Prosper Health's Autism Resource Center

Complex PTSD, or CPTSD, is a mental health condition people can develop after prolonged exposure to trauma. CPTSD is fairly common among autistic individuals, and shares a number of features with autism, like sensory sensitivity and emotional dysregulation. However, they are distinct diagnoses, differing in key areas like how and when they emerge during a person’s life and goals for treatment.

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Autism spectrum disorder is a neurodevelopmental disorder that impacts how an individual communicates and experiences the world. Autistic behaviors may include intense and limited interests, repetitive behaviors, sensory sensitives and difficulty recognizing and expressing emotions. 

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Autistic individuals may experience meltdowns. A meltdown is an intense and involuntary reaction to the challenges that autism presents, like intense sensory experiences, navigating tricky social situations and emotional dysregulation.

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In mental health circles, a trigger refers to an event or feeling that causes a strong emotional response. Neurotypical and neurodiverse individuals alike have triggers, and everyone’s triggers are different. A neurotypical person may feel sadness or nervousness when being confronted with one of their triggers. For autistic individuals, however, being exposed to a trigger can lead to a meltdown. 

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Meltdowns are stressful and incredibly unpleasant to experience. For autistic adults, meltdowns will happen occasionally, but having a better understanding of individual triggers may help them prevent meltdowns when possible.

Our understanding of autism spectrum disorder (ASD) has grown significantly over the years, leading to important changes in how we diagnose and describe its various presentations. One of the most significant changes to the ASD diagnosis is the inclusion of Asperger’s syndrome as part of the autism spectrum.

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Asperger's syndrome was added to the DSM-IV in 1994 but was moved underneath the diagnostic umbrella of “Autism Spectrum Disorder” in the DSM-V in 2013. Though Asperger’s syndrome is considered to be part of the autism spectrum, it presents symptoms that are similar to ASD but may be less severe or pervasive. Asperger’s is typically marked by:

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• Impaired social interaction and nonverbal communication
• Restricted interests
• Repetitive behaviors
• Lack of awareness about how their actions may impact others

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The main difference between Asperger’s and autism is that people who were formerly diagnosed with Asperger’s may have less severe symptoms and no speech delay. In fact, those who have been diagnosed with Asperger’s may have advanced speech and language skills. 

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So, while Asperger’s used to be its own diagnosis, the current diagnostic standards for autism spectrum disorder include Asperger’s. Those who may have, in the past, been diagnosed with Asperger’s syndrome are now likely to be diagnosed with level one autism or to be classified as having low support needs. 

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While it’s true that diagnostic standards have been updated due to the fact that Asperger’s and autism have a large overlap of symptoms, Asperger’s is no longer used also due in part to its controversial namesake. Asperger’s syndrome was first formally named by Hans Asperger after he conducted a comprehensive study on a group of children with autistic traits in 1944. Though Asperger was never an official member of the Nazi Party, he worked closely with them and cooperated with their policies, which targeted neurodivergent individuals. Asperger’s ties to nazi policies, and the harsh language he used to describe his patients is among the reasons that the term “Asperger’s” is no longer widely used.

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However, even though the term is largely outdated, many neurodivergent people were originally diagnosed with Asperger’s syndrome and still resonate with it. Therefore, it’s important to approach the controversy surrounding the name with nuance.

When most people think of psychosis, they think of schizophrenia—not autism. However, psychosis can be associated with several different diagnoses. Although psychosis is not a symptom of autism, it’s more common for autistic individuals to experience psychosis at some point during their lives than it is for neurotypicals.

Psychosis often involves hallucinations and delusions, where an individual perceives things that are not there or believes things that are untrue, respectively.  These experiences can feel very real and quite frightening. However, many forms of support can help people thrive while reducing, managing or eliminating symptoms of psychosis.

It’s perfectly normal for breakups to hurt, criticism to sting, and being excluded to feel lousy. But for people with rejection sensitive dysphoria, or RSD, rejection or failure is distressing on another level. Whether the rejection is real or perceived, RSD can cause severe emotional and sometimes physical pain. 

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While this is something I’ve dealt with as long as I can remember, I didn’t have a name for it until I was diagnosed with ADHD in my 30s. Once I found out that neurodivergent people often experience RSD, the extreme emotional responses I was having suddenly made sense. 

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Rejection sensitive dysphoria was initially acknowledged in relation to ADHD, but it's now increasingly recognized as a common autistic experience too, says Dr. Kelly Whaling, a clinical psychologist and research lead at Prosper Health. 

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While people are quick to point out that no one likes rejection, RSD is something else completely. The shame, humiliation, anger, and sadness I felt when I thought I was being rejected in some capacity would easily ruin my day. But that was only the beginning. From there, I’d start mentally catastrophizing everything, assuming the worst possible scenario was inevitable. 

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If my boss gave me feedback on a project, I thought it meant I’d be fired the next day. If a friend didn’t respond to my text, I thought it meant that I had done something unforgivable and that they were mad at me. It’s a feeling I have to manage to this day, but finding out that I wasn’t the only person whose brain worked this way did help. 

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It’s important to note that RSD itself is not a formal diagnosis, but rather a pattern of experience recognized by clinicians and neurodivergent people alike. So, whether you’re neurodivergent, love someone who is, or have questions about RSD, here’s a clear, compassionate guide to understanding and management.

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Emotional and physical intimacy present unique challenges and opportunities for autistic adults. Autistic people experience romantic relationships differently, navigating complexities related to communication, sensory sensitivities and emotional expression. These issues are compounded if an autistic person’s partner doesn’t fully understand what autism spectrum disorder is or how to support their autistic partner.

However, by fostering an environment of empathy and patience, autistic individuals and their partners can build fulfilling, intimate connections that honor their unique needs and experiences.