Being diagnosed with PTSD was one of the most validating things I’ve ever experienced. Not only did it lead me down a path of healing, it helped me to discover my autism.
When I decided to seek a diagnosis for my autism, I was told, “You can’t be autistic because you have PTSD.”
Because of my history, this was a huge red flag. I grew up being disbelieved. No one seemed to notice the abuse I endured, or how it impacted me. Reaching out for help for my sensory or safety needs meant being gaslit about having them.
It taught me that there’s a big difference between the truth and what people think they know, especially when stigmas are involved.
As I’ve listened to other autistic voices, this same assumption about PTSD canceling autism keeps popping up. Despite their best intentions, professionals seem woefully unprepared to recognize the needs of people who have experience with both.
Research indicates that autism has strong connections with PTSD in two important ways.
- There’s an increased risk of social trauma from bullying, abuse, and alienation. Autistics are also at a higher risk for exposure to other adverse events like poverty, mental illness, or social consequences from our parents’ autism.
- Our neurological variations seem to be located in the same parts of the brain that PTSD injuries occur. Specifically, the autonomic nervous system, which controls our sensory processing, emotional regulation, and fight or flight responses, and in the prefrontal cortex, which helps with things like planning, decision making, and social interactions.
We have several overlapping characteristics with PTSD because the neurology is quite similar. This seems to make us more vulnerable to developing the stress disorder.
This is why things like masking and fawning are very similar to each other. Rumination, sleep disturbances, anger, and avoidance are other common shared traits.
There are many differences, though. For example, meltdowns are not the same as flashbacks. Both can be triggered, but they are distinct entities. Flashbacks are from sensory information causing an onslaught of memories, both conscious ones and the ones we store in our bodies. Meltdowns are from sensory or social overload.
Autism also comes with restricted interests and different types of social impairments.
The Developmental Disorder
The type of complex PTSD that stems from childhood adversity is considered in some research to be a developmental disorder.
Trauma at early ages prevents developmental milestones from occurring. Children can’t develop healthy attachment styles, emotional regulation skills, or a proper sense of self. They’ll struggle to recreate stability as they grow older. These issues are made worse when kids are exposed to totalitarian control, like abusive households or what it seems to be the point of ABA.
Autistic children who grow up with narcissistic abuse will display complex PTSD symptoms as well as autistic traits. It can be difficult to tell which is which, but they are different from each other. They absolutely can occur together.
Making Distinctions Between PTSD and Autism
The myth that PTSD excludes autism, especially in abused children, sounds eerily similar to the Refrigerator Mom school of thought. This was a theory proposed in the 40’s that said autism was caused by mothers who wouldn’t nurture their children.
The fatal flaw of the theory was that it overlooked all the kids that didn’t fit that model. It ignored abused children who weren’t autistic, autistic kids who weren’t abused by their mothers, and neurotypical children who shared parents with autistic children.
Once research uncovered the genetic components of autism, this theory lost its support. Yet, the stigma remains, haunting the lives of diagnosis seeking adults who want their autism recognized. Or whose autism was overshadowed by the effects of trauma.
Trauma imprints itself on our bodies and our minds. It creates in survivors a need to measure all future events in relation to the trauma. Will this person, place, or opportunity keep me safe or take me back to a place of danger?
Autistic people experience our environments in heightened ways. Our social experiences are perceived through a lense unique to us. We are more likely to notice our traumas and experience them more deeply on a biological level. Regulating stress reactions is more difficult for us.
Our biology and our perceptions may predispose us to PTSD, but the autism is an inborn neurotype. PTSD is an injury that occurs after an event. The genetic components of PTSD only represent a predisposition towards it. People without this genetic connection can still get PTSD.
Our Perceptions Do Not Make Us Weak
The bottom line is that there are a lot of comorbid conditions associated with both PTSD and autism. The idea that these two are some special exception is short-sighted at best. At worst, it causes harm by moving people away from being able to recognize their authentic self.
Personally, I think autism is what saved me from my abuse– not in some hokey Pollyanna way, either. Being autistic meant that I questioned things and spoke the truth no matter the social costs. My sense of justice, my passion and focus for seeing below the surface of things drove me to find the coping skills needed to live a better life.
We are empathetic people who experience an intense world. Our trauma is real. We deserve to know our neurology fully. Authentic living saves lives.
Sources:
Haruvi-Lamdan, N., Horesh, D., & Golan, O. (2018). PTSD and autism spectrum disorder: Co-morbidity, gaps in research, and potential shared mechanisms. Psychological Trauma: Theory, Research, Practice, and Policy, 10(3), 290-299.
Laidler, J. R., MD. (2004, September 15). The “Refrigerator Mother” Hypothesis of Autism. Retrieved from https://www.autism-watch.org/causes/rm.shtml
van der Kolk, B. A. (2005). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408.
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41 Responses
Congratulations on your first post on The Aspergian!! I especially related to this: “Being autistic meant that I questioned things and spoke the truth no matter the social costs. My sense of justice, my passion and focus for seeing below the surface of things drove me to find the coping skills needed to live a better life.”
I was the same way. I questioned EVERYTHING and didn’t understand the need to keep “family secrets”, which sounds horribly dirty to me every time I say it. *shudders* Ick!
I wanted to cry reading this. The gaslighting I have been going through with doctors is ridiculous & scary; every time my trauma is blamed for my physical pain or sensory overload, I feel like screaming. I have been in RO-DBT for years (extreme ocd therapy) & just started adhd medication & I literally have no idea how I’m supposed to feel. What the hell is normal?!! I’ve been trying to fit in my whole life while getting shut down for speaking my truth/standing up to others/learning adaptive social techniques (but not rally getting why others act the way they do) & I feel like I’m being punished for surviving what I went through without a ton of support. Reading this article made me feel so validated in my experiences. It’s so hard to feel confident when you’ve been told your experiences are wrong or you’re overly sensitive or the abuse you survived made you weaker. I feel so much less alone after reading this & I hope you are feeling happy & healthy. Thank you so much for sharing your experiences; I am so grateful to you.
Such a great article! Well written and researched, there are some very interesting differences you point out!
I can relate. Still waiting at the age of 50 for an official diagnosis due to the complexity of my own circumstances blurring the line between Autism and trauma. I thought that having Autism would so impair stress management that the possibility of PTSD would be multiplied, especially when a lack of accurate diagnosis in less aware past times would relegate any behavioural issues to be due to personal character flaws.
Trauma and autism can definitely look similar. In case anyone is reading this article because they’re looking for an accurate diagnosis, here’s something that could help: https://www.wikihow.com/Distinguish-Between-CPTSD-and-Autism
Number 2 on the list — Rule out CPTSD if no trauma is present. This totally ignores the role of preverbal trauma, which is the root of many people’s trauma history. It also ignore that many people are traumatised in ways that just feel normal to them because they’ve nothing to compare it to — I find this especially with childhood emotional neglect.
Hey, I’m one of the editors on this article and you’re right that people don’t always recognize trauma easily. Thus, they may falsely “rule out” trauma even though they’ve actually experienced it.
I made some changes to step 2 and added a tip near the end to reflect that sometimes people don’t realize they’ve endured trauma. What do you think?
I can’t find the section anymore.
If you mean that you can’t find the step I’m talking about, it’s step 2 of the article.
If you mean that you can’t find any problems with the article anymore, then that means I fixed it!
Sorry I meant I can’t find the tip near the end that you say reflects that sometimes people don’t realize they’ve endured trauma. There are several things in the article that for me don’t reflect an understanding of how invisible a trauma history can be and really in my opinion how impossible it is to disentangle developmental trauma from autism. I don’t think we can ever know for sure where the line is, Trauma can happen in the womb and you may never know. Autism doesn’t have a specific gene you can locate to definitively separate it either. Maybe it doesn’t matter anyway.
Oh, I integrated it into step 2 of the article. I felt that the fact that people may not fully understand they’ve been through trauma was important, and if I made it a footnote, it could be missed.
One article can’t capture all the complexities of trauma and autism and potential reasons for things, but I’m hoping the overview will help people inform themselves so they can do further research, exploration, and/or therapy to untangle it.
Of course I agree one article can’t capture everything and it’s great you’re bringing up the topic but I don’t see how what you wrote in point 2 says that people can have suffered developmental trauma and not know they have, that there can literally be no story of what happened.
I’ll leave it here but the section below makes many assumptions that suggest a lack of understanding of the fact that trauma can be invisible not only to the outsider but also to the person themselves:
‘The fatal flaw of the theory was that it overlooked all the kids that didn’t fit that model…, autistic kids who weren’t abused by their mothers, and neurotypical children who shared parents with autistic children’
I don’t agree with the theory of the refrigerator mum but somebody can be seriously wounded by their mum and not know, it can be invisible from the outside and two children in the same family can have totally different experiences with the same parent / of the same situation.
Also re the below quote genetic components suggests autism can be delineated by genes which isn’t true and I don’t see how the genetic components would change anything in terms of the refrigerator mum theory.
‘Once research uncovered the genetic components of autism, this theory lost its support’.
Thanks for writing it it’s brought up really useful discussions.
ladysnessa,
Thank you for writing this. I had pondered this question a few weeks ago myself, and may have searched to see if anyone else had wondered as well. I don’t remember coning across anything significant at that time. But now when I wasn’t specifically looking for it, here it appears, with research, comparisons and sources cited. Again, thank you so much 😊
This really resonates with my own experience. I thought I had post-traumatic stress before I considered autism. After diagnosis I suppose I assumed that I didn’t have post-traumatic stress, but keep being existentially overwhelmed to the point of despair at how much harder things feel than pre-trauma. Had a traumatic childhood which to a great extent I had overcome, but traumatic events from five years ago are very much with me. Thank you.
Thank you so much for this great post. I feel invalidated so often when I hear from a doctor that my autism isn’t real, it’s just my trauma. Masking ~= fawning is not something I’d considered before. Thank you thank you thank you.
As a therapist who supports Autistic people who have PTSD I’d really like to hear from the Aspergian community about what you feel helps with the ongoing pain and distress.
As an autist with PTSD I have not found any sort of therapy that helps. I tried EMDR but the practitioner kept falling asleep. I also could not focus on any discrete memories, which I was told was necessary for EMDR to work. Cognitive behavioural therapy did nothing. Another practitioner told me to keep a “gratitude journal”, and I was “experimented on” with various psychotropic medications because none of them worked. I still have side effects from one of them, and I haven’t taken any for at least a decade. I just have to live with it all, for better or worse.
In 2014 off my own bat I got into Mindfulness to help me deal with a bout of panic attacks I started suffering on top of the usual Anxiety I’d been diagnosed with for 20 years along with Depression. I wasn’t seeing a therapist at the time and just winged it but it really helped in abating the attacks and then avoiding them altogether. I haven’t looked back and expanded it into deeper meditational practices which really help accelerate the effective Mindfulness-based therapy I’m now getting.
It is hard work dealing with resurfacing traumas and letting them go, it can be very painful, but ultimately it’s very rewarding for me. Getting the formal Autism diagnosis earlier this year aged 50 also really helped confirm the link between my undiagnosed Autism in my earlier days and the subsequent Trauma (including intergenerational) that I’m now dealing with.
This is a question i ask a lot. Just ran into this today.
https://www.scientificamerican.com/article/does-autism-raise-the-risk-of-ptsd/
This is the first article I read as I travelled home on the train, after receiving my official autism diagnosis.
As late-diagnosed woman who is continuing to recovering from CPTSD, it was timely.
Thank you for writing this!
“narcissistic abuse”
That’s an ableist term. Narcissism =|= abusive. They can co-occur, but they’re not synonymous.
How is this ableist? Narcissism is a personality disorder, not a neurotype.
Narcissism is more of a personality trait, which in its problematic manifestations forms the basis of NPD. I feel the original commentator missed the context of the use of Narcissism in this article implied NPD manifesting as parental gaslighting-style abusive behaviour, rather than its non-pathological forms. https://www.researchgate.net/profile/W_Keith_Campbell/publication/225077608_The_narcissistic_self_Background_an_extended_agency_model_and_ongoing_controversies/links/54c30a970cf219bbe4ea2e6f.pdf
I don’t believe the term narcissistic abuse means that they have to be occur together, I read this as a specific type of abuse. Someone with NPD has certain characteristics, and if they become abusers, the recipients of such abuse tend to report very similar types of abuse. We can all display narcissistic tendencies, this is not the same as having the disorder. It is very unlikely that someone with this disorder will not be abusive in some way, abuse is not always physical. I’m not sure what was ableis about the term, however, I’m open to your view.
I can confirm, since I am autistic and have PTSD. I can tell the difference between flashbacks and meltdowns, but I’m not sure anyone else can. Both are difficult to live with and I am certain the abuse I received from nearly everyone as a child was due to non-diagnosed autism.
I was 33 before Asperger’s even had a name, and I didn’t hear of it for another decade. I’d spent my whole 20s (= the horrible Seventies) trying to become “normal” by listening to therapists who (naturally) saw PTSD and tried to help me by constructing exaggerated victimization scenarios arrived at by reverse astrology. Autism awareness has given me the realization that I’m always already the “real me.” Thanks for this article and others that are helping us sort all this out by ourselves.
I am so excited to have found this!! I am being treated for CPTSD (though I often think I am an imposter). I started seeing a psychologist to try to find a way to better cope with pain from peripheral neuropathy. I don’t have an official diagnosis but therapist believes trauma as a child is playing a significant role in how I respond to pain. Lately I have come to suspect I am also on the spectrum. Every autism test online I have found indicates I am likely ASD. But then I started thinking a lot of my autistic traits could be from CPTSD. I am embarrassed to ask to be tested for both but it sure would be nice to have confirmation… and not feel like an imposter…
As for the empathy question. I am curious if anyone experiences this.: If I see someone get hurt like maybe scrape a knee or even have a near miss from injury I get an electric like surge through my body and it takes 10-15 seconds or more to recover. Is it typical, autistic, PTSD??
I absolutely love this article, so often those who provide diagnosis are closed minded to the possibility of multiple instances. In your case Autism and PTSD as in mine Autism, G.A.D. and CPTSD. This is exceptionally well written and moving.
autism is an ‘inborn neurotype’ do we know this? My understanding is that there has been no specific gene found that links directly.
Personally, I think autism is what saved me from my abuse– not in some hokey Pollyanna way, either. Being autistic meant that I questioned things and spoke the truth no matter the social costs. My sense of justice, my passion and focus for seeing below the surface of things drove me to find the coping skills needed to live a better life.
We are empathetic people who experience an intense world. Our trauma is real. We deserve to know our neurology fully. Authentic living saves lives.
Yes yes yes!
Yes! I agree completely!
I started having counselling for what, at first, I suspected was attachment issues – already had a formal diagnosis of Asperger syndrome at 17, which current therapist “confirmed” in early session but has now reneged on after I asked the difference between concrete/abstract concepts and realised I could understand both. I’ve always questioned the original diagnosis anyway, although at the same time it felt like a relief to find out, and every test I’ve taken indicated I could be on the spectrum. Never had meltdowns, though, and feel I understand body language/expressions fairly well. Non-offensive hand/arm gestures often baffle me. I used to obsessively collect information about things I was interested in (a favourite singer, animals etc). I have trouble making/keeping friends and have lost a lot of interest in/got more discerning about building friendships with as I’ve got older. Means I only have one or two acquaintances but I’m ok with that.
I experienced parental abandonment at an early age (post partum depression/neglect) and was bullied through all school years/college. The longest I went without being picked on was one weird, but glorious week! Not saying this to get sympathy but I’m just getting more confused about what I actually have. Leaning more towards PTSD on it’s own.
Autistic people absolutely can have PTSD and it’s disgusting and outdated to think that someone on the spectrum can’t experience negative emotions or feelings. We might not always show emotions externally but we absolutely feel them inside.
In my own experience, I am diagnosed ADHD/Aspergers and self diagnosed as cPTSD. I noticed that after I was able to complete remove myself from my abusive childhood and read a lot about working through trauma, my PTSD symptoms gradually decreased to the point that I don’t think I would qualify for a diagnosis anymore. In contrast, my ADHD/Aspergers symptoms have gotten worse, as is common with age. In particular, I noticed that the “positive” aspects of being of the spectrum, such as rapid learning, hyperfocus, and special interests all greatly increased as my PTSD lessened.
Hmm, that is an interesting symptoms relationship and it does feel like it should make logical sense.
As for me, was professionally diagnosed cPTSD a couple years before the professional autism diagnosis.
And a couple years before that was diagnosed ME/CFS.
Haven’t noted interaction between the cPTSD and autism but have noticed both of those get more intense during ME/CFS flares.
Everybody is different and you don’t truly know how which will interact with what until it happens.
Who thinks ‘that someone on the spectrum can’t experience negative emotions or feelings’? That’s bizarre. I’d say that autistic people are more prone to CPTSD if the environment is adverse. The two (autism and CPTSD / insecure attachment ) can be hard to separate though.
The environment I was raised in by adoptive parents certainly was adverse! My adoptive dad had bipolar, was an alcoholic and put the family through narcissistic abuse, whereas mum wasn’t strong enough to stand up to him effectively, or leave when she probably should have. Have since found out from talking to a biological sibling, my birth mother had bipolar, too, but if she’d been psychologically well, would likely have been a better parent for me than my adoptive ones.
My counsellor has been great for the most part, but she is still human and as such has blind spots. One like that shouldn’t exist though, I agree.
Thank you I believe I am on the spectrum All my life I had so ial prems but I had abuse it wasn’t until later in life when I realize I responded differently though I overcame allot and succeed everything I did ,I struggled daily .I cannot name all of it .After working with children with these conditions…and having a son who displayed the same still I had to fight for him throughout his education..I realize later that my score for Asperger’s was much higher in which I tested myself .Because I was abused and suffered with anxiety depressing eye contact and social/ communication … dyslexia eyesight .Many more …I believed it was trauma…I trained and struggle with this as a child .and as an adult I trained myself to talk to maintain eye contract and to phra phase especially in my health care classes.Help me allot with learning to communicate in which I shared with My son with Asperger’s…as a child I taught him emotions ..early on..I believed that you can teach behavior But is this masking or teaching response ,to difficult socializing confrontations to involve oneself to interesting interaction with yoru own self interests as learning to understand another’s ..although briefly ..it is a catch of successful interaction.So I am traumatized ..with all these debilitating neoudivergents and PTSD could this be both …Triggered Trauma ss and social ,,triggers along with physical triggers .Are debilitating …So it is that Both ..I have aquired and masked though successful endeavor these .This can leave you Traumatized..do to continuations of traumas ..In which is debilitating for most . Those who where mis diagnosed or misplaced or pushed under the rug for being intelligent and persevere a daily struggle to intwine in society as( just odd )or troublesome behaviors Such as defiant or stubbornness
Therefore in the eyes of society you are just that.
In reality you are unique and much more than that .For this I am ,both .
This article really helped. I suffered abuse as a child: emotional neglect, physical neglect, physical and verbal abuse, sexual abuse… I had a childhood that can only be comparable with a dumpster fire. Still, I was the perfectly quiet kid, getting on with work, seating calmly in her stained shirt, covering her face with her dirty hair, doing everything as perfectly as possible. I could speak since a freakishly early age and writing and art were my special interests. I could tell if anyone had been in my room and touched something because the order of my beloved trinkets would be upset. Each part of the day had a feeling to it, and that feeling would get mangled if something different appeared or happened. When I could not take the abuse anymore I stood up to my abusers and threatened them with contacting my school and the police disclosing everything to them. I am the strongest person I know. I have survived and thrived only thanks to my neurodivergence. I live with profound trauma and undiagnosed autism. I am 50 now, in my forties a very expensive therapist told me that I could not be autistic because I had PTSD. I can only make sense of my life from the lens of having a different neurotype. I have been waiting for 2 years to get my assessment. I only need it to access accommodations at my day job. I know I am autistic.
“…in my forties a very expensive therapist told me that I could not be autistic because I had PTSD.”
And if you hadn’t been a PTSDer, that so-called ‘therapist’ would l,ikely have told you that you can’t be autistic because you’re a woman. Anything to avoid giving out the official label and directing appropriate support towards someone who most needs it, amirite?
“For example, meltdowns are not the same as flashbacks. Both can be triggered, but they are distinct entities. Flashbacks are from sensory information causing an onslaught of memories, both conscious ones and the ones we store in our bodies. Meltdowns are from sensory or social overload.”
You clearly haven’t realised that meltdowns can also be triggered by emotional overload (as they are in me), and thus can be indirectly triggered by flashbacks occurring in PTSD and cPTSD in autistic people.