The Trauma of Not Knowing: Why So Many Late-Diagnosed People Also Have CPTSD

Here's the thing about being a high-achieving woman with undiagnosed AuDHD: you don't get to coast. You don't get to have an "off" day. You don't get to just be — because just being has never, ever been enough.

You learn this early. Maybe you were "too sensitive." Too intense. Too much. Or maybe you were too quiet, too in your head, too somewhere-else. Either way, the message was clear: the way you naturally exist is not acceptable. Please adjust.

So you adjust. And adjust. And adjust. For decades.

And here's what doesn't get talked about enough: that adjustment, that constant, exhausting, shape-shifting performance of normalcy — that's not just inconvenient. It's not just "oh, I wish I'd known sooner."

For many of us, decades of being undiagnosed is the trauma.

This Isn't Just Sad. This Is Traumatic.

I was diagnosed with ADHD and autism in my early fifties. I have a PhD in clinical psychology. I've been practicing for over 26 years. I've trained thousands of mental health professionals. And I had absolutely no idea.

(I know. I know. The irony is not lost on me.)

When I finally got my diagnosis, I expected relief. And there was relief — a profound, bone-deep "oh, so that's why" that I still feel sometimes when another puzzle piece clicks into place.

But I wasn't prepared for what came with it: grief. Anger. And a creeping recognition that what I'd experienced wasn't just "a late diagnosis." It was decades of developmental trauma that I'd never named, because I didn't know there was anything to name.

The not fitting in, ever, anywhere, even when you desperately wanted to.

The trying harder and harder and still failing at things that seemed effortless for everyone else.

The relationships that fell apart because you couldn't explain what you didn't understand yourself.

The jobs you lost or left because the environment was unbearable and you thought that meant you were unbearable.

The way you learned — deeply, cellularly, in your bones and your nervous system — that you were fundamentally broken. That something was wrong with you. That if you just tried harder, mastered yourself better, controlled yourself more, you could finally be acceptable.

That's not just unfortunate. That's traumatic. And your body has been keeping score the whole time.

The Diagnostic Criteria No One Talks About

Complex PTSD — CPTSD — develops in response to prolonged, repeated trauma, often in situations where escape feels impossible. It was originally conceptualised around experiences like ongoing abuse, captivity, or growing up in a chaotic or neglectful home.

But here's what I've observed in my practice, and in myself: growing up neurodivergent without knowing it creates remarkably similar conditions.

You're trapped in environments that don't fit you — classrooms, social groups, workplaces, sometimes even your own family — and you can't escape because you don't even know you're trapped. You just think you're failing.

You experience repeated "small" traumas that don't look dramatic from the outside: the constant correction, the social rejection, the sensory overwhelm that no one else seems to notice, the exhaustion of translating yourself into a language that isn't yours.

You can't leave, because where would you go? The problem seems to be you. And you can't understand what's happening, because no one has given you the framework.

This isn't one terrible event. This is the water you're swimming in. And it creates the same wounds that "classic" trauma creates:

Emotional flashbacks — sudden, overwhelming floods of shame, fear, or despair that seem to come from nowhere (or from something "small" that shouldn't warrant that response).

A brutal inner critic — the internalised voice of everyone who ever told you to try harder, be normal, stop being so sensitive. Except now it's inside your head, running commentary on everything you do.

Chronic shame — not "I did something bad" but "I am something bad." The fundamental sense that your existence is somehow wrong.

Difficulty with emotional regulation — because your nervous system has been running on high alert for decades, and it doesn't know how to come down.

Relational patterns that swing between desperate attachment and protective withdrawal — because people have been both essential (you needed them to survive) and dangerous (they were often the source of injury).

Dissociation and disconnection — from your body, from your emotions, from the present moment. Because sometimes leaving wasn't an option, so you left in the only way you could.

Sound familiar?

The Specific Wounds of Not Knowing

I want to name some of the experiences that create CPTSD in undiagnosed neurodivergent people, because naming them matters. When you can see the wound, you can begin to tend it.

The trauma of relentless correction. Being told, over and over, in ways big and small, that how you naturally do things is wrong. Sit still. Make eye contact. Don't be so literal. Why can't you just... The message underneath: you are not acceptable as you are.

The trauma of social rejection. Being excluded, bullied, or simply never quite fitting in. Not understanding the unwritten rules everyone else seems to know. The loneliness of being surrounded by people and still feeling completely alone.

The trauma of sensory overwhelm without explanation. Meltdowns or shutdowns that got you labelled as "dramatic" or "difficult." Environments that felt genuinely painful while everyone else seemed fine. The gaslighting of being told it's not that bad, you're overreacting, there's nothing wrong.

The trauma of academic or professional inconsistency. Being "so smart" but somehow always underperforming. Starting strong and fading. Having potential you couldn't seem to access. The shame of being called lazy when you were working twice as hard as everyone else just to stay afloat.

The trauma of misdiagnosis. Being told you had anxiety, depression, borderline personality disorder, an eating disorder, bipolar disorder — anything except the thing that would actually explain the pattern. Years, sometimes decades, of treatments that didn't quite work for conditions you didn't quite have.

The trauma of broken relationships. Friendships that ended without explanation. Romantic relationships that fell apart because you couldn't understand each other. The accumulating evidence that you are somehow impossible to love as you are.

The trauma of masking. Learning to hide your real self so thoroughly that you lose access to who that is. The exhaustion of performance. The loneliness of being liked for a version of you that isn't really you.

The trauma of medical dismissal. Chronic symptoms — fatigue, pain, gut issues, headaches — that doctors couldn't explain, so they blamed stress, or anxiety, or "just" being a woman. The erosion of trust in your own body and perception.

The trauma of trying harder and harder and harder. And still not being enough. Ever.

These experiences, repeated over years and decades, wire your nervous system for threat. They teach your body that the world is not safe, that people are not safe, that even you are not safe. And by the time you finally get a diagnosis — if you get one — that learning is deep.

The Body Keeps the Score (Even When the Mind Doesn't Know What Happened)

Bessel van der Kolk titled his seminal book The Body Keeps the Score for a reason — and for late-diagnosed neurodivergent adults, this truth cuts deep.

One of the cruelest aspects of late-diagnosed CPTSD is that you might not have memories of "trauma" in the way people usually mean it. There might not be a single terrible event you can point to. No dramatic story to explain why you feel the way you feel.

But your body knows. Your nervous system knows.

It's there in the way you startle at unexpected sounds. The chronic tension you carry in your shoulders, your jaw, your pelvic floor. The digestive issues that started God-knows-when. The fatigue that sleep doesn't fix. The way your heart races in situations that "shouldn't" be threatening. The way you freeze when someone raises their voice. The way you fawn and people-please and abandon your own needs before you even register you have them.

Your body learned, before your mind could understand or remember, that it had to be vigilant. That something was wrong. That you weren't safe.

And here's the thing about the body: it doesn't care whether your conscious mind knows why. It just responds to the learning. Decades of not fitting in, of trying and failing, of shame and rejection and overwhelm — that gets stored. In your muscles. In your gut. In your nervous system's baseline settings.

This is why so many late-diagnosed adults have "unexplained" chronic health conditions. The fibromyalgia. The chronic fatigue. The IBS. The autoimmune issues. The doctors said they couldn't find anything wrong.

They weren't looking in the right place.

Why Diagnosis Is the Beginning, Not the End

I wish I could tell you that getting diagnosed fixes everything. That once you know, the trauma resolves, the symptoms lift, and you ride off into the sunset with your shiny new self-understanding.

That's not how it works.

Diagnosis is a door, not a destination. And what's on the other side of that door is complicated.

There's relief, yes. The "I'm not broken, I'm autistic/ADHD" realisation that reframes your entire life history. That's real and it matters.

But there's also grief. Sometimes enormous, crushing grief. For the years you lost. The person you might have been with early support. The relationships that might have survived. The career you might have had. The suffering that might have been prevented.

There's anger. At the systems that missed you. The professionals who got it wrong. The people who told you to try harder. Sometimes at the people who loved you but didn't see. Sometimes at yourself, for not knowing sooner (even though you couldn't have known — the anger isn't rational, but it's real).

There's a strange disorientation. If you're not who you thought you were, then who are you? If your coping strategies were masking, what's underneath? If you've been performing your whole life, what happens when you stop?

And there's the realisation that the trauma is still there. The diagnosis explains it. It doesn't erase it. Your nervous system doesn't get the memo that everything makes sense now. It's still running the old programmes. You still flinch at the same triggers. You still carry the same somatic patterns. You still have the same inner critic, now perhaps with new ammunition.

This is why so many late-diagnosed people feel worse before they feel better. The knowing opens everything up. And before you can heal, you have to actually feel what you've been bypassing for decades.

It's a lot.

The Path Forward

I'm not going to tell you this is easy, because it isn't. I'm not going to promise quick fixes, because there aren't any. What I will tell you is that healing is possible. Not healing in the sense of erasing what happened or becoming neurotypical, but healing in the sense of coming home to yourself. Finally.

First, the knowing matters. Even when it's painful. Even when it brings grief. Understanding that you're neurodivergent, that you developed CPTSD from decades of trying to fit a world not made for you, that your symptoms make sense — this is the foundation. You can't heal what you can't name.

Second, the body has to be included. Talk therapy alone won't resolve trauma that's stored in your nervous system. You need approaches that work with the body — somatic experiencing, EMDR, BWRT, polyvagal-informed work, nervous system regulation practices. The goal isn't to think your way out. It's to help your body learn, finally, that it's safe.

Third, demand reduction isn't optional. You cannot heal while still burning out. The masking has to decrease. The overwhelm has to decrease. This isn't weakness or giving up — it's creating the conditions where healing can actually happen. You can't pour from an empty cup, and you can't regulate a nervous system that's constantly in survival mode.

Fourth, community heals. Finding other late-diagnosed people — people who get it, who don't need everything explained, who reflect back to you that you're not alone — is profoundly healing. The trauma happened in relationship (being rejected, misunderstood, corrected). The healing happens in relationship too (being seen, accepted, belonging).

Fifth, grief has to be allowed. There's no shortcut through this. You have to let yourself mourn what you lost. The years. The possibilities. The self you might have been. This isn't self-pity. It's the necessary acknowledgment of real injury. And on the other side of grief, there's often space that wasn't there before.

Sixth, self-compassion is the long game. That inner critic took decades to build. It's not going away overnight. But every time you catch it, every time you offer yourself the kindness you'd offer a friend, every time you remind yourself that you were doing the best you could with what you knew — you're building a new pattern. You're slowly, slowly, rewiring toward something gentler.

A Note on Reading This

If you've read this far and you're feeling a lot of feelings — that's appropriate. This is heavy material, and if it resonates, it's probably resonating with something real and tender in you.

You might want to stop here and let it settle. Maybe take some breaths. Maybe notice where you're holding tension. Maybe go do something that regulates your nervous system — whatever that is for you.

You're not broken. You were undiagnosed in a world that wasn't built for you, and you developed adaptations that cost you. Those adaptations made sense at the time. They helped you survive. And now, with knowing, with support, with time — there's another way.

I won't say "you've got this," because honestly, I find that kind of thing annoying. What I will say is: you're not alone. Many of us are on this path. And it's worth walking.

If you're recognising yourself in this post and want support, please reach out to a neurodiversity-affirming therapist who understands trauma. You deserve someone who gets it.