Autism Borderline Personality Disorder

Autistic women and misdiagnosed BPD

Today is World Autism Awareness Day so I wanted to write about autistic women and misdiagnosed BPD.

Autistic women and misdiagnosed BPD - Just A Square PegIf you’ve visited my blog before, you’ll know why I’m blogging about autistic women and misdiagnosed BPD.

You might also be wondering how often autistic women are misdiagnosed with borderline personality disorder (BPD) and other mental health conditions. From chatting to women from all walks of life, the answer seems to be: far too often.

Autism has always been seen as a male condition and for the women who have been living undiagnosed or misdiagnosed, they deserve to be seen and noticed too.

In this blog post I’ll be talking about:

  • autism diagnosis in females
  • why autistic women are being missed
  • Misdiagnosed mental health conditions
  • My mental health diagnosis experience
  • Moving forward

Along the way, I’ll be using some terms you might not be familiar with so they’re below in case you need to refer back to them:

  • Masking: A common behavioural trait which involves learning how to mimic ‘socially acceptable behaviour’ in order to hide autistic behaviours (I’ve discovered I do this and it’s EXHAUSTING!)
  • Stimming: A repetitive self-soothing action that might look a bit out of place in society but helps to calm someone (for example, hand flapping, making noises, and rocking to name a few)
  • Neurodiversity: A range of differences in brain function and behaviours in relation to being autistic

Autism diagnosis in females

Getting a formal diagnosis if you’re female is really difficult, with many women being diagnosed later in life. The reason these women are being missed is because of the gender stereotype associated with autism which is providing a gender gap in diagnosis and also, support. It’s thought that for every three males diagnosed, one female is diagnosed (source).

There are a few reasons that professionals and charities alike have listed, including:

  • Females ‘mask’ or camouflage better than males
  • Lack of understanding as to how autism presents in females
  • The diagnostic criteria has always leaned more towards autistic males
  • There’s more extensive research about autistic males than females
  • Females ‘show less restricted and repetitive behaviours and interests compared to boys’ (Source)

It’s therefore really tricky to try and ask a medical professional for an autism assessment, instead of them giving medication for a mental health condition you might not have. Women also tend to have ‘internalising symptoms’ like depression, anxiety and even eating disorders (Source).

Why autistic women are being missed

Autistic women and misdiagnosed BPD commonly seem to come hand-in-hand. After doing some research into it for my own situation, I discovered some interesting reasons why autistic women are being misdiagnosed with mental health conditions:

  • Women internalise their feelings which means they can show as depression, anxiety, eating disorders and, borderline personality disorder
  • We’ve learned social cues so can disguise ourselves, like chameleons, in plain sight (society).
  • Women like me are going for private assessments only to be told we don’t ‘fit the criteria’ because our interests aren’t so intense
  • Many women don’t question their diagnosis if they think it might be wrong.

Questioning your mental health diagnosis, given by a mental health professional, can seem like a rookie move. These people are the experts and they know best. And a lot of the time, they do. But when it comes to neurodiversity and mental health, they’re learning as they go. This is great but there are so many women being missed in the process.

Misdiagnosed mental health conditions

According to the National Autistic Society, ‘women and girls are more likely to be misdiagnosed, with 42% of females diagnosed with a mental disorder instead of autism.’ (Source). So women like me, are being diagnosed with anxiety, depression, bipolar, eating disorders and personality disorders, could actually just be autistic. They might not need medication to help them function. Instead, they might just need access to good support and guidance to help them navigate life with a neurodiverse brain. If someone had told me earlier on in my life that I was autistic, I would’ve been able to do the research, find support and learn as I went. Instead, I’ve been reading information that hasn’t really helped me that much. Now I know why a lot of it didn’t resonate with me.

My mental health diagnosis experience

As with anything, it’s not been the most straight forward. The road to recognition and diagnosis has taken unexpected twists and turns. There have been points where I’ve wanted to give up. But then I realise that I deserve to be recognised and understood. When I went for that first GP appointment over 10 years ago and was told I had depression, I was in the dark about anything to do with my brain. I thought I was never on the same wavelength as anyone else and depression almost proved it. 10 years on and I’m still getting to know me better and being a square peg isn’t all bad. However, being in the middle of two diagnoses is confusing. Even though the two overlap, I feel like my identity is in jeopardy.

Moving forward

It would be amazing to see the criteria changed/updated so that more females receive a diagnosis. The difference it would have made to me growing up would’ve been HUGE. There would have been a real explanation of the way my brain works. I wouldn’t have thought that being different was a bad thing. I wouldn’t have thought that not understanding instructions right away or flapping my hands when I got overwhelmed were failures. Females deserve to be assessed on the same level as males. Autism isn’t just a male thing. The sooner the criteria is updated, the better it will be for future generations who need help understanding who they are.

Beth x

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