Thanks to social media (looking at you, TikTok), TV shows (hi, Love on the Spectrum), and passionate advocates (sup, Holly Robinson Peete), there’s been a major increase in autism awareness. That’s obviously a lovely thing, but you’re not alone if you’re still wondering, What exactly is autism, and—actually—do I have autism?
Autism spectrum disorder (ASD) is a neurodevelopmental condition (like ADHD and dyslexia), that specifically impacts how you behave and socialize, according to The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). That’s because, when you have autism, your brain processes social interactions and sensory information (the way things sound, taste, feel, etc.) differently, says Lauren Kerwin, PhD, a clinical psychologist specializing in ASD. Those differences can make you feel overwhelmed, isolated, and anxious in everyday scenarios, she adds.
The way this shows up in someone’s life depends on a lot of factors (more on that later), but if you’ve spent a little time on ASD TikTok, you might assume autism mostly means loving routines, hating certain textures and sounds, and being super into your hobbies. Which, relatable! While that might be true for some with ASD, having special interests, despising cotton balls, and being totally inflexible of altering your schedule doesn’t automatically mean you’re autistic. [Heads up: Some people prefer to say, “I am autistic” whereas others prefer “I have autism.” We’ll be acknowledging both preferences here by using both in this article.]
To help you figure out what’s an actual trait of autism, what’s not, and what that means for you, we asked experts for all the details. Plus, we’ll explain what causes ASD and how to get a diagnosis and support.
One quick thing before we dive into the details: Mental health is complex and everyone has a unique experience, so don’t go diagnosing yourself just because you read a few articles on the internet (though, we do appreciate you stopping by to learn a few things). If this resonates with you, consider it a jumping-off point in your journey to getting care. OK, let’s get into it…
What is autism?
Neurodevelopmental conditions like autism impact the brain and nervous system, according to the American Psychological Association (APA). By definition, ASD traits start showing up during childhood, but many people aren’t diagnosed until they’re adults, possibly because they learned “masking” to blend in with neurotypical people, and also because autism can be misdiagnosed as anxiety, says Agnesa Papazyan, PsyD, a clinical psychologist who specializes in ASD.
While autism traits have to have been present since childhood, how they show up can change with time, per the APA. Dr. Kerwin adds that a few things can impact how your traits manifest and how severe they are, including your environment, your coping strategies, and what accommodations you have access to. Your age and developmental stage also play a role. “Much like when you become a teenager and experience a shift in your emotions and behaviors, or when you're an adult and experience your relationships in a new way, autistic individuals will experience changes in how their characteristics present as their lives progress,” Dr. Papazyan says
What are the characteristics of autism?
There are two main categories of ASD traits. The first is a persistent struggle with "social communication and social interaction" across multiple areas of your life, like school, work, home, and interpersonal relationships, according to the DSM-5-TR. That could look like struggling to have a back-and-forth convo, catch on to non-verbal cues, or maintain friendships. Some people with ASD are totally nonverbal or rely on just a few words or phrases to communicate, which would be classified as ASD with an accompanying language impairment, the DSM-5-TR states.
The second bucket of characteristics is called "restrictive, repetitive patterns of behavior, interests, or activities” in the DSM-5-TR. Traits that tend to fall under this category include repetitive movements or speech, like repeating someone else’s words or rocking back and forth to self-soothe when you feel overwhelmed, Dr. Papazyan explains.
Engaging in “restrictive, repetitive” patterns can also impact what you do for fun and make you hyperfixate on specific interests, like memorizing flags or collecting trinkets, which could be a source of comfort. This goes beyond getting stuck on a specific phrase, fixating on a niche hobby, or making the exact same breakfast for months/years at a time. For peeps with ASD, this might feel almost like a dopamine hit when you find something you're truly interested in, Dr. Kerwin says. When your brain’s tickled in this way, it can make you want to engage even more and understand everything about a certain topic, like memorizing pi or every Chanel bag, she explains. These hyperfixations can impact your ability to get things done or connect with others, even if you don’t necessarily realize just how invested you are in these things, Dr. Kerwin says.
Sensory issues are also common for autistic people and can contribute to restrictive and repetitive patterns. This can go one of two ways: You’re super sensitive or hyposensitive, meaning not sensitive at all, to different sensations, says Dr. Papazyan. This can affect many aspects of a person’s life, including the clothes you wear, the foods you eat, the places you go, and how you experience pain. For example, someone who’s hyposensitive may be less bothered by hot or cold temperatures, while someone who is hypersensitive might be incredibly bothered by certain fabrics or textures.
To be diagnosed with ASD, you have to have experienced all of the social difficulties above and at least two of the restrictive, repetitive traits listed in the DSM-5-TR at some point in your childhood (even if you managed to function just fine at the time). And these characteristics have to negatively impact your professional, social, or personal life today, even if you don’t necessarily notice the impairment.
Again, the way this shows up varies from person to person. Every autistic person is unique––and their traits manifest on a super broad spectrum with a variety of presentations, says Dr. Kerwin. FYI: That’s what the “autism spectrum” means; it’s not a scale from least to most severe.
That said, the level of severity when it comes to autism traits is also something that experts care about because it can help them identify what kinds of support you’d need. According to the DSM-5-TR, there are three “levels” of severity: Level 1 is least severe, Level 2 is moderately severe, and Level 3 is most severe. Sounds simple, but it’s not. Though more severe levels of ASD could require more care, that’s not always the case, per the DSM-5-TR. Plus, severity in one class of characteristics doesn’t necessarily mean severity in the other type, says Dr. Papazyan. “You could have a person who is super social and can have back-and-forth conversations at a Level 1. At the same time, they are a Level 3 for rigid, repetitive behaviors, like they're constantly flapping their hands.”
What causes autism?
Neurodevelopmental disorders are ones that impact the brain, so we know that the characteristics of autism are related to neurological differences. But researchers aren’t sure what’s responsible for those brain differences, Dr. Papazyan says. While the DSM-5-TR suggests things like premature birth, being exposed to medications that cause fetal abnormalities while you were in the womb, or your mother’s age when you were born might play a role, this is all pretty speculative. As is pretty much any explanation you see from a sketchy medical “expert” on social media.
There could be some genetic factors at play too, Dr. Papazyan adds. For example, if your family tree includes autistic folks, you’re more likely to have autism, notes the DSM-5-TR. This doesn’t mean you’re destined to have it though. And you can have ASD even without a family history. The DSM-5-TR also says “as many as 15% of cases of autism spectrum disorder appear to be associated with a known genetic mutation,” which means it’s not always caused by this.
Whatever the case, we know there are a variety of differences related to brain development and functioning in people with autism. Research suggests that people with ASD experience an overgrowth in some parts of the brain in early childhood, followed by a decline in size during and after adolescence. Some of the brain regions that are thought to be impacted in ASD include the frontal lobe (which rules executive functioning—like planning and flexibility), the amygdala (which helps us process emotions and social cues), and the temporal region (which is involved with language and socializing), Dr. Kerwin says.
All these differences can make it challenging for autistic people to do things like decode body language or facial expressions and have conversations that flow. Switching tasks and adapting to new information can also be really tricky and distressing. “This can make social situations difficult to navigate, potentially leading to social withdrawal or misunderstandings,” Dr. Kerwin says.
How do I get diagnosed?
Speaking to a therapist or other mental health pro who specializes in autism is a solid first step if you think you might be autistic. On top of considering the diagnostic criteria in the DSM-5-TR, they’ll have you fill out questionnaires that ask about your friendships, work, and hobbies to get a clearer picture of your life, Dr. Papazyan says. Since ASD affects social functioning, a big part of getting a diagnosis is the provider seeing how you interact with them, Dr. Kerwin adds. They’ll likely pay attention to things like eye contact, speech patterns, and how you react to nonverbal cues, she explains. If possible, they might even speak to people who know you to get a full picture of how you behave and interact with others—now and throughout your life. Ultimately, this assessment can help determine if you have ASD and, if you do, what areas of your life you need the most therapeutic or caregiver support with.
You might already be thinking about diagnosing yourself, which is popular thanks to more people sharing their experiences with self-diagnosis on social media, increased awareness about the condition in pop culture, and tons of posts listing off “signs and symptoms of ASD.” Or maybe mental health care is inaccessible for you (relatable) and you’re annoyed by the lack of diversity in ASD studies and the fact that even experts say the diagnostic criteria can be lacking and biased. All that can make self-diagnosis feel way more empowering.
But without a therapist's help, it can be hard to know if what you’re experiencing is actually autism—especially since ASD can overlap with anxiety, depression, ADHD, and OCD, Dr. Kerwin says. The DSM-5-TR also states ASD is often linked to other developmental disorders too. Plus when you don’t get a professional evaluation, you risk living with an incorrect self-diagnosis, which could mean you use coping tools that don’t actually work for you and that could lead to worsening or new problems, Dr. Kewin adds. Still, looking to legit resources (like The Organization for Autism Research, the Autism Society, or the CDC) can help you learn more about the condition and yourself and can be a jumping-off point for seeking professional support, Dr. Papazyan says.
What does support look like?
Because the condition impacts everyone differently, there's no one-size fits-all support. Whatever route you go, the goal isn’t to overhaul your life and turn you into someone you’re not. Instead, the aim is to help you manage in a way that makes socializing, adapting to change, and regulating your emotions easier, Dr. Kerwin says.
The best type of support for you will depend on what characteristics you are targeting. But most people with autism could benefit from talking to a mental health pro (like a therapist, psychologist, or psychiatrist), Dr. Papazyan says.
For starters, a therapist can talk you through whatever tough feelings come up in your life—whether they’re related to ASD or not—and any overlapping conditions, like depression and anxiety, Dr. Papazyan says. Talk therapy modalities like dialectical behavior therapy (DBT) can help you address any unhelpful restrictive or repetitive behaviors, while also teaching you emotion regulation skills, Dr. Kerwin adds. DBT is especially helpful if you experience suicidal ideation, which is prevalent among autistic people, the DSM-5-TR states.
A therapist can also work with you to develop self-soothing techniques if your restrictive, repetitive behaviors stem from emotional distress or sensory issues. If you struggle to convey your needs or complex ideas, a therapist can help you understand and communicate why you feel or think a certain way, Dr. Papazyan explains.
Working with a psychiatrist is useful if you’re curious about adding medications to your mental health toolkit. While there’s no pill for people with autism, there are some promising antipsychotic medications that are used to treat irritability and restrictive, repetitive behaviors in children, Dr. Kerwin says. And if you tend to experience anxiety or depression, you can talk to a psychiatrist to determine if taking medication for those conditions could help your mental health in general.
Support can also look like working with specialists and coaches to assist you with things like social skills, sensory issues, and professional interactions, Dr. Kerwin says. If having a back-and-forth conversation is your biggest area of opportunity, a speech therapist can help you understand nonverbal communication and develop more conversational skills (like asking follow-up questions) so you can play off the other person a bit more. If you struggle with sensory issues, an occupational therapist can help you get more comfortable with various sensations or learn more effective ways of coping, like using noise canceling headphones at a loud coffee shop. If landing a job is the goal, a job coach can help you navigate the pits of LinkedIn and Indeed while preparing you for interviews and workplace politics, Dr. Kerwin adds. Honestly, the list goes on and on.
When searching for any sort of coach or therapist, it’s important that they’re qualified to work with autistic people and can help you achieve your goals, so don’t be afraid to ask for their credentials, Dr. Kerwin notes. (If you want to build a dream team of specialists but don’t know where to begin, try the Autism Society’s provider referral program.)
If you’re really struggling with your condition and can’t live on your own because you can’t communicate with others or take care of your daily needs, support could include a reliable and constant caregiver who can help you cook, clean, manage finances, interact with other people, or even care for your basic health and hygiene needs, Dr. Papazyan says. In some regions, there are government-backed programs that can connect you with a group home, adult daycares, and other special services, she adds.
Whatever support path you choose, you might also want to connect with other autistic folks to continue to learn more about the condition and have people you can relate and talk to, Dr. Papazyan suggests. On top of tapping into local support groups, you could also follow advocates who share their experiences with and expertise in ASD on social media, Dr. Papazyan says. To get you started, consider seeing what content creator Callum Stephen or autistic psychologist Dr. Joey are sharing.
Whether you have autism or not, help is available for whatever obstacles you might be facing.
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
