Introduction: Autism spectrum disorder (ASD) in women is often misdiagnosed, as symptoms are usually masked. This is most often confused with generalized anxiety, leading to a delay in diagnosis and early recognition of symptoms. Recognising how these differences show up across genders helps us identify patients more accurately and meet their needs sooner.
Case Presentation: We describe a 43-year-old woman with long-standing anxiety and depression who came to the clinic with worsening restlessness, panic attacks, and exhaustion. Although she had been treated for years with different medications and therapy, her symptoms kept fluctuating, especially during stressful periods. Her family also noticed that she struggled in noisy or bright environments, became overwhelmed easily, and avoided social interactions. During the visit, she appeared anxious, spoke in a monotone voice, and had difficulty shifting between topics. She was aware of her anxiety but unaware of deeper communication and sensory differences. After adjusting her medications and providing supportive care, her anxiety improved. Still, her sensory sensitivities and communication patterns continued, raising concerns for unrecognised autistic symptoms that her generalized anxiety had masked.
Discussion: This case shows the difficulty in recognising autism in women, primarily when anxiety masks their underlying features. Most women learn to mask their struggles so well that the social communication differences and sensory sensitivities become easy to miss. Recognising these patterns early and focusing more on the behavioral and emotional aspects in women, especially, can help prevent misdiagnosis and ensure that they get the kind of support they actually need.
Conclusion: Having a clearer picture of how autism is in women is essential to making a more accurate diagnosis and avoiding treatments that don’t actually address the core issue. We still need more research to modify our assessment tools, understand these gender specific patterns and differences more clearly, and create practical clinical approaches that help physicians recognise when a woman’s symptoms go beyond anxiety alone.
International Journal of Research in Psychiatry
