Is It Trauma or Autism?  Or Both?5 min read

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.

Learning that I had PTSD was the first time I felt validated in a way that allowed me to be myself.  I didn’t have to prove my abuse anymore, because science could measure it.  As I healed and dug deeper for the realest version of myself, I found out I was autistic.

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.

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Why the Confusion?

Research indicates that autism has strong connections with PTSD in two important ways.  

  1. 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.
  2. 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.

11 Comments

  1. 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!

  2. Such a great article!  Well written and researched, there are some very interesting differences you point out!

  3. 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.

  4. 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 😊

  5. 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.

  6. 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.

  7. 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.

  8. 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!

  9. “narcissistic abuse”

    That’s an ableist term.  Narcissism =|= abusive.  They can co-occur, but they’re not synonymous.

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