody ever wrote it down. I do not want to waste your time if I am wrong. You are not wasting my time, and you do not need a piece of paper to be allowed in the room.
I am pragmatic about this.
Half of the music this city is famous for was made by people who never learned to read a chart. The song does not care whether it has been written down, and neither does the thing that is making your weeks harder than they should be. If you tell me something is not working, that is enough for me to work with. A great deal of what people actually struggle with does not sit neatly inside a diagnostic label, and waiting for the label is a good way to lose a few years.
If you can describe the difficulty, we can work on the difficulty.
A transcription
is not a performance.
Assessment and therapy are not competing options, and you may well want both. A good evaluation is a careful transcription: it tells you precisely what has been playing all along. It takes hours, it draws on training I do not have, and the people who do it well are worth what they charge.
Therapy is the playing. The transcription is useful, and it is not the same as knowing how to run a Tuesday. I have sat with people who got an excellent report, felt real relief for two weeks, and then found they still had to figure out how to live inside the information. That is not a criticism of the report. That is where the other job starts.
Four reasons,
all of them good.
- Accommodations. If work or school is asking for documentation, you need the documentation. The most common reason, and the most straightforward.
- Medication. A prescriber will generally want a diagnosis on record before writing for ADHD medication.
- Legal and disability processes. Formal determinations require formal records.
- Your own clarity. For some people the question will not rest until someone qualified has looked at it properly. That is a real reason, and I will not talk you out of it.
If none of those is your situation, and what you are really after is permission to stop white knuckling your life, you do not have to buy that. You can begin now.
What I do and do not do.
I am a Licensed Professional Counselor. I do not run testing batteries. That work is a specialty and it should be done by people who do it all day. What I do is the therapy, and it does not require a completed assessment to begin. If it turns out along the way that a formal evaluation would genuinely serve you, we will both see it, and I will help you find someone good and choose among the options, the same way I coordinate the rest of your care.
Recognizing yourself
is not nothing.
Many adults arrive at this through their own reading, or a child’s assessment that made them look sideways at their own history. There are good reasons it happens late: the autism criteria were built primarily from studies of boys, which is a documented reason women are identified later and less often,1 and if you learned early to mask, you have been obscuring the evidence for decades, at a cost the research ties to depression and anxiety.23
So no, noticing it yourself at thirty eight does not make you a hypochondriac. It makes you someone who caught a pattern the system was not built to catch. Bring that pattern to the first call. It is enough to begin with, and it is usually more useful than a report anyway. The specifics live on their own pages: ADHD, autism, and both at once.
- Rynkiewicz A, et al. Girls and women with autism. Psychiatria Polska, 2019. doi.org/10.12740/PP/OnlineFirst/95098
- Cage E, Di Monaco J, Newell V. Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 2018. doi.org/10.1007/s10803-017-3342-7
- Somerville M, MacPherson SE, Fletcher-Watson S. The associations between camouflaging, autistic traits, and mental health in nonautistic adults. Autism in Adulthood, 2024. doi.org/10.1089/aut.2023.0018
Start by ear.
The first consultation is free, by phone or video, and there is nothing to prepare. No records, no history, no right words required. Virtual across Louisiana, insurance and private pay. What is the pattern you would describe first?