ADHD & autism
A lot of people arrive at this in their thirties or forties, after a working life of being told they have potential, are too sensitive, or just need to try harder. If that is you, this page is about what to do next: how diagnosis actually works in Germany, what it costs, what it unlocks, and what to do while you wait.
Nothing here requires a diagnosis, a referral, or certainty. Suspecting is enough to read on.
If you read nothing else on this page.
Who can diagnose
In Germany: specialists in psychiatry and psychotherapy, neurologists, or a specialised ADHD or autism outpatient clinic (Ambulanz). Your GP cannot diagnose it, but can refer you.
How long
Realistically three to nine months for an appointment in a large city, and often longer for autism. Start the process before you feel ready — the queue is the slow part, not the decision.
Free advice while you wait
teilhabeberatung.de
EUTB — free, independent, nationwide advice on disability rights and benefits. No diagnosis required to walk in.
If it is bad right now
Autistic and ADHD people are at meaningfully higher risk of suicide, and that is a consequence of how the world fits, not of who you are. Crisis lines: kantholz93.com/suicide. Immediate danger: 112.
The system was built around children, and adult assessment has been bolted on afterwards. It is navigable, but nobody hands you the map.
A proper ADHD assessment is a long clinical interview plus validated questionnaires — typically the ASRS for current symptoms and the Wender-Utah scale for childhood — sometimes neuropsychological testing, and careful ruling-out of other explanations. School reports and a parent's recollection help, because the diagnosis requires signs from childhood, but their absence is not disqualifying. Assessment for autism in adults works similarly and usually takes more than one appointment.
The German S3 clinical guideline on ADHD was substantially revised in 2026, and one of the main changes is tightening who is qualified to diagnose. That is good news for quality and bad news for waiting times. If a practitioner offers you a diagnosis after twenty minutes and a leaflet, get a second opinion.
With statutory insurance (gesetzlich versichert), assessment by a practice with a Kassensitz is covered. Private assessments run roughly several hundred to well over a thousand euros and are not automatically recognised afterwards — before paying, ask specifically whether the report will be accepted by your Krankenkasse and by prescribers, because a diagnosis nobody downstream accepts is an expensive piece of paper.
A caution about autism assessment specifically
Autismus Deutschland, the national organisation, currently states that it cannot recommend specific diagnostic addresses because waiting lists are closed and catchment areas are restricted. That is an unusually honest admission from an umbrella body, and it tells you the scale of the bottleneck. Their regional member associations and the therapy-centre map on their site are still the best starting point.
Worth answering honestly before you spend a year in a queue, because the answer is genuinely “it depends what you want from it”.
A diagnosis is the only route to
You do not need one to
One honest caveat in both directions: a diagnosis is a medical record. It is protected health data and you are under no general obligation to disclose it to an employer — but it can matter for private health and life insurance applications, and for a small number of professions. That is not a reason to avoid assessment. It is a reason to know it before you are asked.
This is the part most people never find out about, and it is where the practical difference lives.
teilhabeberatung.de finds your nearest office. The Ergänzende unabhängige Teilhabeberatung is free, nationwide, and deliberately independent of the authorities that decide your applications — which is the point of it. They advise on GdB applications, Nachteilsausgleich, Eingliederungshilfe, work and everyday support, and many offices are staffed by people with disabilities themselves. Genuinely one of the best-kept secrets in the German system.
A GdB is a number from 10 to 100 describing how much your participation is impaired — not how “bad” you are. For autism the full range is possible depending on impact. For ADHD it is usually assessed where there are substantial additional impairments. From GdB 50 you are schwerbehindert and can request a Schwerbehindertenausweis, which brings extra dismissal protection, additional leave, earlier pension options and tax allowances.
Applications are frequently underestimated on first assessment. A Widerspruch within one month is normal, expected, and often succeeds. Do not treat the first decision as final — this is exactly what EUTB and the VdK or SoVD advise on.
A legal adjustment to conditions so that an exam measures your knowledge rather than your executive function. Common forms: 25–50% extra time, a separate quiet room, breaks, splitting an exam, permission to use noise protection, or an alternative format.
You do not need a Schwerbehindertenausweis — universities generally work from the definition of disability in § 2 SGB IX, meaning a long-term impairment. Apply through the disability officer (Beauftragte:r für Studierende mit Behinderung) or the examination office, and apply well before the exam period. It is almost never granted retroactively.
Severely disabled employees have a legal right to workplace adjustment — technical aids, flexible hours, structural changes, or personal support. In practice this covers things like a quieter workspace, noise-cancelling equipment, written rather than verbal instructions, or protected focus time.
Arbeitsassistenz & Budget für Arbeit
There is a legal right to reimbursement for necessary work assistance, funded through the Integrationsamt. The Budget für Arbeit (§ 61 SGB IX) can fund a job coach or specialist support in ordinary employment. The Integrationsamt advises employers too, which is useful — a manager who learns the support is externally funded usually becomes considerably more flexible.
A legal right to receive support as a cash budget you direct yourself, rather than as services someone else chooses — for household management, mobility, work or leisure assistance. You apply at a single provider, which then has to coordinate the others. Administratively heavy to set up, and for many autistic adults the difference between coping and not.
Being signed off (krankgeschrieben) for burnout, depression or exhaustion while you wait for assessment is legitimate and common — the exhaustion is real whatever its name turns out to be. Longer term, medizinische Rehabilitation and Leistungen zur Teilhabe am Arbeitsleben through the Rentenversicherung exist precisely for keeping people in work. EUTB will explain which applies to you without trying to sell you anything.
Stimulants are the first-line treatment for adult ADHD and among the better-evidenced treatments in psychiatry. In Germany they are controlled substances (Betäubungsmittel), which means a special prescription, no repeats by phone, and a prescriber who is willing to take it on. Finding that prescriber is often harder than getting diagnosed — a well-documented gap where people are assessed and then left with a diagnosis and nobody to treat it. Ask about ongoing prescribing before you commit to an assessment provider.
Supply shortages have been a recurring problem in Germany. A pharmacy that knows you and orders ahead is worth more than convenience, and it is worth asking your prescriber early what the alternatives are if your medication becomes unavailable.
Therapy does not treat ADHD or autism itself, and any practitioner promising to cure either is one to leave. What it does treat is what tends to accumulate on top: depression, anxiety, and the accurate but corrosive belief that you have been failing at things everyone else finds easy. For autistic people specifically, look for someone who has actually worked with autistic adults — the usual route in via 116 117 applies, and the section on getting a therapy place at kantholz93.com/suicide covers the mechanics.
National Autistic Society
0808 800 4104Mon–Fri 10:00–15:00. Impartial information and advice for autistic people, families and carers. autism.org.uk
Right to Choose
The single most useful thing to know in England: you can generally ask your GP to refer you to any qualified NHS-funded provider for an ADHD or autism assessment, not just the local service. Waits on that pathway have typically been considerably shorter. GPs vary in how readily they offer it — asking for it by name helps.
ADHD support
ADDISS: 020 8952 2800. ADHD Foundation: 0151 541 9020. ADHD UK is run by people with ADHD and keeps current guidance on assessment routes.
Almost every country has a national autism association and an ADHD association, and they are usually the fastest route to who assesses adults locally. Search for the national body rather than a private clinic — the clinics buy the advertising, the associations keep the honest list.
Broadly the same system, reached through different doors — and considerably faster than the adult route, which is the one genuine advantage of being a parent here.
A note on the language
Most autistic adults prefer identity-first language — “autistic person” rather than “person with autism” — because it is not a thing carried separately from the self. Preferences vary and nobody will be offended by being asked. The German system still speaks in the vocabulary of disorders and deficits, and you will meet that vocabulary on every official form; it is a description of how the paperwork is organised, not of you.