Are your difficulties more than anxiety?
Autism is often missed in childhood, meaning that many adults do not realise that the day to day struggles they are experiencing are due to undiagnosed autism. Many undiagnosed autistic adults have been led to believe that their differences are due to anxiety in this article we will outline 5 common signs of autism in adults.
What is autism?
Autism is a neurodevelopmental difference, this means that that an autistic person perceives and processes information differently to a neurotypical person. Autism is often described as a social disability, meaning that most difficulties experienced by an autistic person relate to the social norms, expectations and environment of a predominantly neurotypical world.
Why is autism missed?
Despite increased awareness of autism through professional training programmes, awareness raising campaigns increased media coverage, autism continues to be misunderstood by both public and professionals.
The core characteristics of autism remain the same for all, but the way in which the characteristics impact each person is different. Some people present with the obvious ‘stereotypical’ signs of autism in childhood, whereas the presentation of others is more nuanced and subtle.
Autistic individuals with higher levels of social awareness in younger years often hide or mask their difficulties when around others, and this means that their needs are not obvious and social behaviours are often attributed to personality traits or being ‘shy’ or ‘anxious’.
Frontline professionals such as GPs or primary mental health workers have limited training in the more nuanced signs of autism in adults and therefore do not recognise the patterns of behaviours that undiagnosed adults often present with.
Autistic adults are more likely to have other neurodevelopmental conditions such as ADHD, and this can impact the clinical presentation of autism.
How is autism treated?
Autism is not a condition that needs treatment and there are no pharmacological interventions specifically for autism.
However, recognition of autism can be of great importance in relation to self-understanding and the understanding of others.
5 Common Signs of Autism in Adults
Autistic adults often experience anxiety, however, the experiences of undiagnosed autistic adults are related to a pattern of differences that cannot be explained by anxiety alone.
1. Stress or anxiety specific to social situations
All autistic people experience difficulties with social interaction and communication, which in turn leads to feelings of stress or anxiety around social situations.
Some people will find all social situations that involve chatting to others difficult, whilst others only struggle with new or unfamiliar social situations.
Adults who have developed masking behaviours as a coping strategy may not be acutely aware of how stressful they actually find social situations or may not recognise that their coping strategies are not typically used by others.
Strategies used to manage stress relating to social situations include:
- Avoiding situations where social chit chat is expected, such as declining social invitations or avoiding the canteen at work
- Staying quiet when in a group situation
- Allowing a friend or partner to lead social exchanges with others
- Having a bank of ‘stock phrases’ that you use when interacting with others, or using the same questions to avoid unexpected conversation topics
- Rehearsing conversations in your head before having them in person
Often the stress or anxiety around social situations is related to a fear of making a social error or misreading a situation and many autistic adults find themselves worrying about such possibilities and also tend to mentally dissect social interactions after they have happened.
2. Sensory Differences
Most autistic people experience sensory differences, either finding sensory input overwhelming or needing to source sensory input in order to feel balanced.
For some individuals sensory input can be an issue all of the time, and for others sensory issues become apparent at times of stress or overwhelm.
Sensory differences can affect any of the senses, common difficulties experienced include:
- Finding loud, busy places overwhelming
- Feeling irritated by specific noises such as people chewing or the radio in the car
- Hearing sounds in the environment that other people appear oblivious to
- Struggling to filter out other people’s conversations when in public
- Feeling pain-like sensations when around bright lights or sunshine
- Being more sensitive to temperature, often feeling too hot or too cold
- Needing to stroke or fiddle with objects
- Not liking the texture of certain foods
- Being unable to wear certain types of clothing or certain fabrics
3. Struggling with changes
Having difficulty when things change, do not go to plan, are unfamiliar or unpredictable is also an indication of possible autism.
Autistic people tend to prefer familiar, predictable routines and find new experiences difficult. The level of difficulty with changes varies between different people, but common experiences of autistic people include:
- Having a set routine for doing certain things, such as getting ready, and feeling unsettled if this cannot be followed
- Needing to do the same things each day, for example, eating the same thing for breakfast or having a cup of tea at the same specific time
- Disliking or avoiding new or unfamiliar situations, such as going on holiday or changing jobs
- Feeling anxious or unsettled when there is a change in the environment or there are new people in your life, for example a change of manager or a new neighbour
- Needing to know exactly what will happen in your day or week, planning ahead and feeling unsettled when these things cannot be predicted
- Being irritated or annoyed when things do not go to plan, run on time or when others change plans at the last minute
- Needing advanced notice to prepare for something out of the ordinary, such as a medical appointment or meeting with an old friend
4. Having specific interests
Whether in work or through pleasure, autistic people often have specific areas of interest that they enjoy pursuing. For some, this may be a lifelong interest in a hobby, leisure activity or particular topic and for others the interest maybe shorter lived and is regularly replaced with different area of interest.
Following an interest intensely is a common characteristic of autism, and many autistic people find that the only time they are able to switch off from their worries and anxiety is when they are engaged in their interests or hobbies. For some, the interest becomes a focus of their career. Examples of experiencing specific, intense interests include:
Spending significant time engaged in a specific activity, often forgetting to meet your basic needs such as eating or drinking
Needing to purchase items relating to an interest, for example collecting items or needing to buy a range of equipment before trying a hobby
Researching facts relating to a particular interest, developing an in-depth knowledge of a particular subject area
Having an interest in things that follow a pattern or have an order
Only having friendships or relationships with people that share your interest
5. Frequent periods of exhaustion
Coping with day to day life, social norms and expectations in a neurotypical world is often exhausting and common sign of autism in adults is burnout as a result of this. Burnout is a debilitating phenomenon which is likely to be caused by the demands of managing sensory differences and masking autistic traits in daily life. Burnout can be acute or chronic and recovery time ranges from hours to months. Chronic burnout is often mistaken for depression.
For some people, acute burnout happens on a daily basis, for example, being unable to function after work or needing to rest in a dark room or sleep on return from work. For other people, burnout is experienced in cycles, entering periods of being unable to function every few months or even years.
You can find out more about autistic burnout here.
Summary
Autism is often missed and many adults with undiagnosed autism attribute their difficulties to anxiety. Autistic people have a pattern of differences and common signs of autism in adults include social anxiety alongside other behaviours. Assessment and diagnosis of autism can help individuals and those around them understand person’s strengths and differences, and in turn supports emotional wellbeing.
