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Autism is most commonly identified in childhood, yet studies suggest that approximately one percent of adults are on the autism spectrum, often without realising it. Without a diagnosis, these adults might not be recognised as neurodiverse and may miss out on the support they need to reach their full potential.

“It’s important to understand that autism is not a disorder to be ‘fixed’, but rather it is a different way of thinking, feeling, and interacting with the world. A proper diagnosis is a tool that can empower adults to embrace their differences and maximise their potential in every aspect of life,” says Dr Jeanri Combrinck, a psychiatrist who practises at Netcare Akeso Kenilworth.

“A diagnosis of autism in adulthood can be a turning point because many adults on the spectrum may have spent their lives feeling ‘different’ or struggling in ways that they couldn’t quite explain. Many individuals develop coping mechanisms over the years, masking their symptoms or compensating through learned behaviours, yet core challenges associated with social interaction, sensory sensitivity, and rigid thinking can remain.”

Awareness
“Creating awareness about adult autism spectrum disorder (ASD) is crucial for improving the lives of people who live with this neurodevelopmental condition, often in silence, without the appropriate support or recognition,” Dr Combrinck says.

“We refer to a spectrum, as autism encompasses such a wide range of manifestations in varying degrees from high-functioning individuals to those who require more extensive support. A person with autism experiences the world in a unique way that neurotypical individuals who lack awareness may not understand.”

Some examples of how adults with autism may perceive and navigate their environment differently include:

• Social interactions can be challenging, overwhelming or confusing: While neurotypical individuals may intuitively understand social cues such as body language, tone of voice, or facial expressions, individuals with autism often struggle with these subtle signals. As a result, they may have difficulty initiating or maintaining conversations, understanding sarcasm or humour, or interpreting others' emotions.
• Sensory sensitivities: People on the autism spectrum often experience heightened or diminished sensitivity to sensory stimuli. Certain sounds, lights, textures, or smells that others might not notice can be overwhelming or even painful for someone with autism.
• Rigid thinking and preference for routine and predictability: Changes in plans or unexpected events can cause significant stress or anxiety, and this can affect their ability to adapt to new situations, whether it's a change in work tasks or an unexpected social event.
• Intense focus and interests: Many individuals on the spectrum develop deep, specific interests in certain topics or activities. “This intense focus can be a strength, but it may also lead to difficulties when these interests take precedence over other areas of life, or when others misunderstand them,” Dr Combrinck says.

Adults on the spectrum are more at risk for mental health co-morbidities, which may exacerbate the challenges faced by those with autism, as well as complicate the accurate diagnosis of adult ASD.

“Studies suggest that up to 40-50% of adults with autism experience some form of anxiety, including generalised anxiety disorder, social anxiety or specific phobias. Depression is unfortunately also common, with the chronic social difficulties, isolation, and emotional dysregulation associated with autism can contribute to feelings of sadness, hopelessness, and withdrawal,” Dr Combrinck says.

Many adults on the spectrum also show symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), such as inattention, impulsivity, and difficulties with focus. At the same time, rigid thinking patterns may also overlap with obsessive-compulsive disorder (OCD) symptoms of the compulsions and rituals often seen in OCD, reinforcing the importance of specialist diagnosis and treatment. Identifying autism as the underlying condition can help clinicians target treatments more effectively.

“A proper adult ASD diagnosis can provide several benefits, including validation and understanding for adults and access to targeted support and resources, such as therapy, coaching, or workplace accommodations. This can make a huge difference in reducing anxiety and increasing confidence for many people,” Dr Combrinck says.

“With a better understanding of their unique way of thinking and perceiving the world, neurodiverse individuals can learn strategies to improve relationships and communication with others, leading to healthier, more fulfilling social lives.

“As a psychiatrist, I work with adults on the spectrum to help them develop coping strategies, improve their quality of life, and enhance their social and professional experiences. With the right support, individuals with autism can thrive, feel understood, and achieve their personal and professional goals.”

Tips for coping when feeling overwhelmed

If you're on the autism spectrum, it is common to feel overwhelmed by sensory input, social situations, or unexpected changes,” Dr Combrinck says.

The following tips can be helpful in overwhelming moments:

1. Create a calm-down routine: Having a set of calming activities you can turn to when things get too intense is incredibly helpful. Try listening to soothing music or retreating to a quiet, low-stimulation environment.
2. Deep breathing: Deep breathing exercises can help activate your body’s natural relaxation response. Breathing in slowly through your nose for a count of four, holding for four, and then exhaling slowly through your mouth for four can help slow your heart rate and bring calm.
3. Grounding techniques: Shifting your attention to what you see, hear, or feel can help you regain focus.
4. Break tasks into smaller steps: This helps reduce the sense of being overwhelmed by allowing you to focus on one thing at a time.
5. Communicate your needs: It’s important to express when you’re feeling overwhelmed. This might mean letting someone know if you need a break or some quiet time. It may help to have a pre-established non-verbal signal to let others know you need a moment.
6. Identify your triggers: Understanding what causes you to feel overwhelmed can be the first step in avoiding or managing those situations.
7. Set boundaries: If you're in a social situation or at work and starting to feel overwhelmed, it's okay to set boundaries. This might mean stepping away from a conversation, asking for a change in the environment, or taking a break.

Building neurotypical support and understanding

“If you’re not on the autism spectrum, it can sometimes be challenging to understand what a neurodiverse person might be experiencing. However, there are simple ways to be more supportive and make life easier for someone with autism,” Dr Combrinck says.

• Respect sensory needs: Some individuals with autism might find certain lights, sounds, or smells overwhelming. Be mindful of their sensory needs and try to create a more comfortable environment.
• Be patient and give space when needed: People with autism may need more time to process information or respond in conversations, so try not to rush them. Giving them space to gather their thoughts or feelings can reduce anxiety.
• Be direct and clear in communication: People with autism may have difficulty interpreting indirect communication, such as sarcasm, body language, or social cues. Be clear and direct when talking to someone on the spectrum to avoid confusion.
• Understand the need for routine: Many individuals with autism thrive on routine and predictability. When plans change unexpectedly, it can be difficult for them to adapt. If changes are necessary, try to give advance notice and prepare them for the shift.
• Avoid overloading with information: Too much information at once can feel overwhelming for many people on the autism spectrum. Try to break things down into smaller pieces and present them one at a time.
• Offer empathy, not sympathy: Sometimes, people with autism might face challenges that others might not understand, like social difficulties or sensory overload. Rather than pitying them, try offering empathy by acknowledging their experiences and validating their feelings.

Ends.

*References available on request.

About Netcare Akeso
Netcare Akeso operates a network of private inpatient mental health facilities and is part of the Netcare Group. Netcare Akeso provides individual, integrated and family-oriented treatment in specialised inpatient treatment facilities, as well as certain outpatient services, for a range of psychiatric, psychological and substance use conditions. Please visit www.akeso.co.za or contact [email protected] for further information.

In the event of a psychological crisis, call 0861 435 787, 24 hours a day for emergency support. Psychiatrist consultations can be made through Netcare appointmed™, online at www.netcareappointmed.co.za or by calling 0861 555 565.

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