Do You Think You Might Be Autistic? How one therapist started me on my autism journey.

As my legs buckled under me, I lunged for a seat, leaving my elderly mum to deal with the doctor’s receptionist. By the time I made it back to the sanctuary of my own home, my partner found me sobbing and rocking in my bed.

I explained about the change in plans that had taken course during the day: the unnecessary trip to yet another supermarket because mum needed a particular brand of tea; the unexpected blood tests which added half an hour on to the doctor’s appointment; the incessant chatter with half a dozen people which meant there was no way I was going to fit a gym workout in. This was day five of my mum’s relocation 100 miles south to be nearer to me and I couldn’t cope with the chaos.

Cocooned in the peace of my therapist’s chair a couple of days later, I described the mess, the disorder, the lack of structure, and the extreme pandemonium that had accompanied my mum’s move and that had pushed my anxiety levels—which were fairly bad even on a good day—through the roof. I described how her house, which I’d decorated in carefully chosen colour coordinated hues, was trashed already—strewn with plastic bags, dog food, old red cushions. I explained that my carefully constructed routine of school-run, gym, work—which helped to keep my anxiety levels at bay—was out the window.

After listening patiently, the counsellor said, "Have you ever considered that you might be on the autistic spectrum?"

"No..." I replied. Frankly, it wasn’t a thought that had ever occurred to me.

And yet, I began to wonder whether the problems which I’d experienced my entire life could, in fact, be due to autism. Going right back to my earliest childhood, I’d been described as "highly sensitive," "withdrawn," and plain old-fashioned "weird." My numerous phobias, need for order, social anxiety, complete absorption in subjects and extreme sensitivity to noise all fitted with "autism." But as a woman with a partner and two children, who displayed high empathy not only for my family but for therapy clients, I didn’t fit what I thought was the autism profile. I was determined to find out more, though—as so much of what the therapist had said resonated deeply with me—so I began to research women and Autism Spectrum Disorder (ASD)1.

Here’s what I discovered:

1. Many girls and women fail to be diagnosed as being on the autism spectrum because they do not meet the diagnostic criteria. When Asperger's Syndrome was first identified, it was thought that it was a condition that only affected boys. In reality, girls present differently and—for instance—instead of displaying an extreme interest in objects, they may display an extreme interest in people. Rather than collecting toy cars, they may "collect" facts about their favourite pop star and become obsessional about a celeb in the same way that a boy may become obsessional about trains.

2. Girls tend to have more of a drive to be sociable which means that they learn about social behaviours and social cues and mimic the behaviour of other girls and women in order to "fit in." Like boys on the autism spectrum, they lack the natural ability to pick up and respond to these social cues but they find it easier to "pass" because they put the effort into doing so.

3. Autistic girls are often called "shy" and the quiet behaviour which characterises many (although not all) girls’ experiences can be considered socially acceptable.

4. Girls may become obsessed with characters in books which deviates from diagnostic

Like my female clients with ASD, it was easy to see why I hadn’t been diagnosed earlier in life. I had learned to act "normally" in company. I overcame my huge discomfort of being part of a group by organising events, creating rules and structure. I found a career which could be creatively stimulating and allow me to create my own routine.

So why bother to seek out a diagnosis later in life, when you’ve managed to get by so far? Like many women with ASD, I continued to have meltdowns when things didn’t go according to plan. I found it hard to fit with what was culturally expected of me as a "woman." I suffered extreme anxiety, depression, and exhaustion from just trying to "fit in" and pass as normal. A lifetime of being called "weird" and "sensitive" took its toll on my self-esteem

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For a woman with ASD, understanding that there is an explanation for her behaviour can be very empowering as a way of acknowledging the past and moving forwards in a positive way. A diagnosis of autism can also help women of any age to ensure that they are living a life which is right for them—no matter what they feel they "should" be doing.

Many autistic women experience anxiety because they try and accommodate others’ needs, meeting social obligations and putting the needs of kids and partners first. Knowing that she is on the autistic spectrum can empower a woman to say "no" when that is the right thing for her to do. Having a diagnosis of ASD can help a woman recognise that making time for interests, creating a supportive routine, and avoiding an overload of social obligations is crucial to her mental health.