Find a therapist to help with autism

Misdiagnosis of autism leads to harmful missed or delayed diagnoses, depriving people of essential support.

Co-occurring conditions may "hide" autism, while shared traits often contribute to completely wrong diagnoses.

While many conditions share traits with autism, the triggers and remedies around them are where clarity lies.

Listen to Autistic voices. If a diagnosis has always felt wrong, maybe it is.

Why is autism so often misdiagnosed? And how can autism be mistaken for something like borderline personality or schizophrenia, which seem so very different from autism?

The harms of misdiagnosis are significant, including unnecessary stigma, long-term masking, harmful side effects from unneeded medications, and even reduced life expectancy (Eaton, 2024).

As consequential as misdiagnosis is, it remains common: One in four Autistic adults (one in three Autistic women) report mental health diagnoses that preceded their autism diagnoses (Kentrou et al., 2024). While some of those prior mental health diagnoses may have been accurate, the injurious fact remains that their autism was missed. Not only did they not receive the care or support they needed for autism, but any genuine mental health conditions were treated outside the context of autism, that is to say, incompletely.

Let’s take a look at some of the most common misdiagnoses of autism, why they happen, and how we might spot them to better advocate for ourselves and our children.

1. Attention-Deficit Hyperactivity Disorder (ADHD)

As many as 70% of Autistic people also have ADHD (Hours et al., 2022). AuDHD, as the combination is colloquially called, may in fact be more common than one or the other alone. While some researchers speculate that certain autism traits can be mistaken for ADHD traits—for example, social difficulties being attributed to inattention—most of the misdiagnosis research focuses on co-occurring ADHD and autism.

In this group, autism diagnoses are commonly delayed or missed altogether. W. Sainsbury et al., 2022 found that “ASD is typically diagnosed later when ADHD is present, and ADHD is typically diagnosed earlier when ASD is present,” indicating that ADHD can mask ASD. This also supports the common anecdotal observation of autism being recognized only after initiating ADHD medication.

2. Borderline Personality Disorder (BPD)

Autism co-occurring with depression, anxiety, or ADHD may make diagnosis challenging, but the most common cause of autism being misdiagnosed as BPD is the superficial but numerous shared presentations. Those presentations, however, do not share causes or remedies.

This misdiagnosis, while common, can usually be avoided by........

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