My surprising mid-life diagnosis makes me proud

I’ve always felt like a “normal” person. A bit quirky, sure, but otherwise your garden-variety computer dork who, thanks to a fortunate upbringing, was on an exciting career trajectory.

Working first for a judge, then Google – my minor claim to fame was inventing the “did you forget to attach” popup inside Gmail. Later I co-founded a women’s shoe startup, Shoes of Prey, which raised $35 million in venture funding before it failed.

Searching for a cure to a midlife health crisis, Mike Knapp found an explanation for previous struggles.

It wasn’t until my 40s – particularly after quitting my job two weeks before my wife discovered she was pregnant – that life suddenly felt very difficult. I was crippled by overwhelming anxiety, brain fog, tinnitus, excruciating ear pain, insomnia and fatigue. I had already been prescribed a CPAP machine for “severe” sleep apnoea, but the specialist was perplexed because I didn’t look like someone who needed it. My teeth grinding crescendoed too, sawing in half a hard plastic splint one night. I told my puzzled doctors I felt like “a 90-year-old trapped in a 40-year-old body”.

For a while, I wondered if I had long COVID. The timing matched, as did many of the physical symptoms. The dramatic part of my brain regularly inquired if I might be dying. Medical tests assured otherwise.

After waiting more than 12 months for a formal psychological diagnosis – a lengthy $3,000 report looking back to childhood – I now have an answer. I’m neurodivergent. Specifically, I have autism and ADHD, a combination often abbreviated as “AuDHD”.

This is quite the shock at 43 years of age. It’s like discovering you’ve been wearing a silly hat since the day you were born, though no one ever thought to mention it. All my personality quirks and unique struggles immediately made a lot more sense; every prior awkward encounter could be analysed in a new light.

Swedish environmental activist Greta Thunberg says her neurodivergence is the source of her ‘superpower’.Credit: Getty

About one in 40 Australians are thought to be autistic, whereas ADHD is twice as common (one in 20). Neither condition was identified during my childhood. According to my psychologist, I probably escaped an earlier diagnosis because my intelligence allowed me to “mask”; for example, by consciously monitoring my facial expressions, or scripting conversations ahead of time. Autism in women remains underdiagnosed, and their experiences under-researched, perhaps for a similar reason: it’s said they’re socially conditioned to be better at masking. Our truth can remain undiscovered until a big trauma comes along.

Some of my recent physical symptoms are what’s known as “neurodivergent burnout”, probably triggered by years of gruelling back-to-back video calls during COVID. During this time, my brain was in constant overdrive, trying to read non-verbal cues through a flat computer screen, while also trying to maintain a high level of performative energy. I worked extreme hours due to my “always on” brain and the lack of physical boundaries between home and office. Don’t get me wrong, COVID was very hard for most people for similar reasons, but I believe some of us particularly struggled because of our unique neurology, making us vulnerable to extreme burnout.

Common throwaway responses to my diagnosis range from: “you don’t seem autistic” to “we’re all a little on the spectrum, aren’t we!” Though well-meaning, they’re hurtful because they trivialise the internal nature of the experience. You can’t “see” a brain thinking, or hear my deafening tinnitus. Claiming everyone’s on the spectrum is like saying “we’re all a little bit extremely tall, aren’t we!”

More cynical folk were suspicious I was now applying a “label” in middle age. Is it suddenly trendy? What difference will it actually make? For me, a label provides a framework to better understand myself. It might also provide helpful context too for those that know me. More crucially, it has given me access to the optimal treatment. Counselling techniques for anxiety, for example, are different if you’re neurodivergent. Without a formal diagnosis, a psychologist may, or may not, be prepared to treat you as such. Regular anxiety medication may also not work for you.

The good news is that, with better knowledge and more holistic treatment, the exhaustion and anxiety have started to improve. I’m back to feeling much better after a long and confusing process.

While there are some negatives to being neurodivergent, I couldn’t be more proud of the positives. Greta Thunberg says it’s the source of her “superpower” and I feel that way too. For example, I can be intensively creative and passionate about whatever captures my imagination. I’m also able to quickly dive in on highly technical topics, sometimes seeing patterns and trends before others. These are common AuDHD traits, and I wouldn’t trade them for anything.

I hope my story inspires you to have a fresh perspective on any “quirky” people in your life. We don’t need your unsolicited diagnosis or relaxation tips – thanks in advance – but we do need your gentle support, particularly when we’re burnt out. And, if someone is brave enough to tell you about their own diagnosis, a great response is, “tell me more!”

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