So far, you’ve seen three different clinicians over the years. The first believed it was anxiety. The second diagnosis was depression. The third suggested obsessive-compulsive disorder (OCD). Each diagnosis seemed to cover a bit of what you were feeling, but none of them covered it all.
If this sounds familiar- you’re not alone. Often, the symptoms of autism spectrum disorder (ASD) appear as any of the above neurodevelopmental conditions, and may not be diagnosed until adolescence or adulthood. In the worst-case scenario, symptoms often co-occur, making it even more challenging to identify what a person is going through.
Studies show that it is more common than expected. According to a 2024 study published in eClinicalMedicine, approximately 25% of autistic adults had been diagnosed with another psychiatric disorder before being diagnosed with autism.
That is why your developmental history will be taken into account, along with how you have behaved throughout your life and how that has affected it.
If you’ve recently been diagnosed with autism and are looking for answers, this guide explains why autism can be mistaken for other conditions, how clinicians distinguish it, and what to expect from an autism assessment in Australia.
Key Takeaways:
- The symptoms of autism, anxiety, depression, and OCD are all the same on the outside but different on the inside.
- Secondly, autistic features are often confused with anxiety, depression, or OCD, as they are the most common disorders that are confused with.
- Anxiety, depression, and OCD may occur along with autism.
- These should be differentiated only on clinical grounds, not on self-diagnosis.
What Is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition that impacts the ways in which a person experiences the world around them, communicates, feels, and interacts with others. Since ASD reflects a range of age groups and socioeconomic backgrounds, no two autistic people are exactly identical when it comes to diagnosis.
The Australian Bureau of Statistics estimates that around 290,900 Australians had autism in 2022, and autism ranks as one of the most prevalent neurodevelopmental conditions in Australia.
What Causes Autism?
We have learned a great deal about autism, but much research is still needed. Although the exact cause remains unknown, research shows that parenting or vaccines is not the cause. Instead, it is believed to result from a combination of genetic and biological factors that influence a child’s early brain development.
How Autism Affects Daily Life
Autistic people experience great difficulty with verbal and non-verbal communication. It is often hard for them to understand facial expressions, tone of voice, humor, sarcasm, and social interactions. They may also be hypersensitive to sensory input, such as bright lights or loud noises, which can lead to meltdowns that severely impact their daily routine and relationships.
Common Autism Characteristics
There are many similar traits that may occur with autism in a person, such as:
- Differences in social communication
- Repetitive behaviors or focused interests
- Sensitivities towards sounds, lights, textures, or smells.
- Repetitive and rigid behaviors and preferences
H2: Why Is Autism Often Misdiagnosed?
Although autism spectrum disorder (ASD) is estimated to affect around 1.5% of the population, the diagnosis isn’t as convenient as it seems. Australian research shows that many people—particularly women and those diagnosed in adulthood—receive an autism diagnosis later in life because some autistic characteristics are similar to other mental disorders. As a result, some people are initially diagnosed with another disorder before autism is recognized.
Social communication and interaction are difficult for autistic individuals, and it can be difficult to form relationships at an early age. Likewise, children with autism are not socially engaged or exhibit limited or repetitive social behaviors. Unfortunately, these symptoms are shared with other mental health issues and therefore can be misdiagnosed.
Why Adults Are Frequently Missed
There are changes in the awareness of autism over the years, and consequently, many adults are not assessed. Others learn to control their behavior over time. So, they remain unrecognized until they go to work and form friendships and relationships, which makes the diagnosis more difficult.
The Late Diagnosis Of Women And Girls
Autism can be more difficult to recognize in women because many learn to hide their autistic traits by copying social norms or suppressing behaviors. As a result, their difficulties may be overlooked, leading to a diagnosis later in adolescence or adulthood.
Autism vs Anxiety vs Depression vs OCD
Feature | Autism | Anxiety | Depression | OCD |
Core driver | Neurodevelopmental difference | Fear or worry | Persistent low mood | Intrusive thoughts + compulsions |
Onset | Early childhood | Any age | Any age | Any age |
Repetitive behaviour | Calming | Not central | Not central | Distressing |
Social withdrawal | Sensory overload | Fear of judgement | Low motivation | Time taken by rituals |
Can co-occur? | — | Yes | Yes | Yes |
Autism vs Anxiety
Anxiety and Autism are two of the most prominent disorders that have noticeably increased at an alarming rate in the past few years. Whereas the two are completely unique in their natures, where do they intersect?
When a person keeps feeling worried that something worse might happen in the future, that’s anxiety. Your body triggers a fight-or-flight response, your heart beats faster, your breathing rate increases, and your muscles feel tighter, even when no real danger is present.
That’s the survival instinct- but when it becomes overwhelming and starts disrupting your daily routine, it may be a sign of an anxiety disorder.
Whereas ASD is a broad diagnosis – it slightly differs from anxiety because there isn’t a fear of the future, but such individuals may feel overwhelmed in their day-to-day interactions due to differences in social communication or sensory processing.
Autistic Burnout vs. Depression
If you’ve been diagnosed with autism later in life, you may have wondered whether the overwhelming fatigue you’ve experienced, and the depression diagnoses you’ve received over the years, were actually signs of autistic burnout.
Yes, clinicians often misunderstand autistic burnout for depression, as both are overlapping in nature. Individuals often exhibit signs such as fatigue and low energy, brain fog, social withdrawal, loss of appetite, functioning difficulties, and emotional turmoil during depressive episodes.
While they both seem similar on the surface, the reasons they occur distinguish them from one another. Depression is characterized as a mood disorder followed by low mood, loss of interest or pleasure, or a feeling of hopelessness or worthlessness,
Autistic burnout is different. It’s a state of physical, mental, and emotional exhaustion that a person feels after overwhelming social interactions, depleted mental and physical resources, and their inability to regulate their emotions
Autism vs OCD
OCD sufferers have intrusive thoughts, which lead to a lot of anxiety and/or distress. In order to reduce anxiety, a person may feel the need to repeat behaviors like washing hands because of the fear of germs, repeatedly checking door locks, and setting up cluttered materials. These disabilities affect a person’s life to a greater extent and interfere with their functioning.
It is common to mistake autism for other conditions that can also be accompanied by routines and repetitive behaviors, such as Obsessive-Compulsive Disorder (OCD). But the intent of these behaviors is different.
In OCD, the repetitive behavior is used to alleviate fear/ anxiety; in autism, the behavior may be comforting or used to manage sensory experiences, rather than to alleviate distress.
Signs That May Suggest Autism Rather Than Anxiety, Depression, or OCD
These are signs, especially when they happen together and at an early age, that could indicate a problem with autism or, along with anxiety, depression, or OCD.
Social Communication Signs
- Lack of understanding of tone, body language, or implied social rules
- Likes to communicate directly and literally
- Socializing and being mentally exhausted after the activity, even if it went “fine”
Sensory Differences
- Noise, light, texture, or crowd sensitivity.
- Need for routine and predictability
Behavioural Patterns
- Repetitive behaviors or stimming that are calming (not distressing)
- Enthusiastic and deep interests in areas of study
Developmental Clues
- The traits are not recent months, but actually since early childhood
- Treatment for anxiety, depression, or OCD has not been successful in resolving the issues completely.
- No surprise, just relief when hearing about autism.
Can Autism and Mental Health Conditions Occur Together?
Yes. It’s common; these are co-occurring conditions. While all these mental conditions exhibit different symptoms and behaviors, there are certain characteristics that overlap with autism and other mental conditions.
- Unfortunately, anxiety is common among autistic people, due to various reasons including rigidity, unpredictability, inability to cope with stress, etc. Studies suggest 40% of autistic people suffer from anxiety disorders, which is one of the major reasons for inaccurate diagnosis.
- Similarly, depression is also one of the most common co-occurring mental health conditions among autistic people. It may develop as a result of chronic stress, social isolation, bullying, repeated misunderstandings, or the ongoing effort of masking autistic traits.
- While the two conditions are different, the co-existence of OCD and Autism is very common. Studies reveal that 17% of Autistic young people also had OCD. Understanding the reasons behind repetitive behaviors helps clinicians evaluate the assessment and decide on their treatments accordingly.
How is Autism Diagnosed in Australia?
The clinical diagnosis of autism in Australia involves observing and interacting with a person. There are further assessments afterward, including information on a person’s development, health, and behaviors. This process usually has the following steps:
Visit your GP
The first person to see you is your GP. They will listen to your concerns, perform a preliminary evaluation, and, if they suspect that your child may have autism, they will refer you to a specialist or a multidisciplinary assessment
Comprehensive assessment
The team can include a pediatrician, a clinical psychologist, a speech pathologist, and an occupational therapist to evaluate children in Australia. An adult can be diagnosed by a clinical psychologist or psychiatrist with a special interest in autism assessment.
Clinical evaluation
Assessment includes developmental history, communication and social interaction, behavior patterns, sensory experiences, and daily functioning. In addition to clinical interviews and questionnaires, clinicians can use typical diagnostic instruments, including the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and the Autism Diagnostic Interview–Revised (ADI-R).
Diagnosis and next steps
A diagnostic report will be provided if the assessment suggests that the criteria for autism spectrum disorder (ASD) are fulfilled, including the findings and recommendations. This report can help you access appropriate support and services, including whether you’re eligible for the National Disability Insurance Scheme (NDIS).
Treatment and Support Options
Support looks different depending on what’s underneath the presentation:
Support For Autism
Clinical practice guidelines suggest that environmental and behavioral supports can improve the quality of life for autistic people. The purpose is good recognition and practical assistance.
Support For Anxiety
If anxiety and OCD are present with autism, both Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP) are first-line treatments that can treat them both.
Support For Depression
Psychological therapy and medication are evidence-based treatments to reduce depression, for depression or burnout in conjunction with autism.
Support For OCD
Treatment for obsessive-compulsive disorder (OCD) focuses on reducing the impact of obsessions and compulsions through ERP and CBT
Myths About Autism Misdiagnosis
Let’s debunk eight common myths about autism.
- Autism is always diagnosed in childhood.
- Anxiety causes autism.
- Depression and autism can’t occur together.
- A late autism diagnosis means you weren’t really autistic.
- Repetitive behaviors always indicate OCD.
- Autism and mental health conditions cannot occur together.
- Everyone with autism experiences the same symptoms.
- Girls are less likely to suffer from autism
When to Seek Professional Help
If you haven’t had a diagnosis before but you’re still confused, an autism assessment may help clarify things. An autism evaluation may be helpful if:
- Multiple mental health diagnoses, but they don’t fully cover what you experience.
- You interacted differently from children your age in social communication or sensory behavior.
- You feel common signs of autism.
- Medications for anxiety, depression, or OCD haven’t helped you deal with your persistent problems.
Elyséa Health Services offers full adult autism assessments in Adelaide and Australia. This will enable you to ascertain if it is a co-occurring mental health issue or another reason that would more likely explain your experiences, and help you get the right support and next steps.
How Elyséa HEALTH Can Help
Elyséa HEALTH offers a considered pathway for anyone in Adelaide seeking clarity around autism and its overlap with anxiety, depression, or OCD.
- Assessment – A structured autism diagnostic assessment considering developmental history alongside current presentation
- Psychiatrists – A psychiatrist for autism who can also assess co-occurring anxiety, depression, or OCD
- Psychologists – Evidence-based therapy and coping strategies
- Multidisciplinary approach— Psychiatry, psychology, and general practice working together
- Personalized care – A plan built around your presentation, not a generic checklist
Conclusion
While the symptoms of autism overlap with those of anxiety, depression, and OCD, autism is not the same. Some suffer from a single disorder. Others have two or more, which also require their own support.
For those who have previously had a lack of clarity or had an incomplete diagnosis, it can be helpful to get a professional autism assessment in Australia, especially in Adelaide.
FAQs
Is there a possibility that anxiety could be confused with autism?
Yes. There are some similarities between autism and anxiety: social isolation, avoidance of situations, and overreacting to sensory input. Anxiety is a mental health disorder that can occur at any age, and autism is a neurodevelopmental disorder that begins in childhood.
Is depression a symptom of autism?
Yes. When autistic burnout occurs, autistic individuals may seem withdrawn, have little social interaction, or be depressed. An in-depth assessment can be used to help identify if these symptoms are connected with autism, depression, or both.
Is OCD similar to autism?
Yes. Routines and repetitive behaviors are a part of both autism and obsessive-compulsive disorder (OCD). The main difference is that compulsions in OCD are prompted by a distressing intrusive thought, and repetitive behavior in the autism case is typically comforting, pleasurable or helps control sensory input.
Are adults with autism referred for diagnosis?
Yes. An estimated number of people do not receive a diagnosis until they grow into adulthood, especially those whose symptoms have been attributed to another psychiatric disorder. An adult autism assessment may bring clarity and help provide the necessary support.
Diagnosing autism in Australia.
A comprehensive assessment using developmental history, clinical interviews, behavioral observation, and, if appropriate, standardized assessment tools is used to diagnose autism. This can include psychologists, psychiatrists, or a multidisciplinary team.
Who diagnoses autism?
The most common settings for autism assessments in Australia include clinical psychology, psychiatry, pediatrics (if the child is under 16), and autism assessment services held by multi-disciplinary teams.
Is there a cure for autism?
No. Autism is not a disease and cannot be cured. The right supports, therapies, and accommodations can help autistic individuals develop skills, overcome obstacles, and enhance their lives.
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