Autism is not just for children and while we have many diagnosed adults within the AsIAm Community we do receive requests from many more asking about getting an adult diagnosis. 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 inaffective, 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 and/or alcohol as a coping strategy. In fact, some people may only notice their autistic traits after entering a rehabilitation programme.
Therefore, although autism is not a mental illness, poor understanding of autistic traits and uninformed approach to treatment can cause significant distress to an autistic adult’s wellbeing. 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 way the assessment process works for adults can vary across different professionals.Currently in Ireland, an adult autism diagnosis needs to 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 very obvious ‘signs’ that they are autistic as they have learned to ‘mask’ them over the years.
A good psychologist or psychiatrist with a modern understanding of autism and a neurodiversity affirmative position will be able to still see autism. Meetings with your psychologist would involve talking about your life, your background and why you think you might be autistic. You will discuss information from your past that you think is relevant and try your best to describe how you experience the world.
Some psychologists will insist 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.
The process of getting an assessment as an adult should feel like a collaborative and respectful process between you and your psychologist. While the psychologist is using the DSM-5 in the background, what it should look like is 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 that you will experience with a particular psychologist or psychiatrist, you may need to look around for a different one.
Unfortunately, at the moment in Ireland, there are no public assessment teams dedicated to adult diagnoses. Currently, the vast majority of 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. It is very important that you undertake an assessment with a professional that is 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 also may be advisable to talk to your GP. There are many private psychiatrists who do require a GP referral. While your GP may only refer you to a private psychologist or psychiatrist, it is important that your GP understands you, and also is able to see the demand for these assessments in Ireland and advocate for them appropriately. You will need to provide your GP with a very specific list of the reason why you think you might be autistic as they may still hold outdated ideas about autism (for example that autistic people can’t make eye contact).
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Some autistic people choose to self identify and don’t see the need to access an official diagnosis. This is of course 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 greatly help with this, and can be a therapeutic process. A big benefit to accessing an official diagnosis is it can help provide you hopefully with the right supports and reasonable accommodations either in college, the workplace or in accessing disability benefits. A formal diagnosis is not merely a label. Assessment and diagnosis opens many doors for the following reasons:
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 a lot of anxiety due to sensory overload or the stress of ‘masking.’
Some autistic adults may even have spent time in to psychiatric units when autistic burnout is mistaken for a nervous breakdown. This can lead to being misdiagnosed with a personality disorder or even being given incorrect medication. These combined issues also mean that difficulty entering and keeping long term employment is 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 for them to access.
Some private psychologists provide once off consultation sessions where you can meet with a psychologist to discuss your thoughts around autism, answer any queries you might have 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:
Caroline Winstanley, Online practice providing child and adult autism assessments. Queries email contact@carolinewinstanley.com
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 info@adultautism.ie
Catherine O’Kelly, Irish practice specialising in adult autism assessments. Bookings: https://www.catherineokelly.ie/contact/ Queries: info@catherineokelly.ie
Dr. Emer Bowman Dublin Well Woman Centre, 67, Pembroke Road , Ballsbridge, Dublin 4. T: +353 (01) 668-1108
Honan & Associates, 4 Molesworth Place, Dublin 2, Ireland. E: info@honanandassociates.com
