Common mental health misdiagnoses in autistic adults
At Affirming Autism, we frequently work with adults who’ve spent years navigating mental health systems without receiving a clear or accurate understanding of their experiences. For many, this journey has involved multiple misdiagnoses - often rooted in a lack of awareness about how autism presents in adults, especially those who mask or who fall outside stereotypical presentations.
Ruth Guy, Affirming Autism Director of operations talks about how autism can be mistaken for other conditions
Why are misdiagnoses so common?
Autism in adults is often misunderstood, particularly in those who have learned to mask their differences or who don't fit the outdated, male-centred diagnostic models. As a result, many autistic adults - especially women, non-binary people, and those assigned female at birth are misdiagnosed with conditions that partially explain their experiences but miss the full picture.
Common misdiagnoses
Social Anxiety Disorder & OCD
Autistic people may appear socially anxious, but the root cause is often sensory overload, difficulties with social reciprocity, or past experiences of exclusion - not a fear of being judged.
Autism can sometimes be mistaken for Obsessive-Compulsive Disorder because both can involve repetitive behaviors and strong preferences for routines. However, the underlying reasons are different.
Trauma and personality
Borderline Personality Disorder / EUPD
Autistic characteristics like big emotions, identity struggles, or difficulties in relationships can sometimes be mistaken for BPD, EUPD or PTSD.
While some people are both autistic and have EUPD and have experienced trauma. many are misdiagnosed with it when autism is the better explanation.
Mood and anxiety
Depression and Anxiety
These are common among autistic adults, often as secondary conditions. They're frequently a response to chronic invalidation, sensory stress, or years of not understanding oneself- not the whole story.
The impact of misdiagnosis
Receiving the wrong diagnosis can lead to:
- Inappropriate or ineffective treatments
- A lack of access to autism-informed support
- Ongoing confusion and self-doubt
- Delayed self-understanding and acceptance
Our approach
At Affirming Autism, we take a neurodiversity-affirming, trauma-informed approach to adult autism diagnosis. We understand how autism can be hidden, misread, or misunderstood in adulthood, especially after years of masking. Our process is designed to see the whole person, not just the symptoms.
If you’ve been misdiagnosed, doubted, or dismissed - we believe you. And we’re here to help.