Neurodivergent adults consistently report higher rates of anxiety and depression than their neurotypical peers, which makes this an area managers genuinely can’t afford to get wrong. This article explores what struggling looks like for a neurodivergent team member, and what supporting neurodivergent employees realistically involves for a manager.
World Mental Health Day exists to widen the conversation about mental health at work. This year’s theme is ‘Lived Experiences Heard,’ and it matters particularly for neurodivergent employees, whose experience of struggling often looks nothing like the standard advice managers are given.
Most workplace guidance on supporting a struggling employee describes fairly universal signs: withdrawal, missed deadlines, visible low mood. For a neurodivergent team member, the picture is often different, and a manager relying solely on a generic checklist could miss that their employee needs help.
I’m an experienced Integrative Psychotherapist, a neurodiversity coach in London and online, and I am AuDHD with both ADHD and ASD diagnoses. A significant part of my work with organisations is helping managers understand what genuine struggle looks like in a neurodivergent employee, which is very often not what they’ve been trained to look for.
Why Does This Matter More for Neurodivergent Employees Specifically?
A study using the Vulnerability Experiences Quotient compared 426 autistic adults with 268 non-autistic adults and found autistic adults reported significantly higher rates of anxiety and depression symptoms, alongside lower life satisfaction. Much of that gap was explained by higher rates of negative life experiences, including employment difficulties, that autistic adults face more often than their non-autistic peers.
A separate, larger study of over 14,000 people in mental health treatment found broadly similar patterns across neurodivergent identities generally, not autism alone, with neurodivergent individuals consistently reporting worse depression, anxiety and quality of life scores. That sample was drawn from people already receiving mental health treatment rather than the general population, but it points in the same direction: this isn’t a pattern specific to one diagnosis.
That finding matters directly for managers. If neurodivergent employees are more likely to be carrying anxiety or depression, and more likely to have had difficult experiences in previous workplaces, a manager’s response in the moment someone starts struggling carries more weight than it might for a neurotypical colleague with a more straightforward path back to feeling steady.
What Does Struggling Actually Look Like for a Neurodivergent Employee?
- Increased masking rather than visible distress, so someone can look more composed, not less, right before they hit a wall
- Sudden difficulty with tasks that were previously manageable, often mistaken for a drop in competence rather than a sign of overload
- Sensory sensitivity spiking, so noise, lighting or a busy office that was previously tolerable becomes genuinely hard to be around
- Withdrawal that looks like disengagement, when it’s actually the only regulation strategy available in that moment
- A growing sense of being othered, particularly around the unwritten social rules and office politics that so much career progression quietly depends on
None of these signs may raise the alarm on its own. That’s exactly what makes them easy to miss if a manager is only watching for the more obvious signals described in most general guidance.
What Does This Look Like in Practice?
Imagine two managers noticing the same thing: a usually reliable team member has started missing small details and seems distant in meetings. The first manager, working from generic guidance, reads this as motivation slipping and schedules a conversation about performance expectations. The employee, already masking hard to hold everything together, hears this as confirmation they’re failing, and the gap between them widens.
The second manager starts differently. They ask what’s changed recently, rather than what’s wrong, and mention they’ve noticed things seem harder than usual, without assuming why. That single shift, curiosity before conclusion, often surfaces the real answer: a sensory environment that’s become unbearable, an unspoken accommodation that quietly lapsed, or a wave of masking exhaustion that’s been building for weeks. The difference between these two conversations is rarely about effort. It’s about which questions get asked first.
What Should a Manager Actually Do?
Always start with curiosity, not a script. Instead of assuming you know what support looks like, ask directly what would help, since the answer for a neurodivergent employee is often specific and practical rather than a general wellbeing gesture.
Separate the behaviour from the person. A sudden drop in output or a withdrawn team member is information, not a verdict on their commitment or capability. Approaching it as a signal to investigate, rather than a performance issue to address, changes the entire conversation.
Protect existing accommodations first. If someone already has adjustments in place, a period of struggle is exactly when those accommodations matter most, not a moment to quietly let them slip because things feel busy.
Don’t mistake political fluency for competence. Much of what determines who gets noticed for the next opportunity runs on unwritten social rules, and many neurodivergent employees have never had equal access to learning them. Treating that fluency as a neutral measure of someone’s readiness quietly disadvantages exactly the people this article is about, often for years, without anyone ever naming why.
Know the limits of your role. You’re not there to diagnose or provide therapy. You’re there to notice, ask, adjust what’s within your control, and point toward appropriate support, whether that’s occupational health, an employee assistance programme or external specialist input.
Frequently Asked Questions
Is it appropriate to ask if a struggling employee is neurodivergent?
Disclosure is deeply personal, and an employee can have a number of reasons for not disclosing, so no- not directly and not as a first response. Focus on the behaviour you’re observing and what support would help, rather than asking someone to disclose or label something they may not have discussed with you before.
What if someone hasn’t disclosed a neurodivergent diagnosis at work?
You can still support the employee without a disclosure. The same things that help here – curiosity, flexibility, protecting what’s already working – are good management practice for any struggling employee, whether or not neurodivergence is part of the picture.
Does this replace occupational health or HR involvement?
No. A manager’s role is to notice and respond in the moment, not to manage a mental health condition alone. Occupational health, HR and external specialist support all have a role a line manager shouldn’t try to replace.
What’s the single biggest mistake managers make here?
Assuming a lack of visible distress means everything is fine. For many neurodivergent employees, masking well is often the last thing to go before a much harder crisis, not a sign that support isn’t needed yet.
What if I’m worried someone might be at real risk, not just struggling?
Take it seriously and don’t wait for certainty. Ask directly and listen without judgement, and make sure they know about immediate support such as Samaritans, available free any time on 116 123. This goes beyond what any manager is expected to handle alone, and involving HR, occupational health or emergency services where appropriate is the right call, not an overreaction.
Final Thoughts
World Mental Health Day is a reminder that mental health at work isn’t one-size-fits-all, and that’s particularly true for neurodivergent employees, whose signs of struggle often don’t match the standard checklist.
A manager who understands that difference and responds with curiosity rather than assumption can make a genuine difference long before a difficult moment becomes a crisis.
If your organisation would benefit from training on supporting neurodivergent employees, you’re welcome to get in touch here.
Or if this is something you’re experiencing yourself and you are interested in neurodiversity-affirming therapy, you are welcome to book an initial session here.
Sources: The Vulnerability Experiences Quotient (VEQ): A Study of Vulnerability, Mental Health and Life Satisfaction in Autistic Adults, Autism Research. Kroll, E., Lederman, M., Kohlmeier, J., Ballard, J., Zant, I., & Fenkel, C. (2025). Examining the mental health symptoms of neurodivergent individuals across demographic and identity factors: a quantitative analysis. Frontiers in Psychology, 16, 1499390.
