You’ve always felt a little bit different, but how?
You are an adult and a high achieving professional, you consider yourself smart, but quite often you find it difficult to appear smart because you have always lacked street credibility. You feel like everyone except you has a secret handbook with instructions on how to behave and be part of the team. You cannot follow three plus people conversations and it always seems that you interrupt others or they won’t let you talk. You also don’t know where to stand in gatherings or when walking alongside colleagues. Is there no space or something? You get quite often lost in long corridors and triple over minor floor bumps. You think it is unfair that people are unreasonable and they almost always get away with it. When people and especially bosses are vague about what they expect from you, you find it impossible to work with them. Subtle comments and instructions fly under your radar, resulting in you appearing non conforming or lazy. And then you are often in trouble, especially after trying to explain the situation in a face that never seems to have a convincing expression on, with a voice that comes out of your mouth sounding like a broken tape recorder.
Does this description look familiar?
Main signs of autism
According to the NICE guidelines, we need to consider an assessment for possible autism when one or more of the following characteristics are present:
1. Persistent difficulties in social interaction
2. Persistent difficulties in social communication
3. Stereotypic (rigid and repetitive) behaviours, resistance to change or restricted interests,
plus one or more of the following:
1. Problems in obtaining or sustaining employment or education
2. Difficulties in initiating or sustaining social relationships
3. Previous or current contact with mental health or learning disability services
4. A history of a neurodevelopmental condition (including learning disabilities and attention deficit hyperactivity disorder) or mental disorder.
Unfortunately the above criteria are quite vague and generic, plus we could all potentially identify with some of the traits to a certain degree . An autism diagnosis can be suspected by healthcare professionals or education professionals, but cannot be confirmed, neither ruled out by them. An autism specialist needs to be involved in every case a diagnosis is sought. This is one of the reasons individuals on the spectrum get often self diagnosed. It usually starts with a suspicion and following extended research, the truth is often quite evident, although not confirmed.
Highly achieving individuals will be able to overcome most of the above referred difficulties. The signs will often be quite subtle, especially since they will be able to mask and work their way around uncomfortable or difficult situations. The choices already made, consciously or subconsciously, often reflect the need for limited social interactions, for an example working in IT or choosing a medical speciality with little or no patient contact (radiology, microbiology, anaesthetics, surgery).
What are some of the common signs of autism in adults though and how do they affect everyday interactions?
Some of the signs of high functioning autism in adults can include:
Finding it hard to understand what others are thinking or feeling
People often say one thing and mean another. In our neurotypical world this is considered to be a socially acceptable if not necessary behaviour. Unfortunately people on the spectrum find it very difficult to play by these rules. We often take things literally and therefore we then give the wrong answer. I think most of us must have heard the expression: ‘Oh, you’re too honest!’ more than once in our lives, although most of the times the response takes the form of an uncomfortable silence. This, in combination with the fact that others can make subtle suggestions or comments that fall off the radar, can often lead to misunderstandings and communication problems at work.
Getting very anxious about social situations
Social gatherings can be especially exhausting for autistic individuals for many reasons. I will list a few here, but I am sure you could add more to my list:
1. Too many stimuli (loud music, noises, lights, people coming and going and parallel conversations can be really distracting and stressful).
2. Joining other people’s conversations is difficult if not impossible. We don’t know when our turn is supposed to be and we quite often interrupt or say the wrong thing. The problem is we realise it afterwards when things are already awkward.
3. We hate small talk. It is not only that we consider small talk a waste of time, I mean it really is. It is actually physically painful. I often feel I’d rather be slapped in the face by a complete stranger than having to invent fake and indifferent questions, in order to get fake an indifferent answers and appear polite to someone I don’t know, I don’t care about and I will probably never see again.
We are also very likely to answer honestly questions like ‘how was your day’ and unfortunately people really don’t want to hear how your children have been misbehaving all day, or how you had trouble removing a lubrication bottle out of someone’s rear end. We are good with real one to one conversations though, if anyone is accidentally interested in having one.
4. We don’t like to change specific routines. For an example if Friday night is family time for pizza and a film, so it should be every week.
Finding it hard to make friends or maintaining friendships
Most of us our loners by choice or not. I guess the above reasons explain this as well.
Seeming blunt, rude or not interested in others without meaning to
Facial expressions is not the autistic individual’s forte . When we try to say something which involves feelings, or even when trying to pay an honest compliment, our face appears to be broken as if we intend to mock the other person. We often have to say: ‘I really mean that’ afterwards. This is very annoying taken in mind we are probably more honest than anyone else who can say the exact same thing more convincingly.
Other signs may include:
Avoiding eye contact.
Not getting too close to other people, or getting very upset if someone touches or gets too close.
Noticing small details, patterns, smells or sounds that others do not.
Having a very keen interest in certain subjects or activities.
Liking to plan things carefully before doing them.
I guess the last three characteristics explain the reason why some autistic individuals are choosing specific professions that require a tendency towards perfectionism and a passion for detail and very specialised interests.
Autism in women and men
Autism can sometimes be different in women and men. For example, autistic women may be more shy and may appear to cope better with social situations. This means it can be harder to tell someone’s autistic if they are a woman. Autism in women is a whole different story though that deserves it’s own near future post.
Getting on board the Nebuchadnezzar
What should you do if you recognise more than a few of this traits in you? It is not always easy to decide on whether you want an official diagnosis. There is still a lot of prejudice even amongst healthcare professionals who don’t quite understand that neurodivergent people with their innovative way of thinking have always made a difference when it came to scientific and technological progress, but also in the world of art. On the other hand a formal diagnosis will probably give you validation and relief that could prove priceless. At least for most.
If you are currently in the process of investigating the possibility that autism might be the cause of your problems, I would suggest to start by doing some research. A lot of research. Read articles, get in touch with autistic individuals, read books. You can find some sources here as well. There are also a few good youtube channels that you can follow. Asperger’s from the inside is my favourite. Next, if you are brave enough, you can try taking one (or twenty in my case) of these free online tests. NOTE: they are only indicative and they don’t replace an official diagnosis.
You can try the following:
https://www.clinical-partners.co.uk/for-adults/autism-and-aspergers/adult-autism-test/
https://www.nice.org.uk/guidance/cg142/resources/autism-spectrum-quotient-aq10-test-143968
The procedure of getting an official diagnosis though is an entirely different story and I am planning to tell you all about mine in a near future post. I am also looking forward to learning about your diagnosis pathways and stories, the challenges you faced and how you handled the disbelief you encountered from colleagues and health professionals. In the meantime, research and stay on board!
Pingback: Autistic doctors at work - The Autistic Doctors