Missed ADHD & Autism Diagnosis in Florida Adults | Virtual Psychiatry |

"Was It Really Just Anxiety?" — Missed ADHD and Autism Diagnoses in Florida Adults: What You Need to Know in 2026

By Luisa Garcia, APRN, FNP-C, PMHNP-BC | Sunset Behavioral Health | Telepsychiatry for All of Florida | sbhmind.com

If you've spent years being told you have anxiety, depression, or "just stress" — but something still feels off — you are not alone. Across Florida, thousands of adults are discovering for the first time that what they've been living with is actually undiagnosed ADHD, autism, or both. Here are the questions patients ask us most.

Q: Can adults really be diagnosed with ADHD or autism for the first time?

Yes — and it happens more than most people think. Autism diagnosis rates in large U.S. health systems rose by 175% between 2011 and 2022, and adult ADHD diagnoses have climbed sharply too. These are not new conditions — these are people who were always there and simply deserved to be found sooner.

Q: Why do so many adults get missed?

For decades, ADHD and autism were seen mostly as conditions that affect young boys. The tools used to diagnose them were also built around how those conditions show up in boys — not in girls, women, or adults who have learned to cope quietly. By the time many people reach adulthood, they have become very good at hiding their struggles.

Q: What is "masking" and why does it matter?

Masking means hiding or suppressing your real symptoms to fit in — things like forcing eye contact, scripting conversations ahead of time, or pushing through sensory overload without showing it. Women tend to start masking earlier and do it more completely than men. By adulthood, the mask can be so practiced that even trained clinicians miss what's underneath.

Q: What conditions are women misdiagnosed with instead?

Nearly 80% of women with autism are misdiagnosed — most often with anxiety, depression, bipolar disorder, borderline personality disorder, or eating disorders. Many Florida women we see have been in treatment for years for the wrong condition. When the real diagnosis finally comes, it changes everything.

Q: What does undiagnosed ADHD or autism actually feel like in adults?

Here are signs our Florida patients commonly describe before their diagnosis:

• You feel calm on the outside but completely chaotic on the inside

• People say you're "so smart" or "so capable" but you feel like you're barely keeping up

• You crash completely after work or social events — not from tiredness, but from performing all day

• You've been anxious your whole life but anxiety treatment never really worked

• You were a good student but struggled as an adult when the structure disappeared

• You feel like you've always been "too much" or "not enough" — never quite right

Q: What is AuDHD?

AuDHD is the term used when someone has both autism and ADHD at the same time. Between 30% and 80% of people diagnosed with ADHD are also autistic. When both are present, they can hide each other — making both conditions harder to spot. People with AuDHD often wait the longest to get diagnosed because the two conditions interact and create a more complex picture.

Q: Why does a correct diagnosis matter so much?

When anxiety or depression is treated without finding the real cause underneath, treatment is always incomplete. Research shows that over 50% of adults with ADHD have at least one other psychiatric condition — most often anxiety or depression — that developed because the ADHD went unrecognized. Treating the root cause changes the outcome.

Q: Is it too late to get diagnosed as an adult in Florida?

Not at all. Many people get their first ADHD or autism diagnosis in their 30s, 40s, and 50s. A late diagnosis doesn't make your experience any less real. In fact, most people say getting the right diagnosis finally helped them understand their whole life — and gave them the tools to actually feel better.

Q: What happens after you get the right diagnosis?

You finally have a framework that fits. You stop blaming yourself. You get access to treatments — medication management, supportive therapy, and real coping strategies — that are built for how your brain actually works. For many Florida adults, a correct diagnosis is the turning point they have been waiting for their whole lives.

Q: How do I get evaluated for ADHD or autism in Florida?

You can start with a virtual psychiatric evaluation from anywhere in Florida — no long wait, no driving, no referral needed. At Sunset Behavioral Health, we offer comprehensive evaluations by secure video for children, teens, and adults across the state, from Miami to Jacksonville, Orlando to Naples, Tampa to Tallahassee. When appropriate, we can also guide families toward formal autism testing.

Is Your Child Showing Signs? The CAST Screener

The Childhood Autism Spectrum Test (CAST) is a free, research-backed tool for children ages 4 to 11. Parents answer 39 yes/no questions based on what they see at home and at school. It is not a diagnosis — but it can help you decide whether a full evaluation is worth pursuing.

👉 Take the full CAST screener here

What the CAST Looks At

The 39 questions cover five main areas of your child's behavior:

1. Social skills and friendships Does your child join in easily with other kids? Do they have real friends — not just kids they know from class? Do they start conversations on their own, share things they're excited about, and enjoy joking around? Children who struggle here may avoid group play, prefer to watch from the sidelines, or only play on their own terms.

2. Communication and conversation Can your child keep a back-and-forth conversation going? Do they take turns talking — or steer every conversation back to their favorite topic? Children with autism traits often have strong vocabulary but miss the social rules of talking, like knowing when to stop or how to ask questions back.

3. Imaginative play and flexibility Did your child pretend-play as a toddler — superheroes, tea parties, made-up games? Do they enjoy role-play with other kids now? Or did they prefer sorting, lining up toys, and learning facts? Reduced imaginative play early on is one of the key things the CAST looks for.

4. Routines, repetition, and special interests Does your child need things done the same way every time? Do they have one big interest that takes up almost all of their focus? Do they get very upset when plans change unexpectedly? These are classic autism traits the CAST is designed to pick up.

5. Sensory differences and unusual behaviors Does your child notice tiny details others miss — sounds, patterns, textures, hums? Do they have repetitive movements like hand-flapping or rocking? Is their voice flat, monotone, or sound unusually adult for their age? Do they take things very literally and miss the point of jokes?

How to Score the CAST

The CAST has 35 scored questions and 4 general development questions — about reading, dressing, counting, and cycling — that do not count toward the score.

ScoreWhat It Means

0–14: Below the threshold — autism is less likely, but always trust your instincts as a parent

15 or above: Above the threshold — a full evaluation with a qualified provider is recommended

Important: Many girls score below 15 and still have autism — especially those already masking at a young age. A score is just one piece of the picture. If something feels off, it is always worth talking to a provider.

Q: My child scored above 15. What do I do next?

Don't panic — a high score simply means a formal evaluation called the ADOS (Autism Diagnostic Observation Schedule) is the next step. The ADOS is the gold standard tool clinicians use to assess autism in children. Here is exactly what to do:

Step 1 — Call your insurance first. Ask them for a list of local neuropsychologists in your area who are in-network and offer ADOS testing. This one call can save you a lot of time and money. Your child's PCP can also send a referral to help move things along.

Step 2 — Know what to expect in Florida. In Florida, wait times for ADOS evaluations can be up to 6 months — especially in busy areas like Miami, Orlando, Tampa, and Fort Myers. Starting the process early matters. If cost is a concern, self-pay rates for neuropsychological testing in Florida typically range from $350 to $500 — always ask the office directly before your first appointment.

Step 3 — You don't have to navigate this alone. As your virtual psychiatric provider, I can place the referral for formal autism testing directly and help guide your family through each step — from anywhere in Florida by secure video appointment.

Q: I'm over 18 and my insurance won't cover the ADOS test. What are my options?

This is very common in Florida — many commercial insurance plans do not cover autism diagnostic testing for adults, and the out-of-pocket cost for a full neuropsychological evaluation can feel overwhelming. Here are your real options:

1. Ask for an itemized cost breakdown. Call the neuropsychologist's office and ask what is included in the evaluation and what each part costs. Some offices will unbundle the testing and let you pay in stages. Self-pay rates for adult autism evaluations in Florida typically range from $350 to $2,500 depending on the depth of testing — always ask before you book.

2. Look for university training clinics. Many Florida universities — including USF, UF, FAU, and FIU — have psychology training clinics that offer reduced-cost neuropsychological testing performed by supervised graduate students. Wait times are often shorter and costs are significantly lower.

3. Check community mental health centers. Florida's community mental health centers sometimes offer sliding scale diagnostic services. Contact your county's Department of Children and Families (DCF) or call 211 Florida to ask what is available in your area.

4. Consider a psychiatric evaluation first. A full neuropsychological evaluation is the gold standard — but a comprehensive psychiatric evaluation by a qualified PMHNP or psychiatrist can still identify ADHD and autism traits, support a clinical diagnosis, and get you started on treatment while you wait for formal testing. This is something I offer virtually to adults across all of Florida.

5. Appeal your insurance denial. If your plan denied coverage, request the denial in writing and file an appeal. Ask your provider to write a letter of medical necessity — this can sometimes reverse the decision, especially if you have documented history of anxiety, depression, or other conditions that may be linked to undiagnosed neurodivergence.

Do You Finally Want Answers?

I'm Luisa Garcia, APRN, FNP-C, PMHNP-BC — a dual-certified Family and Psychiatric Mental Health Nurse Practitioner providing virtual psychiatric care for children, teens, and adults across all of Florida through Sunset Behavioral Health.

If you've spent years wondering why anxiety treatment never quite worked, or why you feel so different from everyone else, I'd love to help you find real answers. Se habla Español.

I commonly help with: ADHD • Autism Spectrum Concerns • Anxiety • Depression • Bipolar Disorder • Sleep Issues • Chronic Pain

When appropriate, I can also help guide families toward formal autism testing.

Now accepting new patients — often seen within 48 hours.

Serving all of Florida — Miami • Orlando • Tampa • Jacksonville • Fort Lauderdale • Cape Coral • Fort Myers • Naples • Sarasota • West Palm Beach • Gainesville • Tallahassee • St. Petersburg • Pensacola • Key West • and everywhere in between.

👉 Learn more at sbhmind.com

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You're not alone in this. If you've spent years wondering why nothing quite fit — reach out. I'm happy to help guide you. Feel free to DM anytime.

Luisa Garcia, APRN, FNP-C, PMHNP-BC Sunset Behavioral Health — "A Place for Your Mind – Treating All Ages and Stages" Telepsychiatry Across All of Florida | Se habla Español