Blogger at Musings of an Aspie and bestselling author of ‘I Think I Might Be Autistic,’ Cynthia Kim was 42 when she discovered she is on the spectrum. Wentworth Miller, an actor, famous for his role in shows like ‘Prison Break,’ received his autism diagnosis at 48. The bestselling author and creator of Netflix’s ‘Can’t Cope/Won’t Cope,’ Stefanie Preissner, was recently diagnosed with autism at 34. These are just a few of the countless examples of an adult diagnosis of autism spectrum disorder (ASD).
It is fairly common for adults with autism to go through their lives without a clear diagnosis. Often these adults show milder symptoms – earlier categorized as Asperger’s syndrome (this term is now considered inappropriate and it falls under the wider umbrella of ASD). The condition may manifest itself in the form of difficulty to read social cues, read body language and facial expressions or understand sarcasm; it could also cause a person to struggle to make friends easily, and expressing their feelings is difficult for them. However, being a syndrome with varying levels of severity of symptoms, it could manifest in different forms and ways in different individuals.
A correct diagnosis, however late it may come, helps an autistic person make better sense of the world around them and their response to it. Having a label for what was earlier dismissed as introverted or eccentric behaviour can not only empower them but can also have a positive impact on their mental health.
Effect of adult diagnosis on mental health
Early diagnosis and timely intervention play a major role in improving the quality of life of people with autism. Not only that, but the timing of the diagnosis is also a crucial determining factor in the individual’s access to a referral for diagnostic assessment and subsequent therapeutic support systems. While the healthcare and education services for autistic children are relatively better established, in the case of adults with ASD they are at a nascent stage.
The absence of a diagnosis, combined with the unshakeable feeling of not “fitting in” while also trying to mask the autistic symptoms to appear “normal” can take a toll on the mental health of autistic individuals. This leads to an increased risk of them developing comorbid mental health conditions like anxiety and depression. In some instances, it also leads to self-harm behaviours and addiction.
In fact, a study published in the Journal of Autism and Developmental Disorders that surveyed 420 neurotypical and autistic individuals found similar results. The researchers also interviewed eight autistic adults who were diagnosed much later in life about its impact on their mental health.
Gray Atherton, the co-author of the study said that the age of diagnosis often correlates with increased social anxiety, social avoidance, and a decided lack of social support. In addition to the age of diagnosis, they found that gender also plays a critical role in determining the experiences of the participants.
Can females mask ASD?
Studies also suggest that typically, males receive a diagnosis several years earlier than females, putting them at a greater risk of developing mental health disorders. Other studies have found that for every four boys diagnosed with ASD, only one girl receives a diagnosis. While there are several reasons for this inequity in diagnosis, one prominent reason is that females are adept at masking their symptoms better.
The above study also suggests that women with undiagnosed ASD are more likely to find themselves in unhealthy relationships, passive behaviour, and high-risk situations. A lot of them may also suffer from some form of sexual abuse, many of these instances happening during a relationship. These difficulties were mainly attributed to them finding it difficult to ‘read’ other people’s intentions, being generally a social outcast or loner, and feeling a need to please people in order to be accepted.
How does diagnosis help?
While for children the diagnosis leads to behavioral therapies and interventions, the adult diagnosis of autism is followed by intense sessions of counselling. It helps them identify, and therefore break the cycle of toxic equations – whether it is a friendship or a romantic relationship. It can also help them recognise self-sabotaging behaviour and create coping mechanisms to manage it.
Adult diagnosis of autism has been deemed ‘life changing’ and a ‘breath of relief’ by the adults on the autism spectrum. After years of struggling to understand their own behavioural traits and constant masking of the symptoms, a diagnosis meant finding the right pieces of the puzzle. It demystified all the social differences and provided a logical explanation for their experiences.
It is also likely, however, that such individuals reach the point of seeking a diagnosis after going through several painful experiences. In such a scenario, the most significant difference that a diagnosis can make is perhaps giving them access to a counsellor. A counsellor or a therapist can guide them through their journey of self-discovery and self-acceptance, making it easier for them to get comfortable with their identity.
Receiving an autism diagnosis is only half the battle. In order for adults diagnosed with autism, obtaining ongoing social support is also equally important to help them navigate a previously unchartered territory with ease. The stigma surrounding this often-misunderstood developmental disorder can also negatively impact their mental health causing stress and anxiety.