Autism camouflaging and late diagnosis

Lounge
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While autism is usually diagnosed in childhood, some people remain “off the radar” for a long time and only receive a diagnosis much later. One possible reason is that they have learned socially appropriate behaviours, effectively camouflaging their social difficulties, including maintaining eye contact during conversations, memorising jokes or imitating facial expressions.

This pattern of behaviour could have serious consequences for the lives of some people with autism. It is easy to imagine that camouflaging demands significant cognitive effort, leading to mental exhaustion over time, and in extreme cases perhaps also contributing to anxiety and depression.

If there are gender differences in camouflaging, this could also help explain the well-known male preponderance in autism spectrum disorders. At least part of the gender imbalance may, in fact, stem from an under-diagnosis of autism in girls because they are better at “masking” symptoms.

I have never received a diagnosis of ASD or NLD. I do my best to make eye contact. However I have never memorised a joke(never told one) . As for imitating facial expressions if I do it’s on a subconscious level.

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During premorbid/prodromal phases of my schizophrenia, countering dissociation and trying to cope in order to maintain contact with reality of social behaviours was very similar to camouflaging in autism. I was so efficient in deception that my diagnosis occured very late in the disease’s course : in fact too late when delusional first onset episode was on. Even today a large part of my negative symptoms is mental exhaustion because of the cognitive effort that demands coping which must be efficient because some sz coworkers are jealous of my so-called high functioning profile but they don’t know the high cost of it.