Understanding Misdiagnoses of Autism

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that is often difficult to diagnose accurately. In some cases, individuals may receive misdiagnoses due to various factors, including the ambiguity surrounding neurodivergence, the current diagnostic criteria, and the phenomenon of masking.

Common Misdiagnoses of Autism

Anxiety Disorders

• Symptom Overlap: Strong adherence to routines, difficulty with unexpected changes, and sensory meltdowns can be mistaken for anxiety symptoms.
• Misdiagnoses: Social anxiety disorder may be diagnosed when social difficulties are caused by unpredictable conversations or challenges with body language and tone. Generalized anxiety disorder may also be misdiagnosed when anxious behaviors are not accompanied by nervousness.

Attention Deficit/Hyperactivity Disorder (ADHD)

• Symptom Overlap: Shared symptoms include attention issues, communication difficulties, and challenges with routines.
• Misdiagnoses: ADHD may be diagnosed when symptoms do not fully align with the diagnosis. Autistic individuals may have specific interests they hyper-focus on, leading to difficulties in paying attention to other areas. They may also have difficulty understanding social cues and experience language and communication challenges.

Borderline Personality Disorder (BPD)

• Symptom Overlap: Emotional instability, impulsive behaviors, and difficulties in interpersonal relationships.
• Misdiagnoses: Autistic individuals, especially women, may be misdiagnosed with BPD. Sensory meltdowns can be mistaken for dysregulation, impulsivity may be misunderstood as impulsive spending or substance abuse, and relationship conflicts can arise due to social and communication differences.

Obsessive-Compulsive Disorder (OCD)

• Symptom Overlap: Intrusive thoughts, images, and repetitive behaviors to reduce anxiety.
• Misdiagnoses: Stimming behavior, repetitive language, and adherence to routines may be labeled as compulsions. However, if these behaviors are not intended to reduce anxiety, they are not compulsions.

Post-Traumatic Stress Disorder (PTSD)

• Increased Risk: Autistic individuals may have an elevated risk of trauma due to being neurodivergent in a neurotypical world.
• Misdiagnoses: Autistic people may be diagnosed with PTSD due to the overlap between autistic traits and trauma symptoms, as well as their increased susceptibility to bullying, abuse, and exploitation.

Psychotic Disorders

• Symptom Overlap: Difficulty in communication and social detachment or withdrawal.
• Misdiagnoses: Autism and psychotic disorders share these symptoms, leading to misdiagnoses. Additionally, autistic individuals' literal interpretations of questions on personality tests can elevate scales measuring for psychosis.

Seeking Accurate Diagnosis

If you believe you may have been misdiagnosed, it is important to discuss this with your healthcare provider for further evaluation. They can provide additional information and refer you for a second opinion if necessary. Self-advocacy is crucial in ensuring an accurate diagnosis and appropriate treatment.