AIBU to think that there are adults trying to push for an autism diagnosis, that actually have a personality disorder instead?

[surelycantjustbeme]

Someone I know is currently pushing for an adult autism diagnosis. The “autistic traits” she talks about were never present in childhood and seem to have appeared only in adulthood.

From what I’ve read, that pattern can sometimes fit better with something like borderline personality disorder, where there can be a lot of symptom overlap but the difficulties are more tied to relationships, emotions and past environment, and often show more clearly from the teens onwards rather than right through childhood.

I’m posting here because I can’t really talk about this in real life, and I’m genuinely curious whether anyone has come across similar situations. Has anyone seen someone really push the idea that they’re autistic when it doesn’t quite match their history?

For context, this person has always absolutely refused to work or take on any responsibility, and whenever they’re asked to step up, they suddenly lean on “I’m autistic” as the explanation. I obviously can’t diagnose them, but I’m increasingly wondering whether something like a personality disorder might be a closer fit than autism.

Everyone who knows this person knows there have never been any such symptoms in childhood, it's only recently where responsibilities have become a real demand and it's almost being treated as a get out of jail free card.

I know people who have genuinely severely non verbal children, and I also know people who have children with genuine ADHD and are on the spectrum, and the childhood challenges it presents. So please don't read this as me being insensitive in any way.

Am I being unreasonable to think that there could be adults with personality disorders, trying to push for an autism diagnosis instead as it's more widely accepted and better understood.

I would be considered to have ADHD if the diagnosis only took evidence of the past few years, obviously I don't have ADHD i just have a lot of the traits and I'm so sick of being armchair diagnosed by people and 'encouraged' to get an assessment. I had no traits as a child, teen, young adult etc it's only now in my 40s its being thrown around so casually. So in answer to your question @surelycantjustbeme yes I agree a lot of people use ND as an excuse when actually they are NT and have other issues going on.

A professional should be able to figure this out.

Tbh it’s usually the other way around that autistic women in particular are diagnosed with BPD or whatever it is known as now.

That is often problematic because autistic girls often mask to such an extent that if they don’t have an intellectual disability, problems often aren’t picked up in the more structured life of school, while their parents struggle at home, and their life falls apart at university while living independently for the first time.

And this somehow gets wrongly interpreted as “difficulties only emerging later in life” when they have in reality been there all along.

So I would be very wary of making judgements when you are not qualified to do so op, and as a pp said, if this person has difficulty functioning, then what does it matter?

I get the impression you think that their symptoms are “not genuine” though and speaking as someone with a dd with autism, your scepticism will not be a surprise to anyone who is ND or their families.

If they do have ASD, so many people react to news of a diagnosis with “but you don’t seem autistic” without knowing all of the difficulties that the person struggles with behind their mask. By definition, their struggles are not always evident from the outside.

Autism > auto > self > every individual autistic person is affected by thejr autism differently and their struggles, particularly in women, can be largely internal.

And it’s a characteristic of autism that people can have very spikey not rounded profiles so they can appear completely competent and efficient in one area, and not in another.

The misdiagnosis happens the other way round. Far too many autistic women are misdiagnosed with BPD/ EUPD.

Plenty of people are autistic and have a PD. It’s not either/or. Autism sits within a personality, not to mention a wider mental health context that often includes relational trauma, which is a predictor of PD.

There are some crossovers in presentation between bpd and autism in women, arguably personality disorders have historically been over diagnosed, with autism under recognised. As for only presenting symptoms in adulthood, I'm not sure how easy it is to make that assessment as a third party. Any reasonable autism assessment will look at all this so couldn't lose sleep over it to be honest..

The overlap isn't so huge that a professional can't tell them apart.

My DM would say I showed no signs of ASD as a child. Then she relays stories of my childhood that clearly indicate ASD. She just doesn't know it. I nod and smile.

Unsure but I do think that they need to start renaming Hugh functioning people with autism.

My grandson is nonverbal, cannot use the toilet himself and is severly autistic. It’s not right that he gets lumped in the same category as high functioning people who are just a bit different.

Also op, a statement like,

”and I also know people who have children with genuine ADHD and are on the spectrum, and the childhood challenges it present”

is rather contentious because there are many types of ADHD not just the traditional bouncing around, can’t sit still, impulsive, hyperactive type sometimes evident in little boys.

Girls however mostly present with the quiet, inattentive type of ADHD which is characterized by daydreaming, disorganization, shyness, and being easily distracted, rather than overt hyperactivity.

This subtype is often overlooked because it is
less disruptive than the hyperactive symptoms typical in boys, and that in itself leads to later diagnosis or misdiagnosis.

Autism is definitely under diagnosed in adult women.

However a number of people I know who got diagnosed with ASD as adults have also been diagnosed with a PD and speaking as person with a lot of experience with autism, the PD is distinct, pretty obvious and very much unquestionably present.

4 people I know were diagnosed as adults with ASD (2 of them children of friends) 2 of them with BPD one with HPD and another with ASPD. The overlap with trauma especially with the experiences of not being diagnosed are probably part of this.

There are no high functioning people with autism as to have an autism diagnosis it needs to impact life significantly.

My children are verbal and can use the toilet, how dare you dismiss their disability as being a bit different. They have a significant amount of support from services.

Either that or people who think they are on the spectrum don't realise that a lot of the things they struggle with a NT person would too. Like someone saying that their routine getting changed will give them anxiety (yeah a lot of NT would also find that) or my friend with autism one time saying that he can't learn to drive because if something happens suddenly when he's driving he'll get a shock-yeah me too!

Also I don't really have much faith in psychiatrists to diagnose people, they can't even figure out whether people with severe mental health issues are dangerous and should be out on the streets or not.

More likely, they are autistic and have been diagnosed with a personality disorder - especially women.

Most recent research seems to suggest that people suffering from PDs actually have unmet ND needs.

She can't "push" for an autism diagnosis. She can ask for an assessment which is a perfectly reasonable thing to do if you're struggling with things that suggest you are impaired in interactions, imagination and communication. Someone trained will then do a lengthy assessment and if appropriate, diagnose her.

I think your post is unreasonable because it implies people can get autism diagnoses without having autism, just because they want to.
The opposite is more likely.

Yep , same for me. I was diagnosed in my 50s by the NHS after my children all were NHS diagnosed. I hid it, most girls did and often still do. Said masking can often lead to severe MH struggles as a result.

Exactly this. You have to get through screening even before going through the diagnosis process.

I’m afraid your last psych is literally wrong according to ICD10 which is the classification used in UK psychiatry:

‘There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence’

2 of my children have ASC, ADHD, CPTSD and BPD. The CPTSD lead to the BPD.Autistic/ adhd people are vulnerable and more likely to encounter trauma.

It’s not autistic people saying DBT is better for them than CBT, professionals recommend it for CPTSD /BPD. My daughter has made so much progress with it alongside other therapy that she was told she probably doesn’t meet the threshold for EUPD now. The autism/ adhd diagnoses will never change.

So much ignorance on this thread as per usual on MN autism threads.

You've obviously never heard of masking.

It’s odd that they apparently so regularly do misdiagnose people then isn’t it?

I mean it’s a pretty diagram but lots of the non overlapping bits contain almost the same words and things that are different only in a very subtle way. People might like to think that these are strikingly different and 100% dissociable but I doubt they really are. In real life things are messy and people present with a mixture of neurodivergence and trauma which can be manifested as EUPD. It would easily be possible to be diagnosed with both hence the limited usefulness of such labels

I agree but he will not budge on the diagnosis.

It’s interesting when people proclaim ‘qualified medical professional’ on here, with great reverence and deference, like these aren’t the same fallible ‘professionals’ that misdiagnose and mistreat people (particularly women) fairly regularly. This isn’t me doing doctors down, the majority are good, but they’re far from perfect and in many cases these nebulous diagnoses are fairly new and erroneous.

Anyway - YANBU. I’m not sure I even really agree with ‘neurodiversity’ as a concept. It seems like a new explosion which seems to have more symptoms, ‘explanations’ and profiles added by the day. Nothing has ever convinced me people’s brains divide into neat groups, be it this or transgender or anything else.

She could have been heavily masking throughout her life. How on earth would you know how she behaved throughout her childhood? It’s also not really any of your business.

Many autistic women mask so well that it causes issues in other areas and looks like anxiety and a personality disorder. A psychologist will be able to tell. But unless you are an expert then it’s not really for you to judge.

People need to understand that autism and ADHD is hugely under diagnosed- especially in women. We are going to be playing catch up for many, many years.

The latest thinking around personality disorders is that many are people are misdiagnosed and they are actually autistic. Especially EUPD (used to be called BPD). It’s only recently that we have understood that autism presents very differently in females, hence many women being misdiagnosed with a personality disorder and not getting the support the need.