In recent years, the language of therapy and diagnosis has become part of everyday conversation. Some critics warn that we are pathologizing ordinary struggles, but that misses a crucial truth: for many people, receiving a diagnosis is not a burden or a label. It is a form of liberation, a key to understanding ourselves and finding community.
As a clinical social worker and educator, I don’t view suffering solely through the lens of biological impairment. Inspired by the neurodiversity movement, I consider the complex interplay of biological predisposition, lived experience and social context. This perspective doesn’t deny that suffering is real; it challenges the assumption that suffering stems only from within the individual, rather than also from a society built for a narrow range of minds.
Psychiatrist Allen Frances, who now regrets helping expand autism diagnoses in the 1990s, argues that we’ve stretched diagnostic boundaries too far, “pathologizing normalcy” in a quest for validation. But from a neurodiversity perspective, the issue isn’t pathologizing normalcy. It’s normalizing what was historically pathologized, recognizing that neurodivergent minds are part of human diversity, not deviations from it.
This distinction matters. For decades, countless autistic adults, particularly those without intellectual disabilities, have lived feeling alien, struggling silently with work, relationships and mental health, while receiving neither explanation nor support. Adults who discover they are autistic often report profound relief, clarity and a newfound sense of belonging, not dysfunction. Late-diagnosed adults come to understand that their exhaustion stems not from inherent brokenness but from years of masking who they are to fit in.
Yes, there are TikTok influencers who oversimplify. But there are also communities of neurodivergent scholars, clinicians and advocates offering rigorous, thoughtful syntheses of lived experience and research. Self-diagnosis isn’t just a trend; it is often a reasoned response to inaccessible, expensive and biased diagnostic processes.
I’ve worked with clients who’ve experienced exactly what critics describe: questioning whether a label fits after an evaluator dismissed their self-understanding. One client came to me devastated after being told she wasn’t autistic. However, I am aware that diagnostic protocols are imperfect. I supported her continued exploration. She eventually found a second evaluator who confirmed what she already knew. More importantly, she found an autistic community where, for the first time in her life, she felt understood.
Here’s the real dilemma: To access legal protections and accommodations, people must secure a deficit-based psychiatric diagnosis. Yet the very act of claiming a neurodivergent identity can also be a source of liberation. It is not because we seek to be seen as disordered; it is because we seek recognition as a group whose needs, communication styles and ways of being are too often excluded from schools, workplaces and public life. Embracing a neurodivergent identity helps people move from isolation and stigma toward community, dignity and pride.
Indeed, blaming social factors can sometimes be a way to avoid personal responsibility. But a concern raised by Victor G. Petreca, a psychiatric mental health nurse practitioner, in a Boston Globe column that people adopt labels to evade accountability misunderstands what many of us are actually doing. For many, identifying as autistic is about finally understanding why conventional strategies for success have failed. It is about replacing self-blame with self-knowledge, and then finding better strategies that align with who we actually are.
And the stakes are high. A growing body of research shows that autistic adults, especially those who go undiagnosed until adulthood, face disproportionately high rates of depression, anxiety and suicidality. Far too often, this suffering is compounded by being misunderstood, unsupported and blamed for not fitting into systems never designed for them.
For people whose differences have been misunderstood their entire lives, the choice to adopt a diagnostic label is not trivial. Whether that label comes from a clinician, from rigorous self-reflection or from a community of peers, what matters most is what it unlocks: the ability to ask not just “What’s wrong with me?” but “What do I need, and what becomes possible if I no longer have to force a square peg into a round hole? How might personal responsibility look different when grounded in accurate self-understanding, community welfare and authenticity?”
Ariel Pliskin, a licensed independent clinical social worker, is a lecturer in the department of psychological and brain sciences at the University of Massachusetts Amherst and manager of the Relationship & Sex Therapy Institute at Advance Psychotherapy Practice.