4 Monday February 21 2022 | the times
life
worked with who have received
treatments that have been unhelpful
and even damaging.
I appreciate your thoughtfulness in
terms of not wanting to burden an
already overburdened NHS, but I do
believe you have a right to pursue this
assessment given its importance to
your self-understanding. Indeed
having an understanding could hold
immense therapeutic value to you.
To this last point, I urge you to
challenge the sense of embarrassment
surrounding talking to professionals.
It is not “self-indulgent” and indeed I
wonder whether if you had continued
to meet the psychologist you saw once
when you were struggling with
depression, the issue of autism and the
challenges you have faced in your life
related to ASC might have been
eventually uncovered.
This will be a challenge to you
because, like many on the autistic
spectrum, you struggle with social
communication and emotional
articulation. However, practitioners
who work with those who have ASC
understand this challenge and will
skilfully and compassionately work
with you so that you feel comfortable
and able to make best use of the
process. I believe that the exhaustion
and feelings of “unwellness”
throughout your life plus the
“agonising struggling with social
situations” need to be understood.
Issues with mental health and
function do have equivalence to being
“ill” in terms of assessment and
support. Therefore I advise that you
speak to your GP, who can refer you
to an older adult psychiatrist (or
suggest a private referral). You can
also search for private practitioners
via the British Psychological Society
directory. See also autism.org.uk.
I hope that this could mark a new
chapter in your life, not only of a more
settled understanding of yourself but
also a chance to find communities of
others like you where you can feel at
home. I wish you well.2) difficulty with expressive and
receptive communication, and 3) the
presence of restrictive and repetitive
behaviours. So people with autism
may struggle with communication and
social interaction. They may also find
it difficult to understand how others
think and feel and interpret social
cues, and find social events stressful
and overwhelming, especially in
crowds and if there is a lot of other
sensory stimulation (eg bright lights,
noise). They also get caught up in
repetitive behaviours, have a rigid
need for routine, struggle with change
and show hyper-focus around specific
interests. Children and adults on the
autistic spectrum can also experience
high rates of comorbidity, the most
common being mood and anxiety
difficulties and ADHD.
Women are less likely to be
diagnosed because they can often
mask the key indicators via skills of
social camouflage. High-functioning
autism (which I suspect you may have)
is especially easy to overlook.
Additionally, older adults have rarely
been diagnosed because they reached
adulthood before the time of greater
awareness and understanding of ASC,
and before the current diagnostic
criteria for ASC were formulated.
Finally, it can often be more
challenging to reach a definitive
diagnosis in an older adult due to
challenges in obtaining a full
developmental picture (eg
parent reports, school reports);
also, cognitive decline or other
age-related cognitive difficulties
make assessment complicated.
The risk of all this is not only
that people, like you, struggle
for years with the challenges of
being neuroatypical in a world
designed for neurotypicals. It
also can be misdiagnosed or only
treated for comorbid problems (eg
depression and anxiety) without a
clear understanding of the core
underlying issue. This means that
there are older adults who I haveCan I still be diagnosed with autism in my seventies?
Q
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I am in my seventies
and happily married,
outwardly content,
with a beloved son
who has recently been
diagnosed with
ADHD and has self-diagnosed as
being on the autistic spectrum and
is pursuing an assessment. While
appearing to function “normally”, all
my life I have felt different, the “odd
one out”, and I have reached a point
where I would give anything to find
answers to the awful struggles I have
had throughout my life.
Even as a young child I would
bottle up emotions although I had no
reason to be secretive. I knew I had
a high IQ, but was always shy and
have a strong perfectionist streak.
I still had friends and achieved a
good degree, but the secretiveness,
“otherness” and the agonising
struggles with social situations are
with me to this day.
In career terms I chopped and
changed and generally
underachieved, being without any
real sense of ambition and having
frequent bouts of unexplained
unwellness and exhaustion. I have
what some might describe as
“considerable” musical and artistic
gifts, which I have endeavoured to
spend my life using in a voluntary
capacity for the benefit of others.
In recent years I have been
wrestling inwardly with trying to
understand my complicated
personality. I have only seen a
psychologist once in my life, during a
period of depression in my twenties,
and I don’t recall that doing me any
good. And later on maybe it always
seemed a bit self-indulgent, or even
embarrassing, to think of seeking
any kind of psychoanalysis. After all I
had a husband and child to look after
and a thousand other duties.
I have more than once worked
through autism questionnaires. I
have answered with complete rigour
and honesty and the results would
Ask Professor Tanya Byron
always seem to place me well on the
autistic spectrum. Am I being
ridiculous in wanting to seek answers
at this stage in my life? Do people get
diagnosed with autism spectrum
condition in their seventies?
The thought of trying to speak to
someone at my GP surgery about it
is unimaginable, especially at a time
of such pressure for the NHS. It isn’t
making me ill, after all.
KatrinaA
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N
Your letter moved me
because it is clear that,
despite a well-lived life
with a happy marriage
and a cherished son,
you have struggled
inwardly with many issues since
childhood that have made life, at
times, feel more challenging and have
left you feeling confused in terms of a
real understanding of who you are.
Your question regarding whether
you have an autistic spectrum
condition (ASC) is relevant because it
seems that an answer would help you
to settle in terms of an understanding
of yourself. You are not “being
ridiculous” at all. However, it seems as
if you have done extensive research
and self-administered questionnaires
that suggest a strong possibility.
Additionally, your son’s diagnosis of
attention deficit hyperactivity
disorder (ADHD) and his pursuit of
an autistic spectrum assessment
would add weight to the possibility.
ASC is a complex, lifelong
neurodevelopmental disability/
difference that is thought to be
predominantly genetic or heritable
and typically appears during early
childhood, affecting a person’s
social skills, communication,
relationships and self-regulation.
One in 100 people are on the
autism spectrum and there are
about 700,000 autistic adults and
children in the UK.
The primary characteristics
are 1) social-skill difficulties,Women
can often
mask
the key
indicators
If you would like
Professor Tanya Byron’s
help, email proftanya
[email protected]