At Carlat Publishing, we regularly debate trends in psychiatry—and neurodivergence is one of today’s most charged topics.

Let’s call it opinion divergence: Some on our team feel that the DSM-5 term “autism spectrum disorder” is politically insensitive. Others see it as clinically essential.

That conversation got me thinking: How did we get to a place where a diagnosis is considered offensive?

Why it matters:

• Framing ADHD and autism as “just differences” can discourage treatment
• It sends a mixed message—suggesting diagnosis is something to be ashamed of

Here’s what we know:

• ADHD and autism are neurodevelopmental disorders with functional impairments
• Diagnoses unlock access to support—school plans, therapy, medications
• Over-pathologizing is real—but so is under-serving people who are struggling

Reframe or Clarify:

• If someone with early heart disease said they were “cardiac diverse” and skipped follow-up, we’d call that dangerous
• Why should it be different for psychiatric conditions?
• This is psychiatric exceptionalism—the idea that brain-based disorders are somehow less real, less medical
• And it quietly harms the very people it aims to protect

We need both: affirmation of difference and clinical support when needed.

Discussion Prompt

• How do you help patients understand diagnosis without shame?
• Share to open up a more balanced—and sometimes uncomfortable—conversation about neurodiversity and care.
• Join the conversation on LinkedIn with Dr. Carlat 
• Follow for evidence-based skepticism in psychiatry
  

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