Subclinical? Or invisible woman?

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Hello out there

I am a 40 year old woman and after in depth research and study of autism have recognised that many of the things I have been reading resonates with me and puts my life to date within a context I understand. So, I went to a diagnostic clinician and had a discussion which was very intense for me as I felt incredibly exposed (and maintained my passing act to cope so with held stuff like my food/eating issues) to be told that the framework of Aspergers was very relevant to me but given that I had excellent ways of coping it was felt there was no need to go through the full diagnosis because there was no medical need. I'm married have kids and a job so evidently I'm fine... (I didn't know what to say to this!) Even when I explained the crippling anxiety that literally paralyses me, the excruciating social autopsies I conduct every time I have to interact beyond my sphere of experience. Anyway ,spiel done. Sub clinical feels like nowhere. I'm wondering whether this is because the current parameters of diagnosis don't fit the contours of what autism looks like for woman? I was told that i had too much insight and empathy. It felt like I was being dismissed because my life ticked boxes. Anyone else have this type of experience?

There is sure enough a phenomenon of some adult females often being harder to diagnose correctly, especially if they have gone through life managing to learn "NT" behavior, cope or mask their difficulties outwardly; if I'm not mistaken even clinical psychologist Tony Attwood has acknowledged this. There are often two problems for women, that of running into a clinician who is not experienced with female presentation and the ways it can differ on the surface from men and boys', and also a high functioning female that has learned to "pass" so well that she finds it habitual to keep the cover-up going.

I noticed that you stated how, during the interview with the clinician, you maintained your passing-act in order to cope -- it is indeed some women and girls diligent efforts to fit in and "pass" for "normal" that can stab them in the back when in a diagnostic situation.

is the time of all times to try and discard the coping masks and be candid in fully disclosing all issues you are experiencing or have historically experienced, in order to allow your clinician to fully assess you. They need to know basically everything you can inform them about you in terms of behavior past and present, because it all plays into getting an accurate assessment.

If you hold anything back it may be the thing that would have contributed to your clinician recognizing what's genuinely going on, whether that be the autism spectrum and/or anything else.

If there is any way you can make a new appointment with another clinician, preferably one who perhaps makes a specialty of autism in females, and then start over by including every piece of information, not holding back telling them about events or behaviors of the past, and allowing your mask to stay at home while the evaluative conversations are conducted, you will get a better shot at a more accurate assessment, all things being equal.

Masking "too well" and holding back the information about your history may have been the cause of this clinician so easily telling you all is well. It's also a wee bit ignorant, for want of a less harsh word, for that person to have told you that just because you have a marriage, kids and career, that you must be "fine" and there's no need to be assessed/obtain a diagnosis. That may be true, or it may not. Many members of WP right here have all those things too and yet are formally diagnosed, as the two are not always mutually exclusive despite the social difficulties inherent in the condition.

Also, only you can know if you're truly "fine" on the inside, as another thing about masking and passing is that it can hide a world of woe, struggle, anxieties, and breakdowns that happen behind closed doors back at home. Someone can pass for "not impaired" but are suffering consequences they need to report.

Hope this helps somewhat.

... Oh .

Thank you for replying, that was helpful. Not only to read what you wrote but to have put it out there so to speak. I think I have done just as you said and been too "ok". I am very suspicious of professionals as I have been misdiagnosed with "episodes" and "dysfunction" amongst other things. I think I will try again when I feel resilient enough. I will ask that my medical history is reviewed with this framework in mind. I'm actually not fine but have spent so long getting through not being fine I find it almost impossible to allow myself to be that vulnerable to someone. Hence the issue with how I present and what I actually experience. I really did try but I couldn't say the words out loud. Maybe I should write it down.

Yes, it definitely helps to write down or type out notes detailing anything you can think of that illustrates how and why you believe you may be on the spectrum. There's another thread on WP at the moment, "Got appointment to get tested," where some of us mention the notes we created as reminders of what we want to tell the clinician, and of answers to questions that may come up.

You can bullet point aspects of the diagnostic criteria that apply to you, detailing actual situations to illustrate, and you can also create notes under headings like "Sensory issues" "Meltdown and shutdown history" "Social deficit events" etc. It can help to have these notes to refer to when speaking to the clinician about why you seek an evaluation. List everything that to you is impairing to your life. Outward "success" in things like being able to work, stay married, raise children etc doesn't exclude the possibility of still experiencing impairment in the struggles to have achieved or maintain any of this, indeed, all of it could be falling apart but if all your clinician sees is a happy life "on paper," they can decide it isn't even worth proceeding, all because they don't have the full information on how you really are.

If you bring notes you've prepared beforehand, that deeply explore what you feel your issues really are, it can help give them a much bigger window on your real situation.

Here's the thread:
http://wrongplanet.net/forums/viewtopic.php?t=288250

Basically, if one is "subclinical" and exhibits relatively mild autistic symptoms, it can be said that that person is within the Broad Autism Phenotype (BAP).

I, myself, am sometimes, BAP, sometimes Aspergian. It depends on the day.

Yep...that's me.