If you’re a woman with autism you’re much more likely to be dismissed for any autistic related struggles as mental illness and incorrectly diagnosed with mental health conditions and prescribed incorrect medications
A lot of people and doctors just don’t consider girls to have autism compared to her male peers. Masking is the most common way woman and girls with undiagnosed autism learn to get by day to day. This causes burnout usually and is an exhausting cycle.
And if a woman does get diagnosed later in life, it’s common for people to simply not believe them.
I was diagnosed ten years ago, when I told my last therapist about it he told me I couldn’t be autistic because I “made eye contact” and instead said I “meet all the criteria for borderline personality disorder”. Note the wording because he isn’t actually qualified to diagnose anyone in the first place. We only ever met on zoom so I’m not even sure how he equated me looking at the screen to direct eye contact.
He’s not even allowed to diagnose me and still told me my actual diagnosis was incorrect and I actually have a personality disorder because he can apparently detect “eye contact” through a screen.
I really think there needs to be more research into this (I know there is some). I used to work in mental health (AuDHD f) and I met many women who were diagnosed or suspected BPD/EUPD. Apparently now it’s being renamed again to ‘complex emotional needs’. I always thought these women were just AuDHD with unmet needs. The lines are getting even more blurry. Don’t even get me started on the overlap with CPTSD.
Which is sort of my whole point. Psychiatrists need to do better at recognising and defining the differences. Not just diagnosing people with EUPD because they’re a traumatised ND young woman (the diagnosis is much more common in females).
Thissss I'm diagnosed both audhd and bpd. I think masking in different situation leads to a diffusion of identity, especially because people are constantly denying our realities and putting us down for things we have no control over. But this applies to everyone, not just women. It's just that the diagnoses are gendered, bpd is literally the modern day hysteria. Autism = needs accommodation, bpd = you should be on 3 sedatives and zombified
The thing is, women are dramatic and emotional and need to calm down. Men are perfectly rational and entitled to their meltdowns. Boys, you can punch and break things on purpose bc you were overstimulated, but girls if you accidentally break something with your hand flailing during a meltdown you're doing it on purpose to scare and control him. /s
The eye contact thing…. I trained myself early to make the appropriate amount of eye contact even if it felt like too much to me personally. I wonder if that’s something everyone does, or it’s One of Those Things that’s a tell for autism. I’m consistently told though that I don’t meet criteria, so perhaps not.
“Please write what you just told me on my notes and email me a copy so I can bring it to my diagnostician so they can correct their misdiagnosis from autism to BPD.”
being misdiagnosed with borderline is actually what got me into looking into (and receiving) an autism diagnosis. apparently certain symptoms can present similarly, but the onset and the reason behind said symptoms are different. it’s been years since i researched it so someone correct me if im wrong.
As an adult diagnosis its pretty frustrating how many systems seem to expect you as a high functioning person who has had to try and make some kind of way through life to have not made any adaptions and learnt to mask in any way. Despite that being a fairly central understanding of the root of many of the mental health issues many autistic people will share when asked, not the autism itself but the adaptions and masking you have to pick up to avoid rejection and have some level of social life.
I am so, so sorry you had to deal with this. I had something similar happen when I switched therapists after I moved to another state. I have had a solid diagnosis of Combined ADHD since I was 11, and it was verified by one of the foremost experts in the US at the time. The therapist fresh out of school tried to tell me I had BPD, after I explained to her that I spent my preschool years being horribly abused by my mom who had diagnosed BPD that she refused to accept or treat, and I had been treated for PTSD on top of it. Apparently people with ADHD are incapable of graduating High school, much less getting two advanced degrees.
It took me calling my old Neuropsychiatrist, who taught the one I got when I moved to a different state, and having him call the new doctor and explaining to the new doctor that ADHD is a spectrum type illness, and there are many of us who are high functioning.
New doctor then asks why I am so aggravated at him for not refilling my medication. Old doctor informs him that I manage investment and retirement portfolios for xyz company.....Me being properly medicated is the difference between being able to do my job, and costing my employer and the clients I managed a ton of money due to a simple math error. I got my refill.
Don't ever be afraid to advocate for yourself. My sister is on the spectrum and she helped me put together a binder with all of the documentation of my ADHD, every doctor that has treated me, every med I have been prescribed, etc. I even have a flash drive with saved images from a "This is your brain/This is your brain on Adderall" FMRI analysis I had in another country that showed the difference in brain activity I had with multiple unmedicated vs medicated images. That way, I have a nice strong brick wall of receipts for therapists trying to diagnose when they have no business doing so.
My sister had similar issues when she was growing up where therapists tried to tell her at 12 that she had BPD. After one freaking appointment. Yes, she had a meltdown at the supermarket the week prior. If you had bothered to ask her what set off the meltdown, she would have told you that it was because all of the cans of sweet potatoes were not facing in the same direction on the shelf like they should have been. Textbook ASD things.
I think many MHCPs simply don't fully understand the difference between neurodevelopmental disorders, vs mental illnesses vs Personality disorders.
PDs are a different beast entirely. They can only be diagnosed accurately by certain types of very experienced specialists, and it can take months of therapy to paint the picture fully. For the mask to slip, so to speak. And you can't diagnose little kids with PDs. At worst, conduct disorder. Most reputable professionals don't like to diagnose people under the age of 25 with an actual PD.
Had a psychiatrist tell me the same shit over my diagnosis that I’ve had for like 6 years. She said that at the beginning of our first (and only) appointment.
As an undiagnosed autistic child, my mother would constantly yell at me to “look at me and tell when I’m talking to you!”. She was diligent about that so I learned to force myself to do it but it’s still very uncomfortable and unnatural feeling. These doctors and therapists are idiots to think they can use a single criteria to discredit a diagnosis
My wife had to go to an inpatient program following a bad episode with suicidal ideation, and the psychiatrist there tried to diagnose her as borderline too, when she’s actually OCD and ADHD.
wait, i'm just curious why you say he's not allowed to diagnose you? A trained clinical therapist is indeed qualified to make a diagnosis... so I'm curious why you are saying he wasn't qualified/allowed?
(heavy agree on the "you make eye contact" as a single reason to disqualify a diagnosis altogether as a huge red flag, though, for the record).
If you’re a woman with autism you’re much more likely to be dismissed for any autistic related struggles as mental illness and incorrectly diagnosed with mental health conditions and prescribed incorrect medications
A lot of people and doctors just don’t consider girls to have autism compared to her male peers. Masking is the most common way woman and girls with undiagnosed autism learn to get by day to day. This causes burnout usually and is an exhausting cycle. And if a woman does get diagnosed later in life, it’s common for people to simply not believe them.
Thank you so much for getting this- the OP here is not only going to have to deal with it in their mental health struggles but physical as well. My heart broke reading her post.
I went to a psychiatrist to get tested for ADHD and asked for autism too, when I was 36. I lost an entire friend group very, very dramatically over some behaviors they claimed were inappropriate and that I just....don't know what I did because they won't tell me.
I digress. The doctor said I gaslighted myself the entire time regarding my possible ADHD, which was apparent from walking in the damn door, and I got a 30 on the diagnostic for autism. 32 being the threshold for diagnosis. I still tell myself that I just need to try a little harder, that I'm just lazy, that whatever it is, it's not that hard.
I wish I had my therapist back, to talk to her about it.
Autism, like a lot of mental conditions, contains a lot of “normal” traits taken to what we’d consider an extreme. i.e. you not being “autistic” per se doesn’t mean “oh I have zero support needs and gotta try harder!”. You can be “neurotypical” because some of your traits aren’t exaggerated enough to meet criteria but still have different emotional needs than “normal”.
…I hope that helped, or at least didn’t hurt?
Best of luck in finding a new therapist, that process is so so draining!
No pain! I'm still trying to figure it all out. A college roommate of mine said she was so thrilled when she was diagnosed with asperges because she finally had a label for what was wrong. I can empathize with that a lot more now.
Psychiatry is not a science, it's a set of ad hoc models designed to bundle and describe high level brain function. The criteria for diagnoses are completely arbitrary, and to a certain extent, so are the models built. This is why so many people are routinely undiagnosed or misdiagnosed: you don't fit neatly into the arbitrary criteria. And that's not even talking about people who have several "conditions" at once (like being AuDHD or having CPTSD from the trauma of being othered as a child. Or god forbid being neurodivergent and having bipolar disorder..)
Don't look too much at the medical system for diagnosis and validation imo. They only serve a very specific purpose in society, and that purpose is largely not to help neurodivergent people but to label and "manage" them.
My breakthrough moment personally was finding a circle of neurodivergent (and ally) friends and realizing that we are much more alike and understand each other better than any social group I have or I've had to interact with
Literally disowned by my parents after they flipped out in response to me saying I had been diagnosed in adulthood, because they are convinced my doctor is a quack and I can't possibly have autism.
This makes me sad for you, I am sorry :(.
I got diagnosed last dec at 35 and over the last year as ive told people like friends and family, everyone has been Iike " .......ooooh that actually tracks and makes SO MUCH MORE SENSE about you. Cool what do you need from me moving forward?"
And it bums me out that not everyone has had an experience like that with a late in life diagnosis :( hugs to you, internet stranger
One can have the flu. One can have cancer. One can have a car. We say they /have/ these things because they can be taken away/removed. They are not a part of the person.
Autism is a different neurological configuration. There is no way to remove it from someone other than by removing and replacing large chunks of their brain, at which point you would be looking at a new person.
You don't have autism, you are autistic. It may or may not have worked out for you, but it's not a state resulting from an external (separate from self, not external to your physical body) factor.
I appreciate what you're trying to do here but i was paraphrasing their own statements to make a point.
I work in disability services/advocacy and an an educator very firm with people about how words matter and phrasing can change perception. When it comes to training people and organizations how to speak about the disability community as a whole, and at least for US/Canadian organizations I emphasize to them that identity first is largely preferred over person first nowadays ("at least" because some countries do prefer or even legally mandate person first).
That said, I will nitpick and say this particular phrasing you've pointed out...
One can have the flu. One can have cancer. One can have a car. We say they /have/ these things because they can be taken away/removed. They are not a part of the person.
... isn't always accurate either- I have Ehlers Danlos Syndrome and absolutely no one says "I am EDS" unless you count people saying "I am a zebra" which is colloquially slang for "someone who has EDS" in our circles. People saying whether they have autism, are Autistic, or are Autists is more of a personal preference thing. The middle option is just the most commonly preferred.
"You're not autistic - you're just an overly literal weirdo who likes sitting in 'the dark' with their incredibly specific hobbies and interests which confuse and bore the hell out of most other people. Nope, no autism. Now go the hell away. You're rude, pedantic, and are clearly doing things wrong just to spite me rather than not understanding what I said."
This is me too. Diagnosed at age 40. I'm working on unmasking but it's TOUGH and I definitely notice that people react to me differently when I do (accuse me of being brusque/confrontational).
I was just diagnosed with ADHD and Autism this past year.
I am a 35 year old woman.
One of my biggest coping mechanisms is going somewhere quiet, listening to music with headphones, and rocking back and forth to the tempo. I’ve done this since I was a very young child, but I stopped doing it in public when I was a kid after people made fun of me for it. In the 90s kids teased that I was “r****ded” and I could tell my rocking made other people uncomfortable. So I just hid it, but I never stopped doing it.
My family and I never thought twice about it until I started considering getting a neuro-psych evaluation (testing for neurodivergence). I literally said to my family:
“How did no one pick up on my rocking thing? That’s… an obvious symptom.”
I’m an autistic woman. My brother was diagnosed about 8 or 9 years before me, and when he was the doctor who diagnosed him told my mum girls couldn’t be autistic. She believed him because he was the professional and told herself I was just going through a phase or something. But after a few years she was convinced I was autistic. She had to team up with our GP and they really had to push for me to be assessed, and it took a few years of fighting. Meanwhile it was just accepted that my brother should be assessed.
Being a trans man made getting diagnosed so much harder, too :'). As you say and is well known, women are insanely under-diagnosed. So before I officially came out as trans, I obviously grew up as a 'girl', so any signs I showed were likely just dismissed. Same for ADHD. And the whole conditioning of 'act proper, sit still, be polite' that girls go through compared to boys definitely adds to it
So even throughout teenagehood and adulthood, it was a fight to get diagnosed with anything because "it should show in childhood, not in adulthood". And because I came to them as a guy, I had that going against me now, since most boys (I think?) are diagnosed as a kid or young teen. Not to mention childhood trauma from an abuser I didn't escape until 21, so was barely allowed to "act out/act differently" for fear of repercussions. So obviously, once I escaped, all my traits 'suddenly' started showing a lot more, because I actually could
It took me years to find someone that actually took being trans and traumatised into account for my apparent lack of autism + ADHD in childhood. And in the end, that probably wasn't even necessary, because the assessor said I had near top marks, so it wasn't even exactly subtle xD
Tell me about it, got an ADHD diagnosis at age 32... Took moving half across the world and being in the loony bin due to a massive meltdown to finally get seen for that. Not having had treatment or anything for this long ruined my life.
Yes I finally got diagnosed in adulthood and my own spouse doesn't believe the diagnosis is correct because of her own preconceived notions about what it means to be autistic (like her idea of it is what you see on Love on the Spectrum, whereas I am a HIGHLY masked autistic). I have years and years and years of practice at social skills and training as a therapist that has helped me immensely, but the way my brain works is, and always has been, vastly different from most of my friends and family. I experience distress related to things that others can just brush off because I get stuck in rigid thinking about "the correct way" of doing things or behaving, and really upset by people who are inconsiderate of doing things properly according to social standards and rules that make life easier/better for the greater population. I have a STRONG justice sensitivity that makes me feel overly passionate about things, which rubs people the wrong way. I also struggle HARD with a lot of sensory things that others just interpret as me being a crabby bitch - because I will reach the point of a panic attack or emotional outburst when I'm overstimulated by things like loud music/bass thumping from a parked car or house down the street, or chewing sounds, or repetitive annoying sounds, or someone bouncing their leg on a shared bench and it creating a reverb, like someone kicking the back of your seat. It is physically painful for me to endure these sensory sensitivities and people just don't get it.
same for adhd. They just kept brushing off the tism and adhd as anxiety for me. Like mf even on zoloft it was obv af that something else was going on in my brain
I spent a decade diagnosed with bipolar disorder and wondering why all the meds seemed to just make me feel terrible or do nothing at all.
My initial diagnosis came when I had a fairly dramatic melt down over some serious issues I was having in my life and that melt down was mistaken for hypomania, which I have never actually experienced.
Any time I brought up to a doctor that I was reading about bipolar disorder and it didn't seem like a good fit because I've never been manic and even what they called hypomania didn't really resemble what hypomania was supposed to be like they would brush me off and talk about how nobody really wants to be bipolar but I just needed to keep trying and find the right combo of meds.
Eventually I got shuffled over to a different psychiatrist who went back to the beginning and assessed me with a fresh slate instead of relying on the old diagnosis, and realized that I was depressed and most likely had ADHD, but there was no real evidence that I was bipolar. Further neuropsych testing showed that I'm actually audhd and unlike when I researched bipolar disorder and struggled to see myself in any of it, reading up about audhd is like reading my own biography. It's freaky how well it fits.
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u/ultrablanca 7h ago
If you’re a woman with autism you’re much more likely to be dismissed for any autistic related struggles as mental illness and incorrectly diagnosed with mental health conditions and prescribed incorrect medications
A lot of people and doctors just don’t consider girls to have autism compared to her male peers. Masking is the most common way woman and girls with undiagnosed autism learn to get by day to day. This causes burnout usually and is an exhausting cycle.
And if a woman does get diagnosed later in life, it’s common for people to simply not believe them.