CPTSD in autistic adults is often overlooked because it presents differently than in non-autistic people even though it is common for autistic people to have other co-occurring psychiatric conditions.
For a while I have thought I have CPTSD, but when you also have autism, general and social anxiety, fibromyalgia, the lines can become blurry because of overlap symptoms with autism. I also experience panic attacks and I am sure I have complex trauma, but I don’t know if that means I have CPTSD, thus why I am now seeking an assessment for Complex PTSD.
I have repressed and dressed down the extent of the abuse I received as a child from my parent, authority figures and other people who did not accept my autistic straits.
Growing up I would be triggered by a look on my mothers face fearing it would escalate to the abuse I had previously experienced from them at other times when I was told I was behaving weird.
I learned it wasn't safe to me me and new I needed to find a way to try and be like other children. This was probably the start of my masking journey. However, it only worked sometimes as I couldn't keep it up so it didn't protect me from the abuse I was receiving.
My mother would often hit me around the head and face, call me names, say I would never amount to much, or tell me there was something wrong with me, because I behaved weird and was not like other children. I now know she was reacting to my undiagnosed autism.
I don’t get upset about my childhood so maybe I have disassociated but I have definitely detached from it in some way which I don't see it as a bad thing. I know it was me but it feels like it could have been someone else's life. Both my parents and sibling are dead, and I hadn't had any contact with my mother for about 18 years prior to her death in 2022.
I remember being beaten by my mother with an electric jug chord. When she was in rage she would often use household items like a jug chord or a broomstick. I do not remember all the details, because I often disassociated so I would not feel the pain of their physical and emotional abuse. I do remember barely being able to move my arm for at least a week. After an abusive outburst she would often say do you want a cup of tea, or take me shopping like nothing had even happened. I often thought as a kid, she is not right in the head.
My father would sometimes try to comfort me as long as he could do it without her knowledge, as he feared the consequences from doing that if she was to find out. I often said to my father, you know something is very wrong with her, but he never did anything about it. She also abused him at times, but my sibling was the favourite child so escaped this abuse which I was grateful for.
I disassociated when I was experiencing any type of sensory overload like loud noise, lighting, yelling, fire alarm bells etc, which I know was because I was autistic but I didn’t know it then. I was often abused by teachers or others for not listening when I was trying to disconnect from the sensory issues I was experiencing in the environment, thus to self-regulate, so if I rocked, repeated words, or flapped my hands, I was yelled at and told to stop it.
I believe both my parents were neurodivergent. My think my father was autistic as we were similar and shared a lot of the same autistic traits. Although I believe my mother was autistic, they were very intolerant of my undiagnosed autism. My father wasn’t bothered by them probably because he shared so many of them with me. There was definitely something else going on with my mother.
Both my parents were not affectionate, they very rarely hugged us nor were emotionally available because they were not capable of it. I don't remember my mother ever hugging me. I only remember my father doing so on rare occasions. We were never told we were loved. For the most part I accepted all, as I didn’t like being hugged most of the time due the sensory issues associated with it.
My school teacher often made me sit in front of the class with a book on my head or put my nose in a ring on the blackboard. Walking home kids would laugh, call me names, and throw stones at me.
My sensory issues are often extreme and contribute to my chronic anxiety. I startle very easily and are traumatised when getting a fright. Causes for this are being touched without warning, being approached when I am unaware of someone being there, someone waving their hands around my face or head, and any noise I don’t expect from outside or inside my environment.
I have reoccurring intrusive thoughts around fire alarms, loud noises, unidentified noises, and someone shouting at me. If the fire alarm goes off in my apartment I experience intense anxiety, panic, and urgent toiletry needs. After the alarm has stopped, I can still hear it in my head on and off for days and fear the alarm will go off again soon. I get this with other sensory traumas as well. I just cant get them out of my head for days on end. Other noises I hear can also remind me of being traumatised, and trigger me thinking they are about to happen again.
When I was in 26 I experienced 3 traumas close together in the same year. My brother was killed in a car accident, my five year relationship and engagement ended, My grandfather died two weeks after my brothers death and a pedestrian was killed when they ran out in front of my car. As a result I had a breakdown.
I also do scripting which are both traits and symptoms of both PTSD and autism. I may repeat words someone said to me to hear them back to try and understand what they meant. I also script a pre-planned dialogue I have worked out before a conversation about something important I will be speaking about to someone. I will especially do this if seeing a doctor, dentist or other appointments and engagements.
I experience many other symptoms with my autism, general and social anxiety, which also overlap with some CPTSD symptoms. These are: Shame, guilt, low self esteem, problems with self regulation, difficulty maintaining relationships and why I choose not to have friends anymore, misunderstandings, demand avoidance, very easily startled, avoiding people, intrusive thoughts, avoidance behaviours, decades of masking autistic traits, restrictive eating, irritability, lack trust in people and difficulty concentrating.
I also experience hypervigilance, palpitations, tremors, panic attack, nausea, digestive issues, and a constant feeling of uneasiness that I don't understand. I often have anxiety filled dreams where I feel panic, and wake up from the dream but do not remember what the dream was about.
I exercise daily, I don't drink or smoke, eat a mostly healthy diet, practice meditation, self compassion and mindfulness which I've done for nearly 4 decades. I have substantial support needs that are not being met due to different factors and reasons. I am trying to work through these to navigate what would help improve my quality of life. I have a lot of difficulty working out what I need and processing any emotions around it along with trusting people because of my past experiences.
I’m not one much for dwelling in the past nor do I feel upset when I think about the past, but rather my anxiety sits in the future and will I be okay, how will I take care of myself, and have a roof over my head type of thinking.
The DSM-5 is limiting in many ways to me as it fails to see how trauma manifests in autistic people rather than just the general population.
Complex trauma in autistic people can exacerbate autistic traits to the point where it can cause further regression of skills and communication. I certainly know this is the case for me in relation to the trauma I experienced in masking my autistic traits my whole like, and then experienced autistic regression when I began to unmask decades of this behaviour. Decades of masking was debilitating, exhausting and took a large tole on my mental health which I have not recovered from.
The lines can be blurry when an autistic person is also experiencing C-PTSD symptoms because C-PTSD overlap with autism, and probably why C-PTSD isn’t reported as much as it should be in autistic people. Clinicians need to stop making assumptions when interviewing autistic people, and not defaulting to neurotypical terms and methods, as they will miss the red flags. CBT is often an approach and doesn’t work for many autistic people, and that was certainly the case for me as well and only made my trauma worse.
Social skills can be confusing for autistic people which is why they are also more likely to experience bullying and abuse. Being autistic already makes a person more vulnerable to trauma thus making them predisposed to a lifetime of harm. An autistic brain does not process information as easily as non-autistic people which is another factor in making them more vulnerable to C-PTSD. Autistic brains seem to hold on to trauma which also makes them more likely to experience complex PTSD.
Autistic people can be traumatised by many things that non-autistic people aren’t, so how can many people with autism not also have C-PTSD. They have been traumatised by noise, sensory issues, and abused by society just for being autistic. The fact that autistic people are bullied, made fun of, excluded, and misunderstood more than non-autistic people, and that they are more sensitive to these things, explains to me why C-PTSD in autistic people would be common yet often goes unnoticed.
Physical, emotional, and sexual abuse, violence, natural disasters, and war are all common causes of C-PTSD in the general population. Of course, these things could and do cause C-PTSD in autistic people as well. However, autistic people also experience trauma from things like fire alarms, filling out paperwork and attending appointments, or even a stranger’s offensive comment can also cause instability in an autistic person, thus they can be easily traumatised by other people’s behaviour towards them.
Autistic people are more easily startled and more likely to have insomnia which can make them more prone to anger, and anxiety or have greater difficulty concentrating than may be seen in typical forms of C-PTSD. Sleep is important for all of us to process trauma. Autistic people tend to wake from a dream so they don’t process their memories during dreams which makes theme more likely to be traumatised as a result.
Adults with undiagnosed and diagnosed ASD are 4 times more likely to be diagnosed with C-PTSD than adults without ASD. Traumatic events for autistic people may not automatically lead to C-PTSD but but at the very least they will be associated with other anxiety disorders and depression.
Disclaimer: The writings in this article are for general education and entertainment purposes only and do not replace professional advice. All views are my own opinions, observations, and personal lived experiences. For professional advice please seek help from a qualified provider.