The Misdiagnosis Loop: What Happens When You Don’t Fit the Diagnostic Template
- Dr Miriam Mavia-Zając
- Apr 28
- 3 min read
By Dr Miriam | From the forthcoming book, “The New Normal”
We don’t always get misdiagnosed because we’re unclear. Sometimes, we get misdiagnosed because the system never expected to find us in the first place.
This is The Misdiagnosis Loop—a cycle that explains why so many non-stereotypical neurodivergent people are missed, misread, overlooked, or mistaken for something we’re not. This includes Black and Brown individuals, many white women, some white men, and non-binary people—those who don’t conform to the narrow behavioural and emotional templates that still dominate clinical practice.
We don’t all get dismissed because we’re disruptive. Many of us are overlooked precisely because we don’t cause problems. We people-please. We over-function. We present well. And often, our symptoms are exploited rather than recognised. Perfectionism becomes an asset. Empathy gets mined. Emotional suppression gets rewarded. We’re seen as capable—and that becomes the mask.
This is the Misdiagnosis Loop: a cycle that reinforces systemic misrecognition, delays meaningful support, and keeps entire populations of neurodivergent individuals in the shadows.
Stage 1: Culturally-Atypical Presentation
“You don’t look neurodivergent.”
We show up expressive, articulate, empathic, and creative. We lead teams. We hold space. We crack jokes. These traits don’t cancel out neurodivergence—they often co-exist with it. But when clinicians are trained to see autism or ADHD through white, male, or passive lenses, we are often deemed "too much," "too social," “too empathetic”, or "too capable" to be struggling.
Stage 2: Misreading of Symptoms
“You're too angry. Too much. Too dramatic.”Or worse: “You’re just anxious.”
Distress manifests in ways that are culturally or gender-coded—like emotional intensity, social fatigue, withdrawal, over-talking, or shutdown. But instead of being understood, these are labelled as mood instability, defiance, trauma, or personality disorder. Often, the symptom is not unseen—it’s misnamed.
Stage 3: Masking and Compensation
“If I’m not believed, I’ll just perform being fine.”
We internalise the invalidation. We over-achieve. We mimic neurotypical scripts. We take care of others before ourselves. This masking isn’t a choice—it’s an unconscious survival strategy. But the more we compensate, the more invisible our needs become. We become fluent in 'acceptable pain.'
Stage 4: Breakdown Before Breakthrough
“It had to get that bad before anyone listened.”
Only after burnout, emotional collapse, or crisis are we seen as needing help. By then, the toll is heavy. The pain, long internalised, erupts. For some, diagnosis comes only after they've already been labelled incorrectly for years. For others, it never comes at all.
Stage 5: The Reflection Trap
“Why didn’t anyone see me sooner?”
Post-diagnosis, we replay the years—teachers who missed it, therapists who doubted it, workplaces that profited off our masking. Relief is followed by grief. We wonder who we could’ve been if support had come earlier. We mistrust the system that made us vanish in plain sight.
This is not personal failure. It is structural neglect.The loop exists because the frameworks are too narrow, too white, too male-normed, and too invested in crisis as proof of struggle.
If your system only sees pain when it disrupts order,or only believes distress when it collapses performance—then your system is broken for everyone it was never built to serve.
We don’t need to shout louder.We need the frameworks to listen differently.
The Misdiagnosis Loop isn’t theoretical. It’s lived.And it’s time to break it.
Reflective Prompts
Have you ever been praised when what you really needed was support?
Have you ever been dismissed because you seemed “too okay” to be struggling?
Take a moment to ask yourself: Was I overlooked because I “chameleonised” too well—or because the system didn’t know how to see me?
If you found this piece insightful, you might also appreciate our deeper exploration of neurodivergence and emotional regulation, where we continue unpacking the lived realities behind diagnostic gaps.
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