5 Subtle but Common Signs of Autism in Adults
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Kory Andreas, a 43-year-old from Gambrills, Maryland, always had friends jokingly tell her she was “too much” because she was so intensely passionate about things she loved. But when she became a couples counselor focusing on neurodiverse clients, she began to notice how much she related to her patients with autism, including their struggles with small talk, sensitivity to bright lights and loud sounds, and fixations on hobbies. After seeing a new doctor in 2023, she was diagnosed with autism spectrum disorder (ASD).
Roughly 1 in every 45 adults has this neurodevelopmental condition, but symptoms typically first appear in early childhood. Pediatricians can sometimes spot it right away—ASD can be fairly disabling and severely impact whether or not a child hits big milestones, like starting to speak. But it also exists on a spectrum, so in mild cases doctors often won’t see the signs or will misdiagnose the disorder for something else, like anxiety, which was the case for Andreas. To be officially diagnosed, you also need to have multiple symptoms, not just one or two, Sarah Quaratella, MD, an adult psychiatrist with Hartselle & Associates in Denver, tells SELF. So if you’re “high-functioning”—meaning you’re really good at “camouflaging” or masking any autism symptoms, which is often the case with women—people around you might think you’re perfectly fine. But this can get dangerous: Studies have shown that this can lead to “autistic burnout,” which is the emotional exhaustion, depression, and anxiety that comes from coping with day-to-day life.
To complicate things even more, there is a lot of misinformation about the disorder on social media. For example, one study found that only 27% of the most popular TikTok videos on autism, which collectively received nearly 200 million views, were actually accurate. If you’re wondering if you fit the description, it’s worth asking a doc. Here are five signs you might want to start that conversation.
1. Social settings can be incredibly challenging.
If you have autism, you might struggle to read social cues, navigate conversations, maintain eye contact, or keep friendships. That’s because “people with ASD are going to be processing social information differently,” Dr. Quaratella says. In childhood, this might have looked like a lack of empathy—say, a classmate was pushed down at recess and you weren’t sure why they were distressed—or you didn’t respond to a positive physical gesture, like a pat on the back, as warmly as other kids.
As an adult with ASD, you may not be able to tell if the stranger you’re chatting up at a party is being sarcastic, or know how to come up with an appropriate response after someone tells you a story. Small talk can feel unbearable, which can lead a lot of people to prefer socializing with one or two close pals instead of a big group. Interacting with them via an online gaming group or in another low-lift way may even be a more attractive option. It’s not unusual to be drawn to other people with autism, which Andreas can relate to: Many of her friends growing up were neurodivergent, and as an adult she seemed to gravitate towards dating men with autism.
Of course, most people have felt socially awkward at some point, which is why this can get tricky. It all comes back to having multiple signs, Michelle Gorenstein-Holtzman, PsyD, a clinical psychologist at the NewYork-Presbyterian Center for Autism and the Developing Brain, tells SELF. “You’re not looking for one behavior…. You’re looking for symptoms across settings and different domains, and for it to really impact somebody’s functioning,” she explains. For Andreas, random chitchat, in particular, is agonizing because she’s not really interested in interacting with strangers and is often hyper-focused on how she’s being perceived, so it can cause her to ruminate about what she said long after the conversation is concluded.
2. You’re extremely invested in your interests.
Having a little hobby is a good thing, but people with autism tend to get really, really wrapped up in them. Maybe you deep-dive into niche topics—say, the latest cult docuseries on Netflix or train sets—and then that’s all you want to talk about or do, Dr. Gorenstein-Holtzman says. “It can become their entire world,” she says. When she was a kid, Andreas once became laser-focused on musical instruments, then mastered photography a few months later. When she got older, she went all in on psychology, ultimately making it a career. “I just couldn’t get enough of it. I’m really obsessive about my interests and this became the new thing,” she says.
Having an intense passion for something can be rewarding and exciting, but for some people with autism, it can get in the way of responsibilities, like family or work—it’s estimated that half of adults with the disorder struggle with employment. If you’re on the milder side of the spectrum, your interests may still impact daily functioning, just to a lesser extent. For example, if you’re majorly into photography, you might have trouble talking about something other than developing film when you’re out to lunch with friends, which could impact your ability to connect, Dr. Quaratella says. For others, losing a special interest can be disabling. “If you told me, ‘Hey, go a day and don’t talk about autism,’ I literally wouldn’t know what to do with myself,” Andreas says.
3. You’re supersensitive to lights, sounds, textures, and smells.
When you have autism, your brain processes sensory stimuli differently—or perhaps more strongly—than other people. This might mean that clothing labels are unbearably itchy; bright, flickering lights are distressing; or a waft of someone’s cheap perfume makes you want to cry. For Andreas, a toddler running around screaming with delight, as cute as they might be, is almost unbearable. “A little sensory input can have a big feeling internally,” Dr. Gorenstein-Holtzman says. You may, on the other hand, seek out certain sensations like the vibrations from loud music or the pressure of a weighted blanket because they make you feel calm and balanced.
Again, there’s a wide range of experiences here: Visceral reactions to stimuli have the potential to derail your focus on other things, like school or work, or it may take you hours to get ready if you’re agitated by the feeling of your wool sweater. Studies suggest that this symptom tends to go hand-in-hand with a lack of socializing: People who have intense reactions to these things tend to retreat and want to be alone more often.
4. You require routine and predictability.
With ASD, you might feel very specific or rigid about how you want your day (or life!) to go and get stressed if that suddenly changes, Dr. Quaratella says. Maybe last-minute events derail your routine, stress you out, and prevent you from going about your day, Dr. Quaratella says. Alternatively, you might feel tense if someone rearranges a few items in your fridge or puts your coffee mugs in a new cabinet, Dr. Gorenstein-Holtzman points out. Andreas feels better when her days look similar, and she tends to eat the same thing for breakfast every morning. “It feels very comfortable to know what’s coming next,” she says.
So how can you tell if your surprise-averse nature is a result of autism or something else? Dr. Quaratella says it really depends on whether you’ve got other symptoms on this list, and if your desire for routine affects your ability to function (say, a new meeting springs up at work and you can’t cope).
5. You’re feeling really down or tense in general.
Anxiety and depression aren’t symptoms of ASD itself, but many adults experience them in tandem. Navigating a “neurotypical” society—with unspoken rules about how people should behave and must respond in conversations—can be exhausting and, for some, incapacitating. “Autistic individuals are using a lot more mental resources to get through their day,” Dr. Gorenstein-Holtzman says. Again, this can all lead to burnout: “If your brain is processing sensory input in a different way, it makes sense to have this underlying baseline of anxiety of, ‘Well, I don’t know what to expect in a situation and I’m not sure if I’m going to react in a way that society at large is expecting me to,’” Dr. Quaratella says.
If you relate to some of these signs, it might be worth chatting with a psychologist or psychiatrist. They can run tests, like diagnostic interviews or observing you complete various tasks, to know if you have it—or another issue that presents similarly, like a mood or personality disorder (say, bipolar) or even social anxiety disorder. There are tons of ways to treat autism or related issues, including therapy, medication (like antidepressants), and support groups. Dr. Gorenstein-Holtzman sees lots of people with mild autism who are able to navigate life without taking meds—and that’s totally fine, as it’s not necessarily something that needs to be “cured.” So do what feels right for you.
In the meantime, though, a diagnosis might give you a little validation and relief. It’s something Andreas knows well: Learning she had autism helped remind her that she’s not a mean person or uncaring mom when she, for example, isn’t vibing with her husband’s friend or can’t stand her daughter’s perfume—she’s just someone with a lot of sensory issues who has trouble dealing with change. It’s helped give her self-compassion about why she is the way she is. “I can look at myself with a lot of grace now,” she says.
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Originally Appeared on SELF
