Ellie Middleton spent years in treatment for anxiety and depression before learning she has ADHD and autism. Here, she sits down with Stephanie Anyakwo, LMFT, and shares what it costs to hide who you are, and what she wants providers to know.


Ellie, a writer, speaker, and neuro-inclusion consultant talks about the symptoms that anxiety alone never fully explained. She describes the simple, curious question that prompted her to look into neurodivergence, and how her diagnoses in her twenties gave new meaning to therapies she once thought had failed. 

Ellie’s experience is far from rare. More than half of U.S. adults with current ADHD were first diagnosed at 18 or older, with many arriving in therapy for something else entirely. Our e-book pairs Ellie’s lived experience with current research to help you recognize when a presenting concern may not tell the whole story, and what to do once a diagnosis enters the picture.

In this e-book

  • Why ADHD and autism can go unrecognized into adulthood, including the role of stereotypes and co-occurring anxiety and depression
  • How to decide when to screen, assess within your scope, or refer
  • What masking can look like in and out of the therapy room, and what to ask instead of asking about ability 
  • How to revisit treatment goals after a diagnosis 
  • Ways to support clients through the work of making sense of diagnoses

This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.