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Advancing Mental Health Care for Neurodiverse Individuals: Rethinking Diagnosis and Treatment in Adelaide

By Paul Alexander Wolf

Introduction

The understanding of neurodiversity and trauma-informed care has evolved significantly, yet psychiatric diagnoses and treatments remain entrenched in outdated models that often fail to capture the full reality of patients’ experiences. In Adelaide, as in many other places, individuals struggling with neurodivergence—particularly autism spectrum disorder (ASD), ADHD, and complex trauma—are frequently misdiagnosed, leading to inappropriate treatment and sometimes harmful medication regimens.

This article explores the systemic issues in psychiatric diagnosis, the overlooked role of existential trauma, and the professionals in Adelaide who are pioneering a more holistic, patient-centered approach.

The Problem: Misdiagnosis and the Limits of Traditional Psychiatry

At the core of this issue is the rigid reliance on DSM-based diagnostic frameworks, which often pathologize neurodivergence rather than recognizing it as a valid variation of human cognition. Many neurodiverse individuals report being misdiagnosed with conditions such as bipolar disorder, major depressive disorder, or generalized anxiety disorder, when, in reality, their distress stems from a lifelong struggle with sensory processing differences, emotional dysregulation, and existential trauma.

The Consequences of Misdiagnosis

Misdiagnosed individuals often find themselves subjected to unnecessary and sometimes harmful medication regimens, leading to iatrogenic complications. Antipsychotics, mood stabilizers, and SSRIs are frequently prescribed to “manage” symptoms that arise from an underlying neurodevelopmental or trauma-related condition rather than from a primary mood disorder. This approach can exacerbate symptoms, leaving individuals trapped in a cycle of ineffective treatment and further medicalization.

Existential Trauma and the “Not Meant to Be Here” Phenomenon

One of the most poignant and underexplored aspects of neurodivergence is the profound sense of existential displacement that many individuals experience. Jean-Paul Sartre, in Being and Nothingness (1943), described existential angst as the realization of one’s own radical freedom and isolation in the universe. However, for neurodivergent individuals, this existential struggle is compounded by a fundamental misalignment with societal norms and expectations.

Many report feeling as though they are “not meant to be here”—a deep-seated sense of alienation from the world around them. This is not merely depression or anxiety but an existential trauma, born from a lifetime of being misunderstood, masked, and forced to conform to neurotypical standards. Traditional psychiatric frameworks fail to recognize this distress, leading to misdiagnoses that overlook the deeper philosophical and psychological dimensions of neurodivergent experience.

The Role of Psychotherapists: Advocating for Change

Psychotherapists in Adelaide who work with neurodivergent clients often find themselves at odds with a system that prioritizes medication over deep psychological understanding. Many are advocating for change but are limited by systemic constraints, outdated psychiatric training, and pressure to conform to standardized treatment protocols.

The challenge lies in integrating trauma-informed care, existential psychotherapy, and neurodiversity-affirming approaches into mainstream mental health care. This means shifting from a deficit-based model—where neurodivergence is seen as a disorder to be corrected—to an empowerment-based model that recognizes the strengths and struggles of each individual.

Recommendations: How to Properly Assess Neurodivergent Individuals and Overcome Diagnostic Bias

1. Specialized Assessment Services in Adelaide

For individuals seeking accurate, unbiased assessment and diagnosis, the following clinics and professionals in Adelaide are recommended:

• Adelaide Neuropsychology – Specializes in thorough neuropsychological assessments with an understanding of both neurodiversity and trauma, ensuring a comprehensive evaluation rather than a premature diagnostic label.

• The Autism Clinic (AUSCARE) – Provides neurodiversity-affirming assessments with a strengths-based approach rather than a purely medicalized perspective.

• South Australian Mental Health Services – While highly variable in approach, some practitioners within the system are incorporating trauma-informed and neurodiversity-sensitive care. It is crucial to request a clinician with experience in these areas.

2. Psychiatrists in Adelaide with a Holistic Approach

For individuals struggling with misdiagnosis or ineffective treatment, the following psychiatrists in Adelaide have been noted for their open-minded, trauma-informed, and neurodiversity-affirming approaches:

• Dr. Michael Greenfield – Known for his trauma-informed work with ADHD and autism, advocating for non-medication-based interventions alongside psychotherapy.

• Dr. Pippa Thew – Specializes in neurodevelopmental disorders and complex trauma, focusing on person-centered, individualized treatment plans.

3. Training and Education for Health Professionals

Clinicians, including GPs, psychiatrists, and psychologists, need further training on the overlap between neurodiversity and trauma. Professional development programs should incorporate:

• The role of existential trauma in mental health conditions.

• The limitations of DSM-based psychiatric classifications.

• The impact of sensory processing differences on emotional regulation.

4. Neurodiversity-Affirming Practices

The medical community must adopt an affirming approach to neurodivergence, viewing it as a legitimate variation rather than a pathology. This includes:

• Shifting from deficit-based language to empowerment-based narratives.

• Recognizing sensory and emotional regulation challenges as intrinsic to neurodivergent experiences.

• Providing patients with coping strategies tailored to their individual needs rather than simply prescribing medication.

5. Patient Education and Self-Advocacy

Patients must be encouraged to become their own advocates by:

• Learning about neurodiversity and trauma-informed care.

• Seeking second opinions when faced with a questionable diagnosis.

• Building networks of support within the neurodivergent community.

Final Thoughts

As mental health professionals, we must move beyond rigid diagnostic categories and embrace a more nuanced, individualized approach to care. The intersection of neurodivergence, trauma, and existential distress demands a shift in perspective—one that prioritizes lived experience, deep listening, and collaborative treatment planning.

Adelaide has a small but growing community of professionals who understand these complexities and are leading the way in providing neurodiversity-affirming, trauma-informed care. However, systemic barriers remain, from outdated psychiatric models to limited access to specialized assessments and support.

The responsibility lies not only with psychiatrists and psychologists but also with GPs, therapists, educators, and policymakers to foster an environment where neurodivergent individuals receive the care they truly need—care that recognizes their strengths, acknowledges their struggles, and validates their experiences. Only by dismantling misconceptions and rethinking mental health care at its core can we create a system that genuinely supports those who have long been misunderstood and underserved.

It is time to listen, to adapt, and to ensure that no individual feels they are “not meant to be here.” Instead, we must work towards a future where every person—regardless of how their brain processes the world—has access to understanding, acceptance, and meaningful support.

References

1. Sartre, J.-P. (1943). Being and Nothingness: An Essay in Phenomenological Ontology.

2. Silberman, S. (2015). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. Penguin.

3. Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.

4. Milton, D. E. (2012). “On the ontological status of autism: The ‘double empathy problem’”. Disability & Society, 27(6), 883-887.

5. Walker, N. (2021). Neuroqueer Heresies: Notes on the Neurodiversity Paradigm, Autistic Empowerment, and Postnormal Possibilities.