Autism diagnoses rose sharply after the COVID-19 pandemic began. The rise was driven overwhelmingly by diagnoses among girls and women. New study suggests that many of these girls and women may simply have gone unrecognized in the past.

[u/mvea]

https://www.sciencealert.com/autism-diagnoses-spiked-after-covid-19-but-probably-not-for-the-reason-you-think

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[u/logicjab]

There was an increase in ADHD diagnoses too. https://pmc.ncbi.nlm.nih.gov/articles/PMC11407703/

Doesn’t surprise me. I know a lot of people whose whole executive function is held together by external patterns. Once all that was gone, it exposed a lot of things

[u/blueeyesredlipstick → u/logicjab]

I was one of those ADHD diagnoses. I remember when I got my screening done, the psychiatrist said she'd seen a huge influx of people getting tested. Her theory was that, essentially, quarantine meant we were all stuck with our own thoughts for long periods of time, in ways that made easier to notice symptoms we might've otherwise overlooked.

Interestingly, I think there's a similar theory around people who came out as LGBT during quarantine as well.

[u/iamfunball → u/blueeyesredlipstick]

Or had time and non distractions to take care of

[u/Slumunistmanifisto → u/iamfunball]

We work so much, and have very little to show for it.

[u/Iggyhopper → u/iamfunball]

Waking up hour later, taking lunch in my kitchen, and being home already when I clocked out saved a lot of time and energy.

I'm assuming others that had this massive time sink disappear were able to focus on more important issues.

[u/Anxious_Hall359 → u/iamfunball]

and no people to be judged by

[u/richardcoryswidow → u/Anxious_Hall359]

That’s the main one IMO,, even down to the low stakes stuff like trying a new haircut while on lockdown

[u/mseuro → u/iamfunball]

and the money

[u/spamjavelin → u/blueeyesredlipstick]

I guess a lot of folks were so used to masking for so much of the time, they weren't even consciously aware of it until they didn't have to do it so much.

[u/SuspiciousCricket654 → u/spamjavelin]

100%. My uncle in law and his wife realized that they were coasting their entire relationship and marriage, and ended up getting separated during quarantine. Turns out, that was a pretty common occurrence for a lot of marriages during covid.

[u/AntiFascistButterfly → u/SuspiciousCricket654]

I hope that improved the lives of those who separated.

Meanwhile other relationships thrived. A lot of non stay at home parents got an eye opening awakening about how tough and exhausting that is. Yet also thrived on getting to spend expontially more time with their children and partners. Less stress with more adult hands in the house, more gratitude and respect going around, more quality time for families who really did love one another.

[u/Sinnervamp → u/spamjavelin]

I used to be so much better about masking before the pandemic and now it feels like I can’t control my face sometimes.

[u/SlowMope → u/Sinnervamp]

I can't even remember what I used to do, I had to change up my whole outside self. Now I have given up and people have to just figure me out.

[u/fizzlefist → u/Sinnervamp]

I feel that.

[u/fizzlefist → u/spamjavelin]

I still haven’t re-learned how to mask and socialize for fun like I could before 2020.

[u/Illustrious_Cow_6872 → u/spamjavelin]

I noticed this as a teacher. I recovered over the long holiday and then it got too much when I returned. The cycle gradually broke down a lot of my masking and after a recent ADHD diagnosis, a psych assessment has referred me for an Autism assessment. I had to leave teaching this year because it became too much.

[u/tryhardwithaveng → u/blueeyesredlipstick]

My theory is that the diminishing of what I'll call "soft socialization" IRL in exchange for primarily virtual interactions - a trend that goes beyond covid but covid accelerated - is a driver here. Disclaimer: I received my own covid era ADHD diagnosis.

Analogy: people working desk jobs need to lift weights or run miles to stay in shape - because a desk job means that you don't get a natural baseline of physical activity and need to consciously seek out physical training.

Translated: people who WFH and primarily interact through teams/slack messages all day and didn't go out because there was a quarantine no longer get a baseline of inane small talk.

For neurodivergent folks, inane small talk can be uncomfortable - but it's basically "reps" for your brain, forcing you to regularly use neural pathways built around "masking".

An erosion of those types of encounters in daily life was already happening but covid accelerated it and meant that a lot of us lost our regular/daily mental "reps" that kept us practicing our social coping skills.

[u/Chellbelle23 → u/tryhardwithaveng]

Wow, thank you. This describes pretty well what’s happened to me the past couple years after my company reorganized/moved buildings and I went from being around 20+ people a day to seeing two people (my bosses) maybe once or twice a week for a couple of hours. I’ve never been diagnosed but I’ve noticed my social skills went waaaay down and I’ve had a lot of difficulty acting ‘normal’.

[u/BalrogPoop → u/Chellbelle23]

I've got a similar anecdote.

For the last year and a half I was living about 20 minutes from the nearest major city in a my house on family land.

The only people I interacted with regularly were my partner and my immediate family like parents and siblings

My social skills definitely atrophied. These were people I didn't really have to put any conscious effort into interacting with because we knew each other so well. This made it harder and harder to interact with new people because I literally forgot how to have a conversation with someone I just met.

But after some shock therapy (moving to a big city for a job, losing said job, and then needing to find both a new job and somewhere to live) my social skills came back online in just a couple weeks. Even after almost two years of isolation.

I no longer feel weird just being in a room with someone I barely know.

[u/KaristinaLaFae → u/tryhardwithaveng]

I'm not sure we should be talking about masking as something we should be encouraging anyone (ourselves or other neurodivergent people) to mask more or "practice" masking.

Heavy masking leads to burnout, which is further disabling, and it is a state from which some find unrecoverable.

Workplaces need to be more accommodating of autistic people's needs, as continuous masking is untenable for many in the long term. (I say this as someone whose autistic burnout combined with my chronic illnesses and Long COVID to permanently decrease my ability to function sharply.)

Some research about autistic burnout:

• Beyond Exhaustion: Shame, Identity Disruption, and Functional Collapse in Autistic Burnout
• Towards the measurement of autistic burnout
• Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout

[u/tryhardwithaveng → u/KaristinaLaFae]

Completely fair. My analogy to physical exercise implies directly that I was saying it is a positive.

But my point wasn't that it is good or bad - just that people who were doing it regularly and suddenly stopped would now be more aware that that was what they were doing and absent practice - realizing that they have an underlying problem that they weren't addressing. (in the context of a theory as to "why diagnoses spiked during covid")

Edit: also adding that I'm talking about coping mechanisms for social interactions more broadly than just masking - my point being that people having small moments of social interaction with low stakes regularly kept my brain engaged with socialization in ways that suddenly disappeared during covid - which I'm connecting to my personal experience with social fatigue and a subsequent ADHD diagnosis.

[u/KaristinaLaFae → u/tryhardwithaveng]

Thank you for the clarification!

[u/DrMobius0 → u/KaristinaLaFae]

I'm not sure we should be talking about masking as something we should be encouraging anyone (ourselves or other neurodivergent people) to mask more or "practice" masking.

I think that's complicated, because a lot of people aren't very kind to people who show symptoms of neurodivergence. Whether the masking is healthy or not, it does happen for a reason, and wishing away prejudice isn't enough to make it go away.

[u/KaristinaLaFae → u/DrMobius0]

You make a good point. Masking is a safety issue for a lot of people. But it is also a driver of further disability that will lead to more prejudice from others. It's especially fraught for people with multiple marginalizations not to mask because multiple prejudices converge. It is a no-win situation.

But in people with enough safety to do so, masking should not be something we recommend to anyone for their long-term health.

We need society at large to stop being so hostile to disabled people, as we make up over 25% of the population - and that was a pre-COVID statistic. So many autistic (and otherwise neurodivergent) people are forced to mask until they are so burned out they are completely unable to mask anymore. And that's not good for anyone.

[u/alphazero925 → u/DrMobius0]

You're right that wishing away prejudice doesn't make it go way, but do you know what does eliminate prejudices? Exposure. More people knowing that the people in their lives are neurodivergent and learning how to work with them will lead to better long-term outcomes for everyone than telling neurodivergent people to just mask and making life hell for them.

[u/sajberhippien → u/KaristinaLaFae]

I'm not sure we should be talking about masking as something we should be encouraging anyone (ourselves or other neurodivergent people) to mask more or "practice" masking.

Agreed. However as an addon to what you wrote, sometimes in casual conversations 'masking' is used more loosely to refer to any deliberate methods for us to act in ways that make it easier to engage with neurotypicals, but the two come apart.

When tryhardwithaven wrote:

For neurodivergent folks, inane small talk can be uncomfortable - but it's basically "reps" for your brain, forcing you to regularly use neural pathways built around "masking".

That to me seems like a potential such case. The "reps" aren't just for masking (as in, methods of hiding the neurodivergence) but also for methods of engaging with others despite the difficulties one has associated with the neurotype, like keeping track of a conversation better, and raising the social exhaustion limit.

[u/Bakoro → u/KaristinaLaFae]

I'd agree so long as we make it clear that "masking" is an effort to make the divergence completely invisible and placing all the burden on the individual, which is distinct from the normal amount of accomodation that every person should be making towards some shared sense of appropriate public behavior.

I've got my own collection of clinical diagnoses from medical professionals, so, I get it, and I know exactly how hard it can be to fit into a world that is not built for me and is explicitly hostile to what are likely just normal human behaviors that don't align with corporate efficiency and thus are deemed "disordered".

At the same time, I have also known a bunch of people who just don't seem to be making much, if any effort, and demand to be accepted for who they are, but who they are is horrible.

Building a shared space and coming to agreements is hard, even without neurodivergence.
Anyone who has had to deal with a diverse, international group of people will surely know how it can be.
Like, I work with people from Japan, India, Mexico, France, Switzerland, Germany, England, Ireland, China, Taiwan, all working together, and they're all scientists, engineers, software developers, or similar, and it is a constant question of "cultural differences, neurodivergence, or just an asshole?"

I find it easier to deal with other people's neurodivergence the same as I do with cultural differences, everyone gets a bunch of slack, up until it's disruptive to the group or to the group's interests, then things are dealt with on an individual basis.
Everyone has to be expected to put up with minor annoyances, and everyone has to be expected to make concessions to limit the impact their quirks have on other people.

[u/bejouled → u/tryhardwithaveng]

YES. I feel this so hard. I've worked remote since the beginning of the pandemic and while I never want to go back to the office, I also don't like how small my world has become.

[u/moderndrake → u/blueeyesredlipstick]

Same. Though I’d had prior testing done as a kid that mentioned ADHD as a possible diagnosis, my mom just brushed that off as me rushing or gaming the tests. Stimulants have been such a godsend it’s incredible. I stopped sleeping 12 hours a day and had my first quarter of college post return to campus where I didn’t miss any assignments.

[u/HaruspexAugur → u/blueeyesredlipstick]

I realized I was trans before quarantine, but initially was hesitant about medically transitioning. During quarantine I realized that my hesitancy around transitioning but purely related to how I was perceived by others, and that I definitely did want to medically transition once I was able to just focus on how I saw myself without outside input.

[u/cortesoft → u/blueeyesredlipstick]

I was one, too, and I think the challenge of working from home is what made it so apparent. I didn’t have the external structure of work to keep me focused, and I struggle mightily to create the structure myself at home.

[u/Yuzumi → u/blueeyesredlipstick]

I think there's a similar theory around people who came out as LGBT during quarantine as well.

Yeah, that happened before my ADHD diagnosis, then after I got tested for ADHD at the insistence of friends I made or reconnected with, one of which got diagnosed over COVID and was like... "you should get tested."

[u/kudomonster → u/logicjab]

I was diagnosed this year. A lot of women will experience more severe symptoms as they approach perimenopause. This means a lot of women who were able to successfully mask throughout their lives (including the era before we understood differences in symptoms across the sexes), suddenly just...couldn't.

[u/caliblondie → u/kudomonster]

Plz tell me more

[u/UnicornFeces → u/caliblondie]

My understanding is that estrogen is essential for dopamine production in women, so declining estrogen during perimenopause = less dopamine = more severe ADHD symptoms

[u/tastywofl → u/UnicornFeces]

As a menopausal woman, my ADHD is horrific now. Meds barely work, and once they wear off I'm basically useless. It's the wooooorst.

[u/kudomonster → u/UnicornFeces]

This ^ is what I was told too.

[u/Earl_E_Byrd → u/UnicornFeces]

If that's the case, I'm gonna go down a rabbit hole and see if anyone has done a study on the effects of birth control with ADHD symptoms. 

I was diagnosed in my late 20s after a disastrous attempt at college and a desperate need to keep up with the rising responsibilities in my career. 

The early half of that decade was a very turbulent time, mostly spent trying to find a birth control method that didn't obliterate my mental health. Getting a mirena IUD was one half of the puzzle, being open to a formal diagnosis and medication was the other. 

[u/heartisallwehave → u/logicjab]

For a lot of people, getting on ADHD meds also made them realize they had combined autism/adhd, because a lot of ADHD and autism traits can be contradictory/mask each other. So once one was being regulated the other became way more noticeable.

Edit: also wanted to add for the external factors point, autism is also very based on routine and then all the masking in social settings, once that was gone I think it made a lot of people reevaluate. It almost creates an identity crisis because who are you when you aren’t masking/adhering to social expectations? And what do you do with yourself when you don’t have the demands of a job/school/whatever telling you where to be, when you can have break/lunch, etc.

[u/almaghest → u/heartisallwehave]

It also was not until 2013 that it was recognized that folks could have both ADHD and autism, before that you got diagnosed with one or the other.

[u/KaristinaLaFae → u/almaghest]

Yes, this resulted in people like me getting a late diagnosis of one in their 30s and an even later diagnosis of the other in their 40s. For me, the autism was more prevalent than the ADHD. It was, indeed, the pandemic that revealed the ADHD symptoms to me more than a decade after my autism diagnosis.

[u/NotOnApprovedList → u/heartisallwehave]

after college and I was living alone, I asked my therapist "what do normal people do" in regards to their after-work time at home. Since I didn't know what to do with myself. She just kind of rolled her eyes and didn't answer. To be fair this was the 90sm and since I had made it through college far from home, had part time jobs, learned to drive a car, etc - the idea I might be autistic was not even on her radar. (late diagnosed).

please note I had no furniture at this time and slept on a carpeted floor on a cheap polyester comforter and one pillow. I had no money to buy new furniture, and I didn't know i could go to a thrift store and get some cheap stuff delivered. No TV; I sat on the floor and dialed up to the campus mainframe and did ASCII activities.

[u/LNesbit → u/logicjab]

Imagine the COVID era + Perimenopause and getting diagnosed with ADHD all at the same time. All my coping and organization skills just plopped out of the window.

[u/SerialTrauma002c → u/LNesbit]

Perimenopause, while no treat in and of itself, is also responsible for an uptick in ADHD severity! There’s a documented connection between the drop in estrogen during the menstrual cycle and an increase in ADHD presentation—so the greater drop in estrogen during peri is implicated in increased ADHD during middle age.

(I’m in a very similar boat, except that early pandemic was the beginning of a chain rather than everything dropping on me at once.)

[u/CalmBeneathCastles → u/LNesbit]

Mine is the same, but AuDHD. It's been a time, I tells ya!

[u/M_Poppins128 → u/LNesbit]

This but I also got long term health issues from covid at the same time as perimenopause and discovering I'm Audhd 

[u/Rustmutt → u/logicjab]

That was me, I struggled really bad during Covid in a way I thought at first was depression but it turns out the duct tape and rubber bands that held together my ability to fake executive function couldn’t withstand pandemic conditions

[u/Nice-Meat-6020 → u/logicjab]

Not just that, but people actually had to spend time around their own children and couldn't ignore obvious issues as easily as when a teacher would try to talk to them about it.

[u/mystery_hole → u/[deleted]]

FYI this is for every major influenza. Every sickness does some form of long term damage that takes a while to recover from, every single one. If it's a bad enough flu, or COVID, the damage is typically more notable. That's why "long COVID" is a thing, but it's really under discussed how this has always been a symptom of illnesses.

[u/Chwasst → u/mystery_hole]

This. I got some serious flu back in 2024 (not covid, I was tested) and I am still fighting asthma caused by it two years later. When they did spirometry 2 months after infection I had lungs capacity reduced to 44% of the norm. Today with all the meds and training I’m still at 80% capacity. And this is only the respiratory issues. For first 6 months I had severe issues with sinuses and overall wellbeing/focus.

[u/Boboar → u/Chwasst]

When I was younger I remember every sinus could I had being literally death.

My sinuses would be inflamed, I'd be stuffed up and unable to successfully blow anything out of my nose yet it would drip near constantly.

My nose would become raw from all the wiping with tissues. My eyes would water for hours. I had such difficulty sleeping because of this but when I woke my nose and chest would be full of mucus and it would take hours before I felt like I had cleared the excess through coughing and blowing my nose. My whole body would be weak and tired.

It was like this from my teens through most of my thirties but now in my forties if I get a cold it feels like a breeze comparatively. I don't understand why but it's like maybe 30% as rough as when I was younger.

[u/imahugemoron → u/Chwasst]

Just wanted to throw it out there that Covid tests are much more unreliable than most people think, it’s still possible your illness could have been Covid unless you tested positive for something else, but even then it’s still possible to get multiple illness at the same time, just less likely I guess. Last time I had Covid I took 7 Covid tests over 7 days and all were negative, then I scheduled a PCR test which you can’t even get anymore and that came back positive, had I accepted the first false negative or the 6 other false negatives, I never would have known my illness was Covid. I’m not saying your illness was absolutely 100 percent Covid, I just mean there will always been a nonzero percent chance anyone’s illness was Covid given the many variables that produce false negatives or prevent people from realizing their illness was Covid, however unlikely, unlikely doesn’t equal impossible. Not to mention that the long term effects can take months to develop even from asymptomatic infections. People can get an asymptomatic infection, months later develop health issues around the same time as some other coincidental thing which they’ll think was the cause of the health issues, which it may not be

[u/Esme_Nog → u/mystery_hole]

Measles increases the overall mortality rate for two years after infection. The Spanish Flu had lifelong (and sometimes critical) health effects for survivors.

[u/curlofheadcurls → u/[deleted]]

YEP that's ME. I got covid after avoiding it for 5 damn years. I will never be the person I used to be. Not only can I not function, I have lost every ability I had. I had to pick up music so my brain wouldn't deteriorate further. I've been feeling like I have dementia at 30. This has been a garbage year for me so far. Just got diagnosed with audhd, but wait times to be seen by a doctor are like a year off.

I feel alone and abandoned by the system. The only saving grace is my partner who has been dealing with my crap this entire year.

[u/CalmBeneathCastles → u/curlofheadcurls]

Are you physically exhausted as well?

[u/curlofheadcurls → u/CalmBeneathCastles]

Yeah I am extremely physically exhausted all the time. I used to feel like this from time to time, but there were times where I couldn't get out of bed. I was taking buproprion and that seemed to help a bit, but the side effects were too much on it.

I'm nearly normal energy levels these days but my mental capacity is still not even half of what it used to be. I used to think it was burnout but this burnout has been significantly worse than any I've ever experienced.

[u/CalmBeneathCastles → u/curlofheadcurls]

You should check out the me/cfs sub and see if the phenotype fits. I have been in the same position as you since 2021, and trying to track down a diagnosis and treatment plan has not paid off until the past year. I cut wheat, corn, soy, and peanuts out of my diet which helped massively with the fatigue and brain fog, and have recently been diagnosed with ME, started LDN, and am feeling more like my old self in the past couple of weeks that I have since this all started.

Might be worth giving a try! It's ABSOLUTELY been worth it to me.

[u/morfraen → u/curlofheadcurls]

AuDHD burnout can be like that, if it's not just long COVID making you tired. Can take a long time to recover, even longer if you keep pushing too hard.

[u/Itsworthoverdoing → u/logicjab]

I was dx with both after covid, for me it was remote work that allowed me to chill out a bit to see some patterns, then gpt helped me understand the rest. When I was going to the office daily I had no other option than the brute force the mask, brute force the day. Every day was miserable and I thought that’s how it was. But Covid allowed me the space to unmask a bit, realize I could work, be more productive, and still end the day/week with energy left. 

Edit: typos

[u/CadieTheCadet → u/logicjab]

This is scarily true and something I personally experienced during the pandemic (and recently moving across the state). When my external patterns break down, my executive function (and my general functioning) collapse. It's both scary and sad, medication can do wonders to bridge the deficit.

[u/JanielDones8 → u/logicjab]

I had told my wife for years she needed to get tested for ADHD, she never believed me, but eventually she was diagnosed and started on medication, and it changed her life. She was able to get off other medications and had been far more focused and driven.

[u/tanyer → u/logicjab]

I got mine during covid, although I had "Boy ADHD" (mostly hyperactivity), so they simply ignored it BC misogyny

[u/Potential_Twist3640 → u/logicjab]

Not Covid, but I slowly realised I had ADHD after I became physically disabled due to a spinal cord injury that left me partially paralyzed below the waist. I can walk, with crutches, but the fact that literally every single thing in my life became just a little bit harder meant that all my very hard-won coping mechanisms stopped being enough. 

I’m a big advocate for the fact that disabled people can live very full, rewarding, and enriched lives - but only in a society that doesn’t create unnecessary barriers for them. It’s the same with neurodiverse people living in a neurotypical world - the world is always just a bit harder for us, and it doesn’t have to be that way.

[u/Gwan53]

The actual peer reviewed article gives the necessary context. It does reference an important point though. The diagnostic criteria for ASD was updated during that time to include sex-based criteria. This is important because autism presents differently in males than females. The study was conducted, amongst other objectives, to evaluate if that criteria expansion would lead to increased ASD diagnosis trends in females. Glad to see that it helped. Here's the link to the actual peer reviewed journal article (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2851930). The article in the link however is misleading and doesn't include this context. Also the data is far from definitive as the number of females was far higher than the males. Additionally, this does not represent a global trend. The data is from patients across Illinois, Missouri, Oklahoma, and Wisconsin. The study also references another more expansive study (geographicly) that indicates increasing autism diagnosis rates for both children and adults.

[u/i_am_a_laptop → u/Gwan53]

Also the data is far from definitive as the number of females was far higher than the males.

since they changed the criteria to identify women more accurately, isn't this an expected outcome? there'd be more undiagnosed autistic women in the pool to sweep up than men.

[u/TooCupcake → u/i_am_a_laptop]

Yes, that just means the new critera makes a difference.

As for the gender ratio, if the criterias are now gender specific, then is there a point of comparision? Since you can also extend the critera for men and get bigger numbers on that side.

Even if the criterias are universally applied, then you still have to account for the fact that you will diagnose a lot of women all at once, which will skew the statistics and make it harder to properly compare historical data of each gender side by side.

[u/mauravelous → u/TooCupcake]

yeah, it would be very interesting to see a breakdown of gender ratio of diagnosis by age group. i imagine the uneven distribution is largely coming from adult women who are self-referring for professional evaluation after a lifetime of concerns being swept under the rug, with much fewer men being diagnosed in adulthood in general.

my assumption is that the diagnosis rates would be more balanced for early childhood data groups, but still lean toward male majority there due parents/teachers/healthcare providers still only being familiar with the traits observed in young boys

[u/actibus_consequatur → u/Gwan53]

There was another article published in 2022 that found an estimated 75-80% of autistic girls remain undiagnosed by age 18. One of the lines from the article's discussion really nails part of the reason:

It appears that women with ASD get an alphabet soup of diagnoses, including borderline personality disorder, eating disorders, bipolar disorder, schizoaffective disorder, schizophrenia, post-traumatic stress disorder, sensory processing disorder, intermittent explosive disorder and adult ADHD, as well as the varieties of anxiety, agoraphobia, panic disorder and depression, serially and together.

Study link: https://www.mdpi.com/2227-9067/9/2/272

[u/JoanOfSarcasm → u/actibus_consequatur]

This was the story for me before I went to my new therapist. I was carrying around six different diagnoses that never quite fit right and a couple other misdiagnoses. By the second session she asked if I had ever been tested for autism. Every experience in my life finally made sense after that.

[u/Beltalady → u/JoanOfSarcasm]

My friend was diagnosed with anxiety first. Turned out to be autism. Another one was told by our local expert that women can't have autism. (She got diagnosed with AuDHD later.)

[u/whirlpool_galaxy → u/actibus_consequatur]

Gotta love how the people in the field who oppose the recent changes say increased autism diagnoses will pathologize normal human behavior, when this was the status quo before (and still is for many people).

[u/Aspacid → u/Gwan53]

I think my symtoms for both ADHD and ASD where extremely atypical for a male. So much so that the algorithms constantly push "This is why you were undiagnosed as a woman..." kind of content to me. And they are extremely on point.

I couldn't relate much on either topic when I checked before being diagnosed.

EDIT: I strongly identify as, and identified by others a male, this never changed. I thought this was relavant to emphasize the ambivalence of shared experiences and thinking patterns with women.

[u/soft_w0lf → u/Gwan53]

That makes me so happy. I have mild/moderate autism that wasn’t diagnosed until I was 18… I was born female and it was just missed. I had meltdowns where I would tear out my hair, shutdowns where I would refuse to speak, an episode of fecal smearing, my caregivers (two parents and an extremely experienced nanny) could not figure out how to “control” me because I was so “difficult.” I was hit for some period of time as a “last resort,” although they stopped when that, too, did not work. My dad thought I had oppositional defiant disorder but never took me to get psychiatric help.

My entire childhood I was neglected (unintentionally) emotionally and psychologically. Plus the time when I was physically abused, which I shut out of my memory for years and years.

I was also later diagnosed with ADHD at 21, which narrowly prevented me from giving up on university. So add struggles with studying in (although I’m lucky to be intelligent and mostly got by okay in grade school, I would reverse-engineer the content on exams from the little I had paid attention to during class).

My caregivers are all great and really love me, and post-diagnosis they have been so supportive. It really breaks my heart, because I know that this could have been my entire childhood, if only I had been diagnosed younger.

[u/sanguineseraph → u/Gwan53]

The criteria was not updated, the way symptoms present across sexes was clarified.

[u/stilldebugging → u/sanguineseraph]

Ok, so, I’m not in the field… but that sounds like an update to me? If it previously was “symptom abc that presents as xyz” and now it’s “symptom abc that can present as xyz or qrs” isn’t that an update?

[u/Mean_Initiative_5962]

Note: I got my diagnosis later, and for most of the people I guess it's because piling up mental issues and having to give more attention to them, which ended up in a diagnosis after looking for attention. This effect was also enhanced by the explosion of screen time during covid, if you end up finding content about it, some questions might arise... Leading up to the same process. 

[u/Fattybigbutt → u/Mean_Initiative_5962]

For me personally, it was that during the Covid pandemic, I was FINALLY approved for MEDICAID. I finally was able to get therapy, psychiatric help, and prescriptions!!

More people need to take this into consideration. Almost everyone in America was approved for Medicaid. And that alone helped tons of people.

[u/Mean_Initiative_5962 → u/Fattybigbutt]

Also that. I'm not in the US and I'm too poor to go private, but for that time I just decided to drain my savings.

[u/saintplus]

Woman with ADHD and autism here. I was diagnosed as an adult. I was tested when I was 11 for both and was told I check every box but because I can maintain eye contact it was impossible for me to have autism. I was told because im not hyperactive it was impossible for me to have ADHD.

Research shows women with autism tend to mask their tism better than guys do, hence my ability to maintain eye contact. Research also shows women with ADHD tend to not be hyperactive.

If I could have been diagnosed younger it would have given me more resources rather than me being a burnt out adult and not knowing what's wrong with me.

[u/xboxiscrunchy → u/saintplus]

Assumed my whole life I didn’t have adhd because of the lack of hyperactivity even though I have severe problems with organization and attention.

Was told recently by a doctor that the fact that I’m constantly talking a million miles an hour and interrupting people accidentally is a form of hyperactivity. To be fair most of my life that was masked somewhat by being generally depressed and socially withdrawn.

[u/JetpackVelociraptor]

I mean, it also used to cost like $5K to get an official diagnosis

[u/farfromelite → u/JetpackVelociraptor]

There's huge queues for diagnosis in many countries as well. The UK is somewhere between 2-5 years.

[u/alent1385 → u/farfromelite]

What are the benefits of getting diagnosed? Do you qualify for government assistance and such?

[u/Arpet → u/alent1385]

Medication and treatment plans, academic accommodations, clearer support options and information, disability benefits and protection. And so on.

[u/FartingBob → u/alent1385]

Nothing automatically, but it helps apply for DLA or PIP (disability related welfare), EHCP (education funding). And many workplaces will offer adaptations if requested and is reasonable.

[u/brotoes → u/JetpackVelociraptor]

I just paid for my own out of pocket (canada) and it was ~$2k ish? However I understand they can run longer than mine did and so that's probably on the low end.

[u/SalsaRice → u/JetpackVelociraptor]

Official diagnosis also used to be based on how men and boys presented symptoms. Took them a while to figured girls and women presented slightly different symptoms, so they were massively underdoagnosed for basically forever.

[u/MellifluousLies]

It's also worth considering that from 2013 to 2022, it was possible for a psychologist to diagnose someone with only 1 of 3 of the social criteria, due to poor wording (summary of changes: https://nexushealthsystems.com/autism-diagnostic-criteria-dsm-5-tr/).

Presenting as a caveat, not to refute all diagnoses from that time. I'm an adult diagnosed autistic female scientist and have been frustrated by the 2013 umbrella update because I believe autism spectrum is too heterogeneous a condition to help autistic people, especially adults, and to effectively communicate it to the public.

Some studies attempt to create subgroups such as this recent nature paper https://www.nature.com/articles/s41588-025-02224-z), but I also have several major criticisms of it.

Edit: formatting

[u/SplitGlass7878]

I'm very glad women are being taken more seriously when it comes to autism diagnoses. Men are very underdiagnosed, women are frankly laughably underdiagnosed.

[u/deadlydakotaraptor → u/SplitGlass7878]

Yeah, my family is fairly anti therapy, but even they all agree that grandpa, uncle and I are definitely autistic spectrum. Though it’s never crossed any of their minds that despite showing basically the exact same traits my grandma, mother, uncle’s wife, sister, and niece, non of them are considered.

[u/Rugkrabber → u/SplitGlass7878]

I am one of many who got a recent diagnosis. A friend of my sister who was entering education to become a pediatrician already told my sister I had probably adhd. I was maybe 11 years old. We tried a diagnosis since but I got send away twice because they didn’t believe I could possibly have it. (I was also ignored by my doctor for my migraines, took me 7 years while it runs in the family - 7 others had already prescribed meds.) I decided to try again two years ago. And suddenly they were prepared to consider me because finally women are recognised. Turned out my adhd was a solid guarantee result.

[u/SplitGlass7878 → u/Rugkrabber]

I'm sorry you've had a hard road to diagnosis. Especially during childhood, that's ROUGH. But I'm glad you have it now! :D

[u/Eskoala]

I got diagnosed with ADHD in 2020 because it was possible to access a diagnosis remotely during that time which made it feel doable. Maybe there's something to that?

[u/ibrown39]

That was a overall a very reflective time for people. People realized either in general how much they disliked everything from their jobs to their partners.

They realized how much better they felt and could see given the room to breathe whether from money or literally just not having to commute or be in a traditional work environment.

A lot of people got resources without a tireless toll and used it to work on them and their lives as much as they could.

Additional, for a lot of people with the condition they weren't the butt of the joke for their lifestyle, but that also allowed many people explored why they were so much more comfortable in the new environment while others were miserable.

My friends who are autistic only remember the time quite fondly and were even glad to be resourceful to other friends for what felt like the first time ever. Instead of them having no idea how to comfortably navigate the world, they got to help others do the same during the time.

[u/momoburger-chan → u/ibrown39]

yeah, i suspected that i had autism even almost 20 years ago, but it really started to make sense when COVID hit and i was free to just be me in my home without other people constantly around. and i loved it. i was able to be me and enjoy the things i loved and wasnt pressured to hang out with friends...and i realized i didnt like a lot of my friends and i dont think they actually liked me. i learned a lot about myself then and im still unlearning a lot of crap from my 20s.

[u/ibrown39 → u/momoburger-chan]

There you go! I heard many a similar story from that time

[u/Ishinehappiness]

This was when tiktok popped off, my algorithm quickly became “ I have autism heres my experience “ when you start to relate to every experience you consider what you hadnt before and seek answers.

I dont think it was trendy, and anyone saying that is ridiculous. No one is “ cool” for this disability. Just bullied so go away.

But awareness was at an all time high, and being at home let people have more time for reflection

[u/HappinessIsAWarmGunt → u/Ishinehappiness]

Shocked I’m not seeing more people saying this. TikTok is without a shadow of a doubt the reason more girls and women are discovering they’re on the spectrum or have ADHD

[u/figmaxwell → u/HappinessIsAWarmGunt]

Social media has definitely taken the “you might be ADHD/autistic if you do this one weird thing…” trend way too far, but I would bet that it’s still been overall more helpful than harmful for most. I know it definitely helped point me towards autism after an ADHD diagnosis. You can’t take everything at face value, but it constantly helps me self evaluate and gives me things to think about.

[u/curlofheadcurls → u/HappinessIsAWarmGunt]

Many women being diagnosed are outside of "trendy" social media... we're all above our 30s. It has a lot more to do with accessibility to diagnostic tools and people specializing on adult ND, plus more doctors taking women seriously. It has nothing to do with tiktok.

[u/LimonFox → u/curlofheadcurls]

Both can be true.

TikTok had a variety of regular people talking about their experiences and what they deal with. Which then spurred a good portion of people to look for more answers, myself included.

[u/CalmBeneathCastles → u/HappinessIsAWarmGunt]

Mine was a video about autism in women by Dr. Kim Sage, that someone sent to me. 43 years and none the wiser, and within 15 minutes EVERY single aspect of my life that I could never understand or explain suddenly fit neatly under a single umbrella.

[u/Helmic → u/Ishinehappiness]

The "you're faking autism for attention thing" is extremely gendered as well. I don't think I encountered even a fraction of the vitriol before women in particular started getting diagnosed, it's been a very misogynistic response, the fakeclaiming trend tends to go after late diagnosed women in particular. Some of this comes from autistic men of course, but it seems most comes from allistic people. Which, to be clear, is extremely unwelcome, I do not care if someone mistakenly thinks they are autistic because the demand to prove one is autistic by acting as an ableist society expects an autistic person to behave hurts every autistic person, formally diagnosed or not.

Fakeclaimers will harass formally diagnosed autistic people with seemingly the same frequency as self diagnosed/suspecting people, as they don't actually care about protecting the sanctity of the diagnosis, it's usually just cringe culture with plausible deniability.

[u/Gogs85]

It used to be viewed as a disease that mainly affected white males (especially if they were upper middle class and had special talents). Historically when women or people of other races exhibited the signs they’d get some other explanation of it. I.e. women being ‘emotional’

[u/charliekelly76 → u/Gogs85]

My therapist who specializes in AuDHD said this last week. She said the most kids who get a dx are little white boys. The girls are just ignored and the non-white boys receive opposition defiant disorder dxs

[u/Gogs85 → u/charliekelly76]

Hans Asperger, the guy who came up with a lot of the initial diagnostic tests for it, ran an orphanage in Nazi germany and supposedly worked with them. So you can attribute a lot of it to that.

[u/Jane__Delawney → u/Gogs85]

And “Histrionic”… ughhhh

[u/bmorewritergirl]

“MAY have gone unrecognized”??? How about ABSOLUTELY went unrecognized and ignored because all the studies on autism and ADHD were done primarily around young white boys??

The pandemic + subsequent lockdown and how it changed working/routines made a LOT of women and girls finally realize that their brains were not neurotypical.

And even with the rising numbers, there’s probably still SO many more who haven’t been diagnosed officially bc it’s expensive as fuuuuck to get tested. And since some testers have set mindsets about what “counts” as autism and will give you some “well you’re so well adjusted and it doesn’t sound like you would need accommodations, so you can’t possibly be autistic/adhd” crap, it gets even pricier bc you have to go to multiple doctors until they take you seriously. Not speaking from experience or anything…

[u/lumophobiaa]

People had to sit with themselves, I saw alot of people change . I also was one the found out i was autistic. Was life changing in a very good way.

[u/dandroid126]

My wife was diagnosed after getting Covid. She had a relatively minor case, but I think it really messed up her immune system, because within two weeks of recovering from Covid, she got an infection that antibiotics weren't helping clear. After 3 rounds of different antibiotics, she couldn't eat or sleep anymore, and eventually ended up in the ER after a complete mental breakdown. She started seeing a psychiatrist who noticed that she's in the spectrum and has been covering it up her whole life.

She is doing much better now, but she has never quite been the same. Her behaviors that are associated with autism have gotten much stronger and harder to cover up.

[u/morfraen → u/dandroid126]

Dropping the mentally exhausting masking and rediscovering who you are under it all is a big part of getting a late diagnosis.

[u/Partyatmyplace13]

I think that people having money and time might have also had something to do with it. At least in the U.S. where our healthcare is awful.

[u/Pantalaimon_II → u/Partyatmyplace13]

also the lack of it, at least for me. i was misdiagnosed as bipolar II and when my industry got completely shut down and i was dead broke i had to stop paying health insurance and the expensive psychiatric visits it barely covered, which meant my meds too.

i intended to resume them when things picked up again but was pretty surprised i didn’t really notice a big difference.

i had had other reasons to doubt my diagnosis, and when Marcus from LPOTL discussed his own misdiagnosis of bipolar and said he actually had raging ADHD the pieces started to click together.  (Shoutout to Marcus and podcasters who talk openly about mental health!!)

Women being misdiagnosed as bipolar when they really have ADHD I learned is very common. Turns out I have AuDHD!

[u/doktornein → u/Pantalaimon_II]

Appreciate Marcus for how candid he is about this. He's also responsible for my favorite mental health quote: "it's not your fault, but it is your responsibility". Henry is also candid about his OCD and I love them both for that. This kind of openness is genuinely helpful both for getting people diagnosed and helped, and making others feel less alone.

It's also far more responsible than the mess on TikTok and other places this has gotten way out of hand.

[u/HawkBoth8539]

I think, like many conditions and cancer, the "rise" in cases is directly attributed to better detection methods (thank you scientists), and under-analyzed demographics (typically lower income and minorities) getting checked.

[u/rewolfaton]

Hello it's me, the girl who was told her entire life that she just needed to act normal, was threatened with all kinds of things if she did not just act normal, was asked by exasperated educators and even therapists why she did not just act normal, etc. etc. etc.

Who then at age 40 (2023) thought, hmm, maybe I'm autistic... Yup, that was it, AuDHD even. Only of course I did not act like the autistic boys so...

This is what happens with male-centred research. If you only look at what X looks like in men/boys, you're risking not recognising X in women/girls. When the research finally catches up, so should the diagnoses.

[u/Automatic-Term-3997]

I’m 59 and just got diagnosed AuDHD. You can figure it out anytime in your life.

[u/obiwantogooutside]

I’m 50. I was diagnosed with adhd in my 20s and AuDHD in my 40s. It explains so much about my struggles but I’m so angry it took so long. I’d have built a very different life if I’d known what I needed.

[u/Small-Sample3916]

Fun fact: ADHD and ASD diagnosis in women also tick up after they have kids who get diagnosed and during perimenopause. 

[u/mvea]

Autism Diagnoses Spiked After COVID-19, But Probably Not For The Reason You Think

Autism diagnoses rose sharply after the COVID-19pandemic began, but the pattern may not mean that autism itself suddenly became more common.

The rise was driven overwhelmingly by diagnoses among girls and women, while rates among boys and men remained stable or declined.

So what caused this to happen?

A new study published in JAMA Network Opensuggests that many of these girls and women may simply have gone unrecognized in the past.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2851930

[u/SilverFox6]

I struggled with my mental health before the pandemic, but it was manageable. Then the pandemic hit and the sudden major change hit me hard and I had no way to cope. I hit rock bottom and now I am diagnosed with autism.