I’m an adult female, how do I know if I have Autism?
Autism is frequently misunderstood, and that's especially true in women. Many women with undiagnosed autism go their entire lives believing something is wrong with them because they do not communicate or behave like others around them.
The truth is autism is less likely to be diagnosed or identified in women because women do not always match the stereotype of what many people imagine when they think of autism. Additionally, many women with Autism can often conceal their Autism traits, and have been socialized better or to a degree that allows them to “fit in” and not raise suspicions of being Autistic.
People that come to the Thriving Wellness Center often ask us, “How do I know if I am autistic, some of the characteristics I have read about do not match me?” And, that can be completely true, that is why it is important to understand how autism in women looks and how this is different than autism in men.
Here is a list of 8 common traits shared by women who have Autism or Asperger’s Syndrome:
1. You have learned to camouflage you behaviors and mask your innate tendencies.
People on the autism spectrum are sometimes described as having an expressionless face, neutral tone of voice, or flat affect because they don't have the same automatic social behavior others do. Women with Autism, compared to men, are better at compensatory strategies for hiding or concealing their autism traits, such as nodding and smiling when they don’t understand the nuances of a social interaction.
It is important to think about how you may change yourself, your behaviors, your facial expressions, your body language, or dampened what you have wanted to say to fit the people around you. This is called “masking” and women with autism have have been socialized to be better “maskers” compared to men.
Women are generally held to a higher standard to be socially aware, and because of the are given more implicit and explicit social training from a young age. Additionally, girls with ASD, compared to boys, may be given more explicit training in manners. This may help them, at least at a superficial level, fit in better. Women and girls in are socialized not to disappoint or offend, and so girls on the autism spectrum may intentionally keep behaviors, responses, and feelings to themselves in order to remain pleasing others.
This means if you are a woman with autism you may have learned throughout your life how to change your facial expressions or body language to fit what others around you are doing. You may have even learned how to change the pace of your speech or the tone of your voice to match your peers and family to you to help you fit in and avoid feeling different. This may have even happened without you consciously being aware.
2. You have been diagnosed with anxiety, depression, OCD, bipolar disorder or borderline personality disorder.
The traits, symptoms and signs of autism can often be misdiagnosed as a host of other mental conditions and disorder. This is because many of the traits and signs of autism are very similar to other conditions, and autism usually co-occurs with other mental disorders like anxiety and depression. In addition, many girls and women have become good at masking their autism behaviors and may not realize they are doing such.
A lot of women and girls with Autism, feel alone, socially defective, and inadequate. These feelings can cause depression and anxiety. The symptoms of anxiety and depression can overshadow autism traits and can lead to Autism being missing during a diagnostic assessment. In general, depression and mood disorders are diagnosed at a higher rate in females. This may contribute to why so many autistic women were diagnosed with depression but their autism was missed.
These reasons coupled with the fact that many clinicians are not experienced or skilled in understanding how autism presents in women can prevent many people from being diagnosed with Autism.
3. Social interactions are difficult and tiring for you.
There are many reasons why social interactions and social communication is difficult for women with autism including being unable to read non-verbal communication cues, not understanding communication that is sarcastic, passive aggressive or humorous, having sensory sensitivities, and masking behavior, speech or facial expressions that come naturally. All these things together can case someone with autism to get exhausted from social interactions.
Many people, particularly introverts, find social situations tiring, but women on the autism spectrum may particularly feel this way, since they work so hard to fit in. Girls on the autism spectrum often report feeling fatigued by social interactions because they spend a great deal of energy mimicking others to get by and camouflaging their real desires, such as wanting to read books by themselves, or playing video games. Women and girls with autism may internalize their social difficulties, using masking to help with these social difficulties, become exhausted from masking, and then develop anxiety and depression. Of diagnosed adults with autism, 70% also have depression and 50% also have anxiety.
Because social interactions are difficult and exhausting, many women prefer to engage in task-oriented behaviors that are easier to conceptualize, understand and complete. This is especially true if the tasks or responsibilities have been done before and are completely under her control. In social situations there are many variables and things that can not be planned for, prepared or studied. And like pointed out above, social interactions can be difficult and tiring.
4. You act shy or submissive in social settings
Social problems, like difficulty reading social cues can lead to heightened anxiety are very common for men and women with autism. This may lead both men and women to avoid social situations or maintain minimal eye contact while in social settings. This social avoidance and minimal eye contact can be interpreted by others as shyness. But, for women shyness is considered to be culturally acceptable female behavior. For men that exhibit this behavior, it may raise more alarm bells but for women, this behavior can be misinterpreted for shyness and introversion and not signs of Autism.
5. You have intense and prolonged emotional reactions.
Although it is not part of the diagnostic criteria, many people with Autism have problems with emotional regulation. Emotional regulation refers to the way we handle emotions like anger, excitement, frustration, anxiety or low mood. This includes the ability to behave appropriately when distressed, identify, understand, and accept emotional experiences, and use healthy strategies to manage uncomfortable emotions. Having poor emotional regulation refers to poor emotional control and not being able to handle intense emotions in a healthy way.
Having poor emotional regulation, complied with communication difficulties, can cause women with Autism to react in one of several ways to intense emotions, including having “melt downs” or temper tantrums, aggression, shutting down and dissociating, physically isolating one’s self, harming one’s self, or developing an eating disorder or addiction to cope.
6. You are very sensitive and highly empathetic.
There’s a widespread belief that people on the spectrum have no ability to make emotional connections or form meaningful relationships, and this really couldn’t be further from the truth.
Women with Autism may experience and express empathy differently, but it does not mean they care any less. In fact, women with Autism can be highly empathic and highly intuitive. People with Autism tend to have affective empathy or emotional empathy. This is an unconscious, automatic response allowing you to feel what other people (and other living beings) are feeling, and is absolutely not something autistic people lack. In the case of affective empathy, rather than having too little, autistic people can often have way too much – a condition known as ‘hyper-empathy.’
But, people with Autism may have trouble with cognitive empathy and affective empathy, which is working out exactly what is going on for someone else and how to to help them if it is not explicitly stated.
Women with Autism many find situations confusing and may not quickly work out why someone is so upset over a situation. But, it is also true that women with Autism may be feeling emotional overwhelmed when hearing of someone else’s distress and may not immediately be able to express what they are feeling and her facial expressions and body language may not seem appropriate for the situation. Struggling to identify with a person’s understanding of a situation, whilst experiencing an emotional response to that situation, means that your reaction can appear strange or unfeeling.
Women with Autism may be highly susceptible to outsiders’ viewpoints and opinions and may adapt her view of life or actions based on others’ opinions or words. This can cause taking criticism to heart and focusing on the negative things said or the situations when she has failed versus focusing on compliments and positive attributes.
7. You were bullied while growing up because of your differences.
Because people with Autism have difficulties understanding social cues and differences in the way they speak it may make it easier for others to target them for being different. Problems understanding manipulation, disloyalty, lying, or vindictive behavior can also prevent someone who is Autistic from avoiding or disengaging with someone who has potential to hurt them or does not have their best interest in mind.
Additionally since people with Autism may not accurately communicate certain thoughts and feelings, overshare, monopolize conversation, sound eager and over zealous when excited or interested in something or apathetic or disinterested when not interested in something, they may accidentally offend others or make others uncomfortable. This can all set someone with Autism up for exclusion and bullying. For those with Autism, it may be harder to verbally defend themselves, advocate for themselves or understand when they are being made fun of and this can make the bullying or exclusion worse.
8. You get sensory overload.
People with Autism are often times sensitive to sounds, textures, temperatures, smells and sights. Certain sounds, smells, textures and tastes can also be overwhelming. This can make it incredibly physically and emotionally draining to be in a social setting, especially if the setting has many people and many sounds. This can result in social avoidance or trying to get away from stimuli that most people can easily tune out. So for many people with Autism being in a school setting, work setting or a setting with many people can be very exhausting.
Sensory avoidance can also look like pulling away from physical touch or covering the ears to avoid loud or unpredictable sounds. This can make it difficult to be touched or be around loud sounds. People with Autism can avoid certain kinds of clothing or food because of the feeling or the texture.
In summary, this is a list of common traits shared by women who have Autism or Asperger’s Syndrome:
1. You have learned to camouflage you behaviors and mask your innate tendencies.
2. You have been diagnosed with anxiety, depression, OCD, bipolar disorder or borderline personality disorder.
3. Social interactions are difficult and tiring for you.
4. You act shy or submissive in social settings
5. You have intense and prolonged emotional reactions.
6. You are very sensitive and highly empathetic.
7. You were bullied while growing up because of your differences.
8. You get sensory overload.
It is important to keep in mind that not all women with Autism exhibit the same signs of autism or experience these signs to the same degree and that is why autism is considered to be on a spectrum. Note that the information below is just a list of some of the common signs and characteristics of Autism in women. It is unlikely that you will display all of these characteristics, and it’s important to remember, only a qualified professional perform an evaluation for autism and diagnose autism.
There is Hope For You
Knowing you're not alone can be incredibly empowering. An autism diagnosis can connect you to a supportive community of others who share similar experiences and can offer understanding and empathy.
Here at the Thriving Wellness Center, we specialize in working with Women with Autism. We have locations in New York and New Jersey and perform thorough and accurate Adult Autism evaluations and therapy in-person and online. If you are newly diagnosed with Autism or interested in getting a diagnosis in New York, New Jersey, or virtually please contact us to see how we can help you improve your life.
