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How to Spot Autism in Women: Why Girls Go Undiagnosed Into Adulthood

When talking about autism and Asperger’s in adult women, it’s a tale of the underdiagnosed. Many girls with autism tend to fly under the radar, developing an ability to mask their symptoms and imitate others in social situations — but not without emotional and psychological consequences. Once grown, women with autism struggle under the weight and exhaustion from a lifetime of masking their autistic tendencies.

Women with autism and Aspergers also tend to suffer from mood disorders and other co-existing psychiatric disorders like obsessive-compulsive disorder (OCD).

Anecdotal evidence points to an emerging profile of intelligent autistic women suffering in silence, struggling with a disorder they don’t realize they have.

Autism Vs. Aspergers

To understand autism and Asperger’s in women, you must first understand the spectrum of autism.

According to The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (commonly referred to as the DSM-5, or the manual physicians use to diagnose neuropsychiatric disorders) autism spectrum disorder (ASD) is a condition that affects one’s interactions with others and social communication. It is also characterized by the presence of repetitive or restrictive behaviors.[1]https://www.cdc.gov/ncbddd/autism/hcp-dsm.html

The severity of these behaviors in individuals diagnosed with autism can vary greatly. There is quite a wide range of characteristics that those with autism may embody. For that reason, autism is considered a spectrum disorder, encompassing all of these varied characteristics.

Doctors used to consider Asperger’s syndrome a subtype of autism. However, since 2013, they have done away with Asperger’s as a formal diagnosis. It is now considered on the mild end of the autism spectrum. Some individuals who were diagnosed with Asperger’s before this change may still prefer to use their original diagnosis to self-identify.

High Functioning Autism In Women

Many times, you will hear the term “high-functioning autism” used interchangeably with Asperger’s. However, those in the autistic community generally prefer neurotypical individuals to not use the term “high-functioning” when describing someone who is autistic.

Typically, when people refer to someone as high-functioning, they mean someone with autism that doesn’t have an intellectual disability. However, this doesn’t quite encompass the entire experience for those with autism. After all, there are several ways that autistic people find difficulty operating within societal frameworks that have nothing to do with IQ. The term high-functioning, then, tends to dismiss the struggles of autistic individuals.

Furthermore, research shows there’s not a strong correlation between IQ and struggles to complete everyday tasks like tying shoelaces, getting dressed, or eating.[2]https://journals.sagepub.com/doi/full/10.1177/1362361319852831

 

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Autism In Women Vs. Men

The first psychiatrist to identify autism, Leo Kanner, studied several children and wrote a paper on his findings in 1943. Most of these children happened to be males.[3]https://neurodiversity.com/library_kanner_1943.pdf From this, the conclusion was made that autism affects males more often than females. And while more modern research does tend to back up this claim, gender bias in medicine [4]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761670/ coupled with a potentially slightly different presentation of symptoms in females has likely led many girls to go undiagnosed.[5]https://molecularautism.biomedcentral.com/articles/10.1186/s13229-015-0021-4

Research indicates that while it was once thought autism was more prevalent in males by a ratio of 4 to 5:1, it is now closer to 2 to 3:1.[6]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284309/

How Does Autism Differ In Males And Females?

How is autism different in females? The answer to this question is nuanced.

Researchers note that females with autism tend to have stronger social skills than males.[7]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945617/ This probably allows girls to be more adept at “masking” or hiding their autistic traits.[8]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536256/[9]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925757/#R31 Many women with autism often describe the ability to imitate social behaviors of others effectively, although the process admittedly takes an emotional and physical toll.

And then, other research seems to indicate that females with autism have more difficulties with social interactions than their male counterparts.[10]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935179/ And when asked to self-report their levels of empathy, women with autism tended to have the same levels as men with autism.[11]https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151568

Interestingly, one small study noted a difference in blood biomarkers between women and men with autism.[12]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905921/ However, there is not much research comparing males and females with autism.

Undiagnosed Autism In Adult Women

In general, females tend to be diagnosed with autism later in life than men.[13]https://pubmed.ncbi.nlm.nih.gov/23001766/ And while we don’t have a lot of hard and fast data to support the anecdotal evidence, there appears to be a growing number of female adults realizing that they, in fact, have undiagnosed autism.

These women appear to have successfully camouflaged or masked their autistic traits over the years.[14]https://journals.sagepub.com/doi/full/10.1177/1362361316671012 These women with mild autism often report feeling exhausted from having to work so hard to maintain societal norms.[15]https://link.springer.com/article/10.1007/s40489-020-00197-9

What Are The Signs And Symptoms Of Autism In Adults?

Since most of the focus on diagnosing autism is in small children, the definitive guide to adult autism isn’t available.

In babies, autism is typically identified by a lack of eye contact, developmental delays, language delays, or indifference towards others, including their parents.

For adults, finding a diagnosis can be more complicated. Complicating matters, years of suppressing behaviors in order to fit in often means autistic individuals are exhausted and confused.

Furthermore, research shows many adults with autism may have comorbid anxiety, depression, schizophrenia, bipolar disorder, suicide attempts, and obsessive-compulsive disorder.[16]https://pubmed.ncbi.nlm.nih.gov/25911091/ And adult women with autism also may experience eating disorders.[17]https://pubmed.ncbi.nlm.nih.gov/26056560/[18]https://pubmed.ncbi.nlm.nih.gov/23643773/ This can complicate receiving an accurate diagnosis.

Other common signs of autism in adult women may include:

  • Preferring solitude, avoiding social interaction
  • Considered shy or quiet
  • Having only one or two close friends
  • Escaping into nature or fantasy
  • Need for routine
  • Severe anxiety when routine or ritual is interrupted
  • Wearing comfortable clothing
  • Disliking jewelry or tags on clothing
  • Outbursts at home, where she feels more comfortable
  • Bottling up emotions
  • Social anxiety
  • Specific and focused interests
  • Rejecting fashion trends
  • Exhaustion from years of suppressing autistic behaviors
  • Overcompensating with too much eye contact
  • Planning out conversations or jokes in advance
  • Imitating the expressions of others
  • Changing preferences based on who is around
  • A feeling of being different or not belonging
  • Difficulty coping with high-stress situations
  • Performing repetitive movements
  • Aversion to food textures or having a very specific diet
  • Self-harming behaviors
  • Struggles with executive function (organizing, planning, short term memory)
  • Lack of libido or feeling of asexuality
  • Interpreting things very literally
  • Naive or trusting

It’s also important to note that females with autism are three times more likely to be victims of sexual assault.[19]https://pubmed.ncbi.nlm.nih.gov/29570782/

Now, a doctor isn’t likely to diagnose someone as autistic if she as one or two of these behavioral traits. This is one of those instances where the doctor will consider many aspects of the patient’s life before arriving at a diagnosis.
Nootropics For Autism
Nootropics can’t treat autism, but some of them could be helpful for treating some of the symptoms of autism. Many women and men with autism report difficulty concentrating. Others have problems with executive function or falling asleep at night.

Certain nootropics can address these issues.

Take our quiz to find out which nootropics might help you.

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