The study used interpretive phenomenological analysis and involved conducting one-to-one, semi-structured interviews with 10 participants. Each participant shared overlooked autistic traits from childhood and explained how being misdiagnosed with borderline personality disorder (BPD) had a significant impact on them. This research sheds light on the difficulties of differentiating between autism and BPD, particularly among autistic women who are frequently misdiagnosed.

In recent years, numerous studies have delved into the links between autism and BPD, revealing significant overlaps and challenges in differentiating between these two conditions. Notably, many individuals on the autism spectrum, especially women, have reported being misdiagnosed with BPD.

Stigma and diagnostic overshadowing

Many participants believed that being diagnosed with BPD (borderline personality disorder) led to significant stigma and diagnostic overshadowing, resulting in harmful experiences. They felt that healthcare professionals often neglected their true condition and imposed treatments that were not only unhelpful but also detrimental.

Harmful treatments and masking

“Treating BPD by encouraging the ‘masking’ of behaviours was found to be harmful. Masking, or hiding true autistic traits, has been linked to an increased risk of suicide among autistic individuals. Participants felt powerless, unable to challenge the BPD diagnosis even when they believed it was inaccurate.”

The transformative impact of correct diagnosis

Getting diagnosed with autism was described as “life-changing,” providing profound validation and enabling individuals to embrace their authentic selves. The autism diagnosis shifted the emphasis from attempting to alter their identity to recognizing and encouraging their unique qualities, leading to a considerable improvement in their mental health and overall well-being.

Barriers to autism diagnosis

Participants encountered significant obstacles in obtaining autism assessments after being diagnosed with BPD, leading to delayed access to appropriate support and prolonged struggles.

Comparing stigma

While autism is stigmatized in society, it is distinctly different from the severe stigma associated with BPD. Autism stigma often questions competence, whereas BPD stigma implies individuals are broken and potentially harmful.

Dr. Bruce Tamilson, the primary author of the study and a Psychiatry MSc student currently working as a consultant Neuropsychiatrist and Liaison Psychiatrist in London, added, “This research is crucial in understanding the issue of misdiagnosis and its significant impact on autistic individuals. By sharing these stories, the study aims to humanize and improve mental health services, nurturing a more inclusive and empathetic healthcare system. The experiences of the participants serve as a strong call to action for clinicians and researchers, highlighting the necessity for accurate diagnoses and appropriate support for all individuals.”