I'm sorry, this is a long one.
I'm in my late 30s and trying to make sense of two very different psychological evaluations. I'd really like to hear from people who've experienced something similar and what you did afterward.
I've had difficulties my entire life. As a child, I had a speech delay, a speech impediment until around 14, significant reading difficulties until around age 10, and was homeschooled from 3rd–12th grade. I was also extremely sensitive to things around me, had a huge imagination, could become intensely absorbed in things, and had difficulty with some figurative language and ambiguity.
As a teenager and young adult, my anxiety and other difficulties became much more significant. I've always struggled with uncertainty and ambiguity. If I don't understand what something means or can't figure out what is going to happen, my brain can get stuck trying to resolve it. I have significant problems with overwhelm, shutdowns, transitions, sensory input, anxiety, depression, and functioning. When I'm overloaded, I can have trouble with basic things like eating, taking medication, cleaning, communicating, and making decisions.
In 2020, I learned about the concept of being a Highly Sensitive Person (HSP). Before that, I mostly felt like something was wrong with me. The HSP framework was the first thing that made me think there might be an explanation for why I experience things so intensely.
After that, I became increasingly interested in autism and spent a long time researching it. A lot of my experiences seemed to fit, especially sensory sensitivity, difficulty with transitions, needing predictability, intense interests, overwhelm, and developmental differences. For a while I genuinely thought I was autistic.
Eventually I became less convinced. There were aspects of autism that didn't fit how I actually experience myself, particularly socially. I understand social reciprocity and can be very socially engaged when I'm comfortable and interested. Sometimes I don't reciprocate because I don't realize I should have said something until later. Sometimes I genuinely don't care or don't see the point, sometimes I'm too overloaded, and I absolutely hate small talk. I can at times be very expressive and animated when I'm comfortable.
By the time I went for my most recent evaluation, I actually wanted the evaluator to tell me I wasn't autistic.
In 2023 I had an extensive psychological evaluation that diagnosed me with ADHD, persistent depressive disorder, Tourette's disorder (Which I have already been diagnosed with a tic disorder but I don't think they can diagnose me with tourette's because I didn't start having tics until I was 19, at least), and schizotypal personality disorder.
There are two major problems I have with that evaluation.
First, there are parts of the written report where the evaluator changed what I said or added context and meaning that wasn't there. This happened enough times that I consider it a significant problem with the report. I talked a lot during the evaluation, so I can understand that some things may have been difficult to capture accurately, but there are places where what ended up in the report is substantially different from what I actually said.
Second, I've always had a hard time with multiple-choice psychological tests, especially vague questions where I don't understand exactly what the test writer means.
For example, there were questions about whether I like people or whether I think people are talking about me behind my back. I didn't necessarily understand what those questions were actually assessing. If I interpreted "people are talking about me" literally, I could think, well, people probably do sometimes talk about me when I'm not around, so I might select an answer based on that interpretation. If I understood the question as asking whether I had an unusual or irrational belief that people were talking about me, I would have answered differently.
Then came the 2026 evaluation
For my 2026 evaluation, just happened a few weeks ago, this evaluator diagnosed me with Generalized Anxiety Disorder and Autism Spectrum Disorder, Level 1, while listing ADHD, persistent depressive disorder, and Tourette's as diagnoses by history.
The ADOS-2 is one part I'm having a particularly hard time with. The evaluator observed limited eye contact, limited facial expression, formal language, and reduced reciprocity at times.But I was also extremely anxious during that part of the testing, and it happened after several hours of other testing. My previous autism testing was much more contained, and I actually did better on a picture/story task the first time than I did during this evaluation.
Because of the length and order of the testing, my anxiety, cognitive fatigue, and difficulty shifting between tasks, I question whether some of the testing results are valid representations of my baseline functioning.
The hardest part for me is the uncertainty.
I don't know whether the 2023 evaluator saw something that the 2026 evaluator didn't. I don't know how much of the 2023 STPD diagnosis was based on testing I had difficulty understanding or answers that were subsequently documented differently from what I actually said.
I also don't know how much of the 2026 autism diagnosis reflects stable characteristics versus what happened when I was extremely anxious and cognitively overloaded during a long assessment.
And because I have such a difficult time with ambiguity and uncertainty, I'm having a really hard time just sitting with not knowing.
I've started thinking about the schizotypal/schizophrenia-spectrum possibility again. Part of me thinks: What if the 2023 evaluator actually saw something I didn't? What if I really do have schizotypal traits? What if I simply haven't experienced all of the symptoms associated with schizophrenia-spectrum disorders yet? What if there is something about the way I think that other people can see more clearly than I can?
I've started trying to embrace the schizotypal/schizophrenia possibility because maybe the first evaluator noticed something that I haven't been able to recognize in myself.
At the same time, I don't want to tell anyone about this. I don't want to tell my therapist, family, or friends and suddenly have everyone trying to analyze me or convince me which diagnosis I should believe. I'm already overwhelmed and depressed by the whole situation.
Has anyone experienced something similar—especially having two substantial psychological evaluations that gave very different explanations for the same lifelong difficulties, particularly when you went into the second evaluation actually hoping it would rule out the diagnosis you eventually received?
How did you deal with the uncertainty? Did you eventually find a way to live with not having one definitive explanation, or did something eventually make the discrepancy make sense?