imposter syndrome and the fear of seeking a diagnosis

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long time lurker, first time posting - I had an appt with a new psychiatrist who, after I expressed my concerns that my difficulties may not be something that can be solved through medication (As in i p much went “hey doc here’s a color coded list I put together of symptoms/problems I have and what diagnoses they could line up with and also here’s the my raads-r EQ AQ CAT-Q scores and I’m really thinking a lot of my ‘depression’ might be burnout and we should adjust my meds accordingly”) she was pretty darn encouraging about getting me tested for autism and/or adhd

Which is great! I think.

I’ve suspected that I may be autistic for the last year or so after researching and finding out autism isn’t just for little-kids-who-are-really-big-fans-of-trains. Every online diagnostic test, I’ve scored way above the threshold for autism (I even accounted for me having a case of confirmation bias and subtracted 20% from my scores - I still was well above the threshold value!), and everything I’ve read (diagnostic criteria + anecdotes/stories from the autistic community) really resonates - especially the sensory issues, which growing up, my family brushed off as me being a “sensitive kid who needs to grow up and get over it” except I literally still want to cry every time I touch cardboard and go almost catatonic when my friends drag me out to bars/clubs.

Basically, autism would explain a lot for me. Even before I was thinking this might apply to me, I made a point of following some advice that other semi-late-diagnosed autistics have shared online and it has helped a lot. (a big one is recognizing the difference between depression and autistic burnout - i used to force myself to socialize when I felt godawful b/c that’s what my therapist said helps with depression, but ever since I started taking time for myself when I feel that awful and I’d decrease sensory input around me, I haven’t had any more depressive episodes….)

So. All of this being said, and noting that I went into this appointment hoping that the new doc would refer me for an assessment - Why am I suddenly panicking? I walked out of that appt feeling like I was a horrible human for even bringing this up to the new doc, because there’s a voice in my head going “CLEARLY I’m faking this and want the assessment for attention. I’ve made up all of the difficulties I’ve had with feeling like I’ve never been on the same page as anyone else and the low tolerance I have for social events/activities because everyone else thinks I’m doing fine and even the people who know me best think I’m a personable, empathetic, and great-at-socializing woman. So even though internally I know how much work and effort and energy goes into presenting that facade, CLEARLY I’m faking it and am actually a terrible human being…”

it’s the same way I feel at work when I’m wondering if I’m actually qualified for what I’m doing or if I tricked everyone into thinking I’m more competent than I am.

imposter syndrome is a gd pain.

how am I supposed to know if i’m “overthinking the situation and am clearly exaggerating things b/c I want to get assessed and diagnosed - the friends I brought this up to p much laughed at me for even suspecting ASD” OR if this is actually “a reasonable suspicion to have and my perception of my struggles has mostly been internal so why would my friends agree with me, I’ve been trained to mask not only my neuroatypical traits but also just my own opinions due to a sh***y childhood where sharing my own thoughts/feelings was frowned up, the imposter Syndrome is clearly just anxiety and fear”

So with that, I’m now nervous that I’m going to get this evaluation done and either 1) not get a true response b/c I’ve been considered “decently successful” in most areas of my life or 2) get a true response but that true response is “you’re not autistic, life and socializing and everything is just hard for you and there’s no reason other than you suck at it by default and have to work at it”

I guess I finally got the courage to post b/c I badly want to know if other women or AFAB individuals experienced/are experiencing similar doubts towards their self-diagnoses and if there’s anyone who felt this way and then received a diagnosis, and if it was worth getting evaluated.

Thanks in advance - this has been weighing on me for a long time so any input/response will be appreciated

Initially I didn't think I was autistic (I am outgoing, empathetic, a good communicator: Ask, Don't Assume). I took the AQ for fun and was very surprised. Initially I didn't think I stimmed or had strange eye contact or was anxious or anything. Then I realized what NTs consider normal (less fidgeting, 10-second responses during conversation, intermittent eye contact, less concerns about personal responsibility) and it became clear. I was Autistic (without "intellectual or physical impairment"). I went through my childhood memories (and letters) and made notes sorted by physical, emotional and social differences. I provided the list to my evaluator and later a list about trauma that he prompted. I received a diagnosis more "easily" than I expected. It was a relief and overwhelming.

BTW - I did not meet the ADOS-2 threshold for ASD (I missed the "gold standard" by 1 point), one study suggested that the ADOS-2 gives a false negative for 33% of adult ASD women. It's important to get an evaluator who is familiar with adult ASD women who won't be put off by subclinical ADOS-2 score.

My likely-ASD daughter was not given an ASD diagnosis (IMHO b/c she is young and was not in "sufficient" crisis at the time) and I am seeking a second opinion. I am concerned the evaluator didn't see through my different perspective (and years of masking). The second go around I will be more clear "when I say she's 'flexible' it's relative to... you would call this 'rigid'." My ASD BFF and I agree that it feels like cheating to tell evaluators what they need to hear, but if it's not a good evaluator, then it's simply necessary.

Here's hoping you have a good evaluator (as I did). If not persevere as clearly you have in your life.

Even if the pro diagnosed me, I'd still have the doubts. I have a trust issue, even with myself. I've completed all the tests, being as honest with my self as possible. I've used both dsm-iv and -v definitions. I've interviewed friends and family. If I get a chance to be professionally diagnosed, I will jump at the chance. Otherwise, I'm good with the self-diagnoses and that's the important part.

When I went in for a diagnosis at 19 I was told I was too creative to be autistic. It was disheartening. Then, as I was processing, I realized that I had been infantilized every step of the way. When I walked into the clinic, they had to grab one of the "parent chairs" aka normal, adult-sized chairs for me to sit in. The chairs for the patients were all child-sized. The doctors used the high-pitched baby and puppy voice at me which I did not like. After thinking about it, I realized that I don't need a diagnosis and I can continue to be who I am and who I know I am. I hope you find inner peace no matter the outcome of your visit.

I relate very, very much to the fear that if I go in for an assessment, I'll either feel dismissed or I might be told, nope, not autistic. Turns out you just suck at neurotypical life for no reason.

Looks like I'm older than you and while I've had some therapy, autism never came up. Ptsd, cptsd, one therapist said dysthymia, but not autism. I also tried to broach the subject with a few friends and was mostly shot down. Yet after taking every online assessment I can find and listening to more and more stories of late diagnosed women, I'm increasingly convinced that this is true for me. Yet I've also been taught my whole life not to trust myself so it's incredibly stressful to think of talking to a professional. I heard an autistic therapist on a podcast saying that support groups may be better for autistic adults than therapy, but I'm not sure if i can join a support group being only self diagnosed. I probably would benefit from connecting with other autistic adults though I'm not a terribly social person. But with NTs, i think my masking skills are waning with age as i just feel more and more tired of putting in all that effort. But another part of me wants so much to avoid any more therapists that I think maybe i should just stay self diagnosed and do with that whatever I can.

I think I'd feel more confident going into it with a referral but i can understand the anxiety and even the distrust of yourself and of how accurately you present yourself to others.

PS. Learning about autistic burn out and why some other standard forms of advice don't work for autistic people has been a big deal for me too.

ASPartOfMe, thanks for that note, good to know.

Autistic peer-led support groups are even more likely than professional-led support groups to accept self-dx'd people, or anyone who faces a lot of the same challenges as autistic people and suspects they might be autistic.

Professional-led support groups are less likely to be comfortable with the idea of self-diagnosis per se, but many of them do accept people who "suspect they might be" autistic, and will support you through the process of seeking a diagnosis.

One thing to keep in mind here is that autism is not a single, specific condition. It's just a way of categorizing people based on behavioral traits. There are likely hundreds, maybe even thousands, of different specific underlying conditions. The science is still quite young.

I dont know about the rest of y'all but my Psych Eval was two days, both days being 8 hours. They gave me multiple tests: IQ tests, sensory tests, personality test, grammar test, multiple choice questions, and multiple interviews). I felt very confident that the results would be accurate - and they were.

My first Psych Eval though, 12 years ago, showed all the traits of autism (depression, anxiety, OCD, problems with social interactions, etc.) but they never diagnosed me with the umbrella term of ASD. Instead, I was diagnosed with 6 other things.

Do NOT feel like a fake or an imposter. You want answers to better understand yourself, and self-improvement is a good thing. Just relax and be yourself, and communicate with the testing place/person so they can understand your needs and concerns.