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Selective Mutism in Adults: What It Is, Why It Happens, and What Actually Helps
Imagine a young woman sitting in the cafeteria at work. In between bites of her sandwich and sips of her coffee, she has a spirited, eager conversation with her closest friend. All of this light, peaceful energy ends when a colleague sits next to her and asks how her weekend went.
Suddenly, she’s paralyzed, and as much as she tries, she can’t get any words out. The words are just blocked. As an adult with selective mutism, this is a familiar yet distressing experience.
Many people associate selective mutism with childhood, but it can both persist and start in adulthood, confirms Rachel Loftin, chief clinical officer at Prosper Health. Being unable to speak can feel frustrating, confusing, and alienating. This is especially true in a world where many people don’t understand selective mutism.
In this article, we’ll explain selective mutism in adults, what may contribute to it, and how it differs from (and overlaps with) social anxiety and autism. We will also explore coping strategies, treatment, and support options.
Understanding the Link Between Autism and Alcohol Use
As a young teenager, Chelsey Flood felt drawn to alcohol for the reasons many people do. She felt that it gave her access to a more confident version of herself and the ability to relax in group settings.
Although she was never officially diagnosed with a disorder related to alcohol, Flood started to choose drinking over almost everything else. This kept her from living the life she truly wanted to live—enjoying hobbies, practicing healthy habits, and looking after herself.
After Flood became sober in her early 30s, she learned the main reason social settings came as such a struggle to begin with: she is autistic. Recent research suggests that alcohol addiction is more common among autistic people than previously believed.
While many people ask about the link between autism and alcoholism, we won’t use the latter term. Instead, we will use the term alcohol use disorder (AUD). This reflects that the condition is a treatable disorder and a clinically defined, spectrum-based term that is more precise and less stigmatizing.
In this article, we’ll explore the relationship between autism and drinking, why some autistic adults are more vulnerable to alcohol misuse, and why it can be especially risky for them. We'll also learn why standard recovery models can be tough for autistic adults, and what autism-affirming recovery support looks like.
Social Anxiety vs. Autism: Understanding the Differences and Overlap
Like many undiagnosed autistic people, Chelsey Flood spent most of her life feeling “different” and not knowing why. Other people picked up on it, too. She developed terrible social anxiety, constantly questioning whether or not she was coming across as “normal.”
When Flood received a late autism diagnosis, the pieces started coming together. “I began to better understand why social interactions sometimes felt so challenging,” she says.
Flood’s experience is a common one that pops up often in the discussion of social anxiety vs autism. Many autistic people have social anxiety disorder at some point, notes Dr. Jacqueline Shinall, PsyD, a clinical psychologist with Prosper Health.
With that said, not everyone who has one of these conditions necessarily has the other. The signs of autism and social anxiety can look similar on the surface, but they have different causes. Social anxiety is driven by fear of negative judgment or perception from others, while autism involves innate differences in behavior and communication.
Some people are misdiagnosed with one condition, when really, they have the other. Knowing whether you have social anxiety, autism, neither, or both is crucial to getting the support you need. Only a licensed mental health professional can help you determine which is the case for you.
In the meantime, we’ll explore the difference between social anxiety and autism, the overlap between the two, how clinicians tell them apart, and the supports available for both.
