5 Ways Adults on the Autism Spectrum Present Differently than Children

If you have been diagnosed or are seeking a diagnosis of Autism, you may be realizing just how difficult it is to find someone who specializes in adults. Adults on the Autism Spectrum have different needs than children. Testing and treatment should be different too.

1. High Masking

   When autism is not suspected until late adolescence or adulthood, good masking and coping skills are undoubtedly a factor. However, the better someone masks, the harder it is to identify symptoms, even for professionals.

   
   

   That doesn't mean that masking is easy or effortless. It takes a lot of practice and energy to mask well, which makes every day tasks exhausting. Many adults on the spectrum become discouraged, even depressed, because they feel like they can't do as much as everyone else.

   
   

2. More Life Demands

   Our workload isn't just at work. As an adult, the tasks never end. Driving in heavy traffic, paying bills, doing the dishes, buying food, cooking, taking care of other people, and so much more. After a long day of masking at work, there may not be enough energy to keep up with daily tasks, let alone self care or fun.

   
   

3. Intelligent Testing

   I've heard countless stories of fully grown adults (some with graduate degrees) who have been tested with toys and other infantilizing scenarios. These types of assessments are not only degrading, but echo my own experience getting treatment for my daughter from providers who truly don't understand. Even worse are the incredibly high fees and long wait for appointments.

   
   

4. Medications and Health

   Adults are far more likely to have health conditions that children do not, such as hypertension, arthritis, and kidney stones. People on the spectrum also react differently to medication and frequently have significant side effects or no effect at all. Combining medications for physical health issues and mental health increases the risk for interactions and side effects.

   
   

5. Co-occurring Mental Health Conditions

   Young children that are diagnosed on the spectrum often struggle with irritability, poor sleep and inattention. Most of the research and literature for medication is written for these symptoms and this age group. Adults are more likely to have depression and anxiety caused by stress from finances, job security, marital struggles, or child rearing strain. There is far less information about medications to treat these disorders in someone with Autism. It can be invaluable to find a provider with experience treating adults.

   
   

   
   

Masking can lead to Shutdown

Experiencing low energy and struggling to manage tasks is a frequent issue in Autism. Adults face numerous obligatory tasks, often pushing themselves to the brink of exhaustion or experiencing an autistic shutdown. This shutdown goes beyond mere fatigue and can result in significant life challenges and physical health issues.

For example, Jane got a new job with an "open office" concept. It is loud, bright, and the social interactions are constant all day long. By the end of the work day, she is always too tired to shop and cook. She gets fast food and door dashes 7 to 10 times per week. In a span of three months, Jane put on 30 pounds, and the expenses have led her to fall behind on her credit card payments. She lacks the motivation to begin or complete tasks, leaving her house in disarray.

She consulted her primary care physician and was diagnosed with depression. They tried several antidepressants, but none were effective, and she gained an additional 20 pounds. They suggested exercise, socializing more, and staying active, which only made things worse. She then visited general psychiatry, where she was diagnosed with ADHD. Jane began taking a stimulant, which was initially life-changing. She managed to keep up with everything—the house was tidy, her car had gas, and she was on time for work. She meal planned and lost weight. However, the effects gradually diminished, requiring constant increases in the stimulant dosage. Eventually, even the maximum dose stopped working.

Jane felt like the hole kept getting deeper and deeper. She came to me desperate for help, not realizing what the problem was. When she was finally diagnosed with Autism, I realized she didn't need more energy, she needed more rest. She was always tired because her life was exhausting. She also didn't sleep well, but no one addressed the insomnia.

I worked with Jane to manage sensory sensitivities, identify restorative actions, and reduce work load, which helped Jane feel less worn out at the end of the day. Enhancing the quality of her sleep and obtaining more restorative rest made her feel more energized to begin the day.Once the real cause of her symptoms was discovered and treated, she started feeling better and had the energy to enjoy her life.

Autism is a spectrum, meaning not every aspect of Jane's story will connect with everyone.

However, an incorrect diagnosis and treatment can lead to numerous complications and have life long effects. Finding someone who specializes in adult autism is an essential first step of that journey.

If you reside in Maryland and are seeking an Autism evaluation, click this link to learn more about the process at You Matter Psychiatry.