Autism is not a condition experienced solely by children. While we have many diagnosed adults within the AsIAm Community, we also receive requests from many more asking about accessing an adult diagnosis, either after recognising autistic traits in their children or after completing an online self-assessment or test. In the last few decades, our understanding of autism has advanced far beyond its original definition.
Why should I get an autism diagnosis as an adult?
Many autistic adults, especially women, can be misdiagnosed with mental health issues such as depression, anxiety or BPD. As a result, the prescribed medications and therapies are usually ineffective, which will lead to further feelings of frustration and poor self-worth. Undiagnosed autistic adults may have spent time in a CAMHS unit due to these misdiagnoses.
In some cases, undiagnosed autistic adults may turn to drugs or alcohol as a coping strategy. Some people may only notice their autistic traits after entering a rehabilitation programme.
Therefore, although autism is not a mental illness, a poor understanding of autistic traits and an uninformed approach to treatment can cause significant distress to an autistic adult’s well-being. With this in mind, an adult autism diagnosis often comes as a relief.
Aoife Dooley (pictured here) was diagnosed at the age of 27.
“It’s like you’re constantly looking for an answer you don’t know the question to…When you get a diagnosis as an adult it’s bizarre because everything and nothing changes at the same time. You’re still you, but now you have the tools to understand who you are and how you work.”
Questions We Ask Ourselves
The assessment process currently works for adults varies across different professionals. Nowadays, in Ireland, an adult autism diagnosis must come from a Psychologist or a Psychiatrist. In-depth interviews and gathering of information about your life and how you view the world would be similar across who you may see. You will likely meet with the psychologist/psychiatrist (online or in person) for one or more interviews to discuss your experiences. Sometimes adults seeking a diagnosis aren’t showing undeniable autistic traits as they may have learned to ‘mask’ or camouflage them over the years.
A good psychologist or psychiatrist with an up-to-date understanding of autism and a neurodiversity affirmative approach to their work will be able to understand the nuances of the autistic experience. Meetings with your psychologist may involve discussing your life, background, and why you think you might be autistic. You will discuss information from your past that you believe is relevant and try your best to describe how you experience the world.
Some psychologists may request that a parent or other family member is involved in your assessment (by meeting the psychologist or providing additional information). But not all psychologists insist on this, and many will put your voice at the centre of the assessment. If you do not wish for a family member to be involved, you can look for a psychologist who does not require this.
It’s important to remember that an autism assessment for an adult is an exhaustive process to identify your neurotype, not a test you can pass or fail. Even if you aren’t recognised as autistic, you will likely find answers during this process, whether it is a different neurodivergent condition such as ADHD or an anxiety condition with symptoms which resemble autistic traits.
Getting an assessment as an adult should be a collaborative and respectful process between you and your psychologist. While the psychologist is using the DSM-V in the background, it should look like two adults working together to see if autism is the right fit for your experiences. If you do not feel that this is the process you will experience with a particular psychologist or psychiatrist, you may need to look around for a different one.
Unfortunately, in Ireland, no public assessment teams are dedicated to adult diagnoses. Most adults who think they might be autistic can only get an assessment privately.
Most private psychologists in Ireland do not require a GP referral to access a psychological assessment for autism. You can self-refer by contacting them directly. You must undertake an assessment with a professional familiar with autism in adults and works in a respectful, neurodiversity affirmative way (i.e. that autism is not seen as a problem to be fixed but a naturally occurring difference to be understood and celebrated).
It is advisable to talk to your GP. Many private psychiatrists do require a GP referral. While your GP may only refer you to a private psychologist or psychiatrist, it is essential that your GP understands you and can see the demand for these assessments in Ireland and advocate for them appropriately. You will need to provide your GP with a precise list of why you think you might be autistic, as they may still hold outdated ideas about autism.
Some autistic people choose to self-identify and don’t see the need to access an official diagnosis. This is valid and widely accepted within the autistic community (particularly given how difficult it is to access a public assessment). Some other people would like the opportunity to talk it all through with a professional and help get some clarity and understanding around themselves and their life experiences.
Going through the assessment process with the right psychologist can significantly help and be therapeutic. A significant benefit to accessing an official diagnosis is it can help provide you hopefully with the proper support and reasonable accommodations in college, the workplace or in accessing disability benefits.
Due to financial factors, long waiting lists, misdiagnosis or even outdated ideas relating to gender, there are large numbers of autistic adults who never received a formal diagnosis. Without a full understanding of themselves, these individuals likely have grown up with anxiety due to sensory overload or the stress of ‘masking.’
Some autistic adults may have spent time in psychiatric units when autistic burnout is mistaken for a nervous breakdown. This can lead to being misdiagnosed with a personality disorder or even given incorrect medication. These combined issues also mean difficulty entering and keeping long-term employment is a frequent problem. Since there is no public route for pursuing an adult diagnosis, they may be forced to go private, which may be too expensive to access.
Some private psychologists provide once-off consultation sessions where you can meet with a psychologist to discuss your thoughts about autism, answer any queries, and explore whether a full autism assessment is right for you. See our list of private practitioners for psychologists providing these.
Four practitioners who do provide adult assessment and diagnosis of autism are:
The Adult Autism Practice, Irish practice specialising in a neurodiversity-affirmative approach to adult, autism assessment. For ease of accessibility, all contact is online. Comprehensive details, including cost, waiting time and booking, can be found here: www.adultautism.ie. Queries email [email protected]
Dr. Emer Bowman Dublin Well Woman Centre, 67, Pembroke Road , Ballsbridge, Dublin 4. T: +353 (01) 668-1108