What does Autism look like in high-achieving women?
Over 80% of the Autistic women remain unidentified as Autistic at 18 years old. This means that millions of Autistic women continue to “play life on hard mode” but do not understand why. Women who are high-achieving in their field who have not been identified as Autistic often experience daily challenges and hassles despite being seen as highly competent by others. This contributes to chronic anxiety, feelings of inadequacy, and the tendency to be highly self-critical and hard on themselves.
Some of the challenges and strengths you’ll see in high-achieving women are outlined below.
Interests, study and work
Autistic women often have:
- The ability to hyperfocus and quickly complete an enormous amount of work, when an activity is interesting or challenging
- Intense, long-lasting interests, resulting in deep understanding and expertise in these fields (monotropism)
- A limited number of interests or hobbies outside their deep interests, or many short-lived interests that become intensely fascinating but only for a very short time
- Been previously identified as gifted but are now chronically burned out
Yet, they will also:
- Feel inadequate despite success in their field, for example, having postgraduate qualifications but feeling like a social failure
- Have enormous difficulty doing things that aren’t deeply interesting, which triggers anxiety and shame
Mental health
Autistic women often experience:
- Chronic anxiety, worry, and the tendency to over-analyse everything
- Perfectionism
- Periods of low mood, depression, and self-doubt
- Meltdowns, shutdowns and episodes of being unable to speak
- Recurring or chronic Autistic burnout
- A profound sense of being overwhelmed and exhausted
- Chronic physical and mental fatigue
- Pervasive self-criticism and the tendency to be tough on themselves
- Obsessive-compulsive disorder (OCD)
Physical health
Autistic women have higher rates than non-Autistic women of:
- Body-focused repetitive behaviours, particularly painful ones such as skin-picking, nail-biting, and pulling out hair
- Eating disorders, particularly anorexia
- Sensory aversions to food, including avoidant/restrictive food intake disorder (ARFID)
- Chronic illnesses such as auto-immune disorders, metabolic, chronic pain, dysautonomia (POTS), and chronic fatigue
Sensory sensitivities/insensitivities
Autistic women often have:
- Sensory sensitivities, although they might not recognise them as such because they are usually able to avoid these things
- Intense reactions to specific sensory stimuli such as eating, slurping, chewing, breathing and sniffing (misophonia), finding them distracting, distressing, and intensely frustrating
- Difficulty with understanding and describing physical sensations in their body in ways others understand (interoceptive difficulties
Social challenges and communication differences
Autistic women will often:
- Hide their differences (masking) and adapt their social style to fit different groups and be accepted (camouflaging)
- Strive to compensate for their difficulties, such as being hyper-organised
- Be on the outer edge of friendship groups, with few or no close friends
- Have friendships that are built around their deep interests
- Get stuck in people-pleasing patterns, have difficulty maintaining boundaries, and have the tendency to be “the most helpful person in the room”
- Have difficulty identifying when people are being manipulative or exploitative
- Experience stress and mental preparation before social events
- After socialising, feeling completely exhausted and needing quiet isolation time away from others to recover
- The tendency to talk fast, include a lot of detail, go on tangents, get distracted, and have difficulty stopping themselves from oversharing, particularly when they are anxious
And, many will have an Autistic or ADHDer child, sibling, or parent, and this is how they realise they are Autistic.
While these patterns have sometimes been called “the female Autistic phenotype,” these experiences are not limited to Autistic women. Men, non-binary people and trans people can share many of these patterns, although they are particularly common among Autistic adult women.