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.

A quick internet search will give you the answer to that.

Top marks OP on one of the goadiest threads I've seen on here. Nice when someone puts in the effort.

You should have, but that isn't always happening. The two people I mentioned said they had no contact with their parents, one didn't have any, one had minimal due the childhood abuse they experienced. Both did well in primary school and one did well through secondary, college and uni.

I don’t think any of us can know as we’re not experts.

There are probably all kinds of people pushing for all kinds of things out there.

But you didn't mention any of that in your previous post and I literally just said I also had the same struggles as your daughter and had to drop out of uni because I couldn't cope. You don't even know if I could be on the spectrum.

Define did well.

You don’t need contact with parents for evidence, school reports or history.

On paper I did well. I scraped O levels, very low Alevels and a 2:2. I under achieved massively throughout my education and career because of my adhd and autism. I had an ED and meltdowns a plenty- at home. Plenty of other evidence on my school reports too- inability to concentrate, daydream, communicate etc

https://www.gov.uk/government/statistics/fraud-and-error-in-the-benefit-system-financial-year-2024-to-2025-estimates/fraud-and-error-in-the-benefit-system-financial-year-ending-fye-2025
fraud rate for PIP is 0.4%. This costs £100,000,000 (one hundred million pounds) every year.

School reports aren't available to people over 25, unless their parents kept them, which is pretty unlikely in an abusive household.
This isn't about you. I know autism and ADHD exists, I'm autistic, my DS is autistic, my siblings have ADHD, I work with people with autism and ADHD. I think part of the problem in discussing misdiagnosis is that those who are diagnosed take it personally and think their diagnosis is being questioned.
Misdiagnoses doesn't help anyone, how can treatments be developed and properly evaluated for autism and adhd when there are people involved in the studies who have been misdiagnosed? We could end up with therapies that are effective for PTSD being gold standard for autism or meds that work for menopause being prescribed for ADHD.

Fraud rate for child benefit is 2% costing the tax payer £270 million. Not sure what your point is .

School reports most definitely are available to those over 25 I’m in my 50s and have mine tucked away with exam certificates as do most people my age.

This isn’t about you or the 2 people you mentioned that you’ve decided have been misdiagnosed .

I’m predicting that, as the ASD diagnosis rate increases, the BPD will decrease.

A medic I know is currently researching the link between ADHD and Parkinson’s - evidence currently supports a theory of Parkinson’s being ‘end stage ADHD’.

Well people can research things and it’s good to have a hypothesis but this is a pretty bizarre one. Parkinson’s is clearly not ‘end stage ADHD’ it’s a neuro degenerative disease selectively affecting dopaminergic neurones in the substantia nigra that is progressive and ultimately kills you. ADHD is clearly not that and lots of NT people get Parkinson’s. I think you may have misunderstood.

I can believe you could have a higher risk for Parkinson’s if you already have ADHD because presumably you already have some dysfunction of the dopaminergic system so a preexisting vulnerability but to say that Parkinson’s ‘is end stage ADHD’ suggests that they have the same pathophysiology which is blatantly untrue.

I am quite sure that as the ASD/ ADHD diagnosis rate increases the BPD rate will reduce. Very much like the diagnosis of conversion disorder has dropped off with the rise of FND. Same symptoms but society has decided to call it something different. Medical diagnosis is to a large degree a social construct and is not the pure reflection of biological reality that people might wish it to be.

https://www.cumberland.gov.uk/cumberland-public-health-annual-report-20234/chapter-1-mainstream-medical-paradigms-and-critiques#:~:text=Cultural%20and%20contextual%20bias:%20Psychiatric,view%20of%20solely%20biological%20causation.

I agree. But lots of places assess only for autism or ADHD and has either no experience of working with mental health issues so misses them or does not see a need to look a bit wider than the ticklist diagnostic criteria. It gives people incorrect notion autism is an either/or condition.

I think 'masking' in this context is slightly different. People who are NT adapt their presentation to their audience. They may not fart in front of a client, but might in front of their husband (or might not! - people have different views on it). You might pick up chips with your fingers at home, but use a fork with friends when out.

In ASD, for example, the masking is more extensive. Girls, particularly, observe those around them and mimic them, so they appear 'normal'. They adopt mannerisms and patterns of speech to blend in, etc. Because they are mimicking and attempting to blend, they have to concentrate on every detail of what's happening. It's exhausting.

I suppose I see it as NT people are 80% 'them' and 20% blending to circumstances. People with ASD are often 20% 'them' and 80% blending to circumstances.

I am interested in this! As the mother of an adult dd with ASD (she prefers the D for Disorder) and looking at the diagram posted below showing the overlap between BPD/EUPD and autism …

… while, as an untrained lay person I can look at the symptoms listed in the overlap and understand to a degree the similarities, in reality, or in my DD’s case anyway, the differences between autism and BPD are so stark.

There may be disregulation in both conditions but autistic disregulation tends to occur for quite obvious logical reasons eg sensory overload. Or in response to frustration resulting from a significant miscommunication. My dd is very stable emotionally , one would almost describe her as emotionless, in the right environment eg quiet study, but becomes less so when subjected to unpredictability or stress. Whereas I believe mood in people with EUPD can change hourly and not particularly in sync with outside events.

Impulsivity I believe is listed in both but my autistic dd plans to the nth degree and simply does not do spontaneity. But she may suddenly jump off a train at a random station because the noise in the carriage was overwhelming, or it was too packed with people. But the train trip itself will have been planned months in advanced and practised in advance. She would never spontaneously book a train trip to Paris on impulse for example.

Ditto relationship difficulties. My dd would not react in a disregulated way to the ending of a relationship. She tends to ruminate over the causes of the break up and what she did wrong and attempt to understand in almost forensic detail their miscommunication in quite a logical and detached manner. Ultimately she will end up blaming herself, so the sense of shame perhaps is similar to that experienced by someone with EUPD but it is based on life experiences rather than innate shame.

Does any of that make sense?

Unfortunately for you I read the report released by the UK clinician who diagnosed this person with Asperger so before labelling me as ignorant you should reconsider your manners. Someone who can’t hold a debate without offending is just pathetic.

You obviously have a lot of experience with ASD and I don’t dispute any of your observations there but your assumptions about people with personality disorder are not correct and somewhat tainted with the negative bias that the diagnosis attracts.

People with PDs are usually the victims of childhood trauma and abuse or neglect so their behaviour is really no more their fault than a person with ASD. Their mood doesn’t change for ‘no reason’ it’s just that the reason might be less apparent to others eg it would often be interpersonal conflict or rejection. That is a very subtle distinction from ‘a significant miscommunication’ it’s really just about who is getting the blame for the ‘miscommunication’ the giver (ASD framing) or the receiver (EUPD framing). It would also not always be apparent to others who don’t know your DD that the reason for an impulsive behaviour was sensory overload. People with EUPD also have outbursts of behaviour due to ‘overload’ but the overload might be more of an emotional situation. The behaviour is going to look very similar to an outsider. In your typical one hour assessment and often with no one to give a context I find it unsurprising that the ‘wrong’ label might be assigned.

Given that PD is rooted in childhood trauma and that people with ASD are more susceptible to the effects of trauma it is entirely possible that a person could have both conditions and probably rather common.

That was in reply to MuddyOtter

It's more likely the other way around, in my experience. People get a personality disorder diagnosis when they are actually neurodiverse.

An autism diagnosis requires a developmental history, so it's unlikely to be be given without evidence from childhood.

Yes, you're highlighting that their are overlaps, but there are also stark differences.

As in the case of the relationship breakup, the person with EUPD is more likely to engage in suicidal behaviour as the sense of abandonment is so acute, as in, really unbearable.

The autistic person might be more trying to work it out logically, even though both struggle to let it go. So the difference is definitely there.

Respectable childhood psychiatrists in the UK have been raising concerns around the process of diagnosing autism. Only very expert clinicians can conduct a precise differential diagnosis which requires lots of experience. I’ve seen first hand with one of my children how quick they jumped on the autism wagon, where instead we were dealing with a movement disorder with a very complex presentation. Now there is a huge list of disorders that overlap with some autistic presentations which do not justify the diagnosis of autism. I’ve seen children with severe social anxiety or attachment disorders being diagnosed with autism. Of course this does not exclude an overlap but we need to take into account that diagnosis are done by humans who have their own constructs and different ways of looking at the numerous presentations. Looking at the reply I received from @Cr055ing I am also confident in saying that some of the challenges that our children face have to do with parents who can’t have a civilised dialogue and clearly have some work to do.

I absolutely agree that I have no direct experience of EUPD and therefore my knowledge of it is only gleaned from what I have read but if I portrayed it with a negative bias, that was certainly not my intention, and no where in my post was I apportioning blame to any person suffering from either “condition” for want of a better term.

I also agree that behaviour could look very similar to an outsider but I stand by my point that an experienced psychiatrist, given appropriate time and resources, should be able to distinguish between the two imho. I certainly hope that no professional is diagnosing anyone on the basis of a one hour assessment!

I don't know. I'm currently completing the forms for CAMHs for my DD. While doing that I recognise a lot of traits myself. I was diagnosed with a MH issue which I now believe is actually ADHD.