You do not need a diagnosis,
and a diagnosis may not be enough.
About half the people who ask me this already have a report. They were assessed, the report was accurate, and eighteen months later the weeks still go the way the weeks always went. The other half have never been tested and assume that rules them out. Neither is a problem. Nobody has to certify you before we can begin, and a certificate does not mean the work is done.
I am pragmatic about this.
Sailors crossed oceans by stars nobody had named yet. The star does not care whether it is in the catalog, and neither does the thing making your weeks harder than they should be. If you tell me something is not working, that is enough for me to work with. Plenty of what people struggle with does not sit neatly inside a 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 star chart
is not the voyage.
Assessment and therapy are not competing options, and you may want both. A good evaluation is the star chart. It tells you precisely what is overhead, 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 sailing. I have sat with people who got an excellent report, felt real relief for a fortnight, and then discovered that knowing the name of the thing had not told them how to run a Tuesday. That is not a criticism of the report. It is where the second job starts, and it is the one most people skip.
The star does not care whether it is in the catalog.
Four reasons,
all of them good.
- Accommodations. If HR is asking for documentation, you need documentation, and no amount of self-knowledge substitutes for it.
- Medication. A prescriber will 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 somebody qualified has looked at it properly. That is a real reason and I will not argue you out of it.
If none of those is your situation, and what you are after is permission to stop white knuckling your life, nobody has to issue that. You can begin now.
What I do and do not do.
I am a Licensed Professional Counselor. I do not diagnose and I do not run testing batteries. That is a specialty and it belongs to people who do it all day. What I do is the therapy, and it does not wait on a completed assessment. If an evaluation turns out to be worth having, we will both see it coming, and I keep referral sources across Dallas so I can match you to the right one rather than hand you a list.
Recognizing yourself
is not nothing.
Most people who arrive here late arrived through their own reading. The autism criteria were built largely 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 spent decades obscuring the evidence, at a cost the research ties to depression and anxiety.23
Noticing it yourself at thirty eight does not make you a hypochondriac. It makes you somebody who caught a pattern the system was not built to catch, usually while holding down a job that depends on nobody noticing. Bring the pattern to the first call. If both profiles sound like you at once, that has a page of its own.
- 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
Questions people ask before the first call.
Do I need a diagnosis to start therapy?
No. If you can describe the difficulty, we can work on the difficulty. Most of what we would do in the first month does not change based on what a report says.
Will you diagnose me?
No. I am a Licensed Professional Counselor and I do the therapy. Diagnosis and testing are a specialty and they should be done by people who do them all day.
Can I get ADHD medication through you?
No, I do not prescribe. If medication is something you want to explore, a prescriber will generally want a diagnosis on record first, and I can point you to assessment providers across Dallas.
What if I start therapy and it turns out I was wrong about myself?
Then we will both see it, and that is useful information rather than a wasted month. Nothing we work on in the meantime stops being true.
Start uncharted.
The first consultation is free, by phone or video, and there is nothing to prepare. No records, no history, no right words required. A two line text is a perfectly good way to start. Online across Texas, in person in Dallas. What is the pattern you would describe first?
Currently accepting new clients. I reply within 24 hours.