Recently had my exam and my results appointment is next week. I feel like a lot was left uncovered or not spoken enough about, or I just didn’t understand terms in relation to myself and wasn’t given a clear enough response from my doctor to give my best answer. I was also just very overwhelmed and did not act my best. Instead of matching energy and being pleasant I think I probably came across as negative and flat yet emotional.
I made another post where I asked for advice and was given the suggestion of making notes to share with my doctor. But….Is this too much? I want to make sure to give as clear a picture as possible but I am kind of worried

Document in question:

Thoughts

◦	I feel like I didn’t do a good enough job of representing myself in the appointment. I wonder if i should have attempted to wear a mask. I worry if i came across too flat and worry about the perception. But. I’m compiling thoughts that i wish i had mentioned.   
◦	I developed seemingly normally though around five I just stopped talking and lived in my own world. I was lonely and had a vivid imagination and would just stay there. While others played with each other at recess I was walking around alone catching ladybugs.   
◦	I think one reason I stopped talking was because I couldn’t figure out how to do it correctly. Seems like every time I spoke an adult was getting onto me about talking back. I distinctly remember asking for them to explain and they thought I was just challenging them more. It became easier to be quiet. Don’t say much, can’t have many problems.   
◦	I had one friend in preschool that moved away. I had another in elementary school and we were very close until one day with no warning she stopped talking to me and never did again. I still wonder about that. In middle school I tried to act like others in order to make friends but I didn’t like how I was acting. They were mean. So I stopped and ended up alone again. I ate in the bathroom stall at lunch. Continued on my own. That’s around when I met Caroline. She is the friend diagnosed autistic. I want to say we kind of latched onto each other. Both obsessed with paranormal and had a lot of other common interests that pulled us together. After highschool we have stayed in contact but it is few and far between. We went down separate paths and both ended up in abusive relationships that pulled us apart. Anyway. I now have one friend in college that I actually first met at work. She doesn’t have many friends either and is definitely not neurotypical. And I am working on integrating into my husbands online friend group. They are all kind and a bit different. I feel safe with them and not judged but I don’t always do well in conversations and am really quiet so I still feel on the outskirts.   
◦	I occasionally have full body shivers. As a kid it was worse but I noticed a repetitive thing I would do is spell out words with my finger subtly as I would think. Once I noticed I tried to stop doing that but find myself doing it occasionally still. Now I just have a habit of fidgeting and moving my neck. I did get a trampoline and use that when I’m feeling overwhelmed though and it really helps.   
◦	I can’t talk to people and look at them straight on and focus or really listen because when I do I’m 100% focused on absorbing their reactions so that I can tailor my response. I wear a good mask when I do that but still do notice peoples faces fall sometimes which always feels like I’ve been caught wearing a mask. In general though I would say I’m decent at wearing different masks it’s just exhausting and as I age I almost don’t want to anymore unless I have to, like at work.   
◦	I’ve sat with the routine and structure bit for awhile and realized that at work I do fine when on my own unit and can go through the motions but internally do not do the best when I’m pulled somewhere else. I also just generally handle things better when I have notice.   
◦	I have had many interests over the years. Art is definitely at center stage. For a long time i was drawn to astrology, then moved towards the supernatural, to photography and reading, human anatomy and psychology, gaming. Kind of an array of things but all of those interests have been longstanding. I collect things but I don’t know if collecting in general can classify as a special interest. While I am still interested in all of these I have always gone back to art and reading as fail safe regulating activities.   
◦	I’m very logical and have trouble deciphering meanings of things people say when they aren’t clear. I’ll seem confrontational when I ask for clarity. People would probably say that I’m really blunt and matter of fact. This is probably one reason I have never really been able to make or keep friends, or stay on good terms with family members.   
◦	I am emotional and my family has always labeled me as dramatic. I just have high emotional intelligence. I can read people very well and I believe it’s due to a combination of necessity and interest.   
◦	I rehearse every single interaction if I have enough time beforehand. Then I’ll put on the right expression and try my best.   
◦	I have been diagnosed with MDD and Anxiety but I wonder if they’re FROM being disregulated for a long time. Unsure and need to think on that more. Is it depression or burnout?   
◦	I don’t like too much stimulation. Bright lights and noises can be too much and I occasionally will have an outburst particularly with loud noises.   
◦	I have had three romantic relationships across my life but the first two were highly controlling and abusive. I was with them for a few years but my worth seemed to directly depend on what I could physically do for them. My husband is the first good relationship I’ve ever been in. But even that wasn’t without issue. Not long after we got together we did separate for a bit because I had a mental breakdown because I couldn’t understand how he was so kind and had a sort of crisis. Went to therapy for a bit and we got back together and have been together since.   
◦	I get really exhausted after social interactions and it takes me hours to feel calm and days to really feel okay again. It’s been four hours since the appointment and after worrying, panicking, deep research about ads adults and how they correlate with those with just mdd/anxiety..as well as making an anonymous reddit post asking for advice from any with possibly similar experiences or worries…I then listened to very loud music and have been coloring.   
◦	I guess songs could be another interesting point. I don’t really like to listen to music. I have to be in a specific mood for it to not bother me. Usually I randomly will find one song I like and replay it for weeks until I can’t listen to it again. I have hundreds of saved songs in my Spotify graveyard.   
◦	I hyper fixate on foods. Yes it’s true that I can’t eat things with a gummy texture but they’re terrible. But I’ll also just generally get focused on a food and eat it until I can’t stand to eat it again. Rinse, repeat. Same will go for snacks. I also don’t like food touching. I know they mix in my stomach but I don’t like it mixing on a plate. As an example when we have corn my husband puts mine in a bowl so the juice doesn’t run all over everything else. I think meat is my biggest issue overall though. One bite that’s weird and I lose my appetite and don’t want to try it again for a good while.   
◦	I went on a trip with my husband to a meetup with the online friend group and I escaped off on my own quite a bit which is one reason why the tism jokes ramped up towards me. I just think it maybe means something for so many to mention that maybe it’s a possibility. Even when I was a kid i remember someone saying I reminded them of Luna lovegood which I can only imagine is a somehow nicer way of calling me strange and possibly on the spectrum.   
◦	Have always thought in black and white. I can dissect and rationalize mid ground I guess but I don’t like it and it feels wrong. This just are or they are not.   
◦	The last point actually reminds me of my dad telling me as a kid that I was always all or nothing with everything and asking me to meet in the middle. I told him I couldn’t.   
◦	Executive function difficulties. Often rely heavily on post its, reminder apps and calendars.   
◦	When I was young I had much more emotional outbursts though usually in isolation. I have always shut down, isolated, and internally bubbled over as opposed to outwardly if I can help it. People didn’t seem to care if I did have an emotional breakdown but that’s not why I ever avoided it exactly, it was because I couldn’t also deal with the added comments and judgments when things were already not great. It would just make everything more terrible.   
◦	After the appointment I also had to face the possibility of not being autistic and though I have said it would be fine either way I felt a sense of rejection. Like something that started to click into a puzzle was taken from me. I researched autism for a few hours after and internally freaked out. Eventually made myself stop and tried to calm myself by coloring and playing 8D music very loudly. I was off for the rest of the day but I did calm a bit. 

Research and Comments

◦	I just learned that exotropia is relatively common in ASD. That’s why I said I was running into walls. I have exotropia and prisms in my glasses. Had to have therapy. I’m amazed and researching this. https://pmc.ncbi.nlm.nih.gov/articles/PMC9421935/  
◦	This makes me wonder if there could be a link with hearing loss but research is kind of more unclear about that. Says there could be, it’s more common with ASD than otherwise but that’s mostly just an observation. https://pmc.ncbi.nlm.nih.gov/articles/PMC4641833/  
◦	“Executive functioning challenges can show up differently across neurotypes. In ADHD, difficulties often involve task initiation, time management, working memory, and sustaining attention. In autism, challenges may be more pronounced around task switching, planning in unpredictable contexts, or managing cognitive load during transitions. Many people, especially those who are AuDHD, experience a blend of both patterns” (https://neurodivergentinsights.com/glossary/executive-functioning/)   
◦	I think that if anything burnout led to depression. Still exploring possibility. washingtonautismalliance.org   
◦	https://neurodivergentinsights.com/autistic-burnout-vs-depression/?srsltid=AfmBOoqqInbD9TCEkeBIihWOh4nYDDRSOIRrQ8lAJwO9KzyskrjMc37L  
◦	I have had to research some things, this being one (“what is a preference for order”), because I have never related certain things to myself. But I resonate with this. I often eat the same foods each day. Occasionally I will switch things around but not often. I do have cups and utensils I prefer. I always take the same routes when driving places and I have to keep my map open even if I’ve been there a million times and I will always take the same routes. I’m only really spontaneous if I specifically decide to be spontaneous but I’ll have mental parameters. For example I’ll decide to be spontaneous the next day and go to the park and get snacks. Seems spontaneous but it’s actually not because I’ve prepared myself and planned it. I like knowing and planning what will happen and if I don’t know I’ll come up with different scenarios and mentally work through them. Like my first meeting. I didn’t know if it would be right when the appointment was scheduled but I prepared mentally for the possibility and had a coloring book on my desk. autism.org.uk   
◦	Adding next because I resonate with the quote “I know what I need to do. Why can’t I do it?” It compares the autistic mind to an orchestra and says that the music stops when things unexpected happen. Normally people continue with no pause or issue. But for others there is a chasm of quicksand between intent and action. privatetherapyclinic.co.uk  
◦	I resonate with almost everything on level one. https://www.reddit.com/r/AutismTranslated/s/o4VC9ZcIre  
◦	I looked up autistic rambling because i started to try to pinpoint personal behaviors and see how they do or do not line up. I resonate with the results but I have learned to make myself stop talking when I notice negative or disengaged expressions. Took a lot of years to learn that one. Still stings though and it’s overwhelming in the moment. But it’s better not to make things worse. The search mentioned over explaining for clarity and that is something important to me, clarity, to ensure complete understanding and avoid misconceptions. 

AI assisted Deep Dive

◦	During my appointment, I think I struggled to represent myself accurately in real time. I was already overwhelmed by the pressure of being evaluated and trying to answer correctly, and I think that caused me to become very subdued, flat, and internally shut down. Looking back, I worry that I may have come across as simply depressed, emotionally blunted, or detached when internally I felt cognitively overloaded and extremely self-aware of how I was presenting. Part of the difficulty was that I was actively trying not to heavily mask or perform socially the way I usually do, but I realized during the appointment that I do not fully know how to exist naturally in evaluative situations without either masking heavily or becoming overwhelmed and withdrawn. I think I got lost somewhere between trying to be authentic, trying not to overcompensate, trying not to “act autistic,” and trying to manage the stress of the appointment itself.

◦	After my appointment, I used AI as a structured reflective tool to help me process and organize experiences that I either did not mention, minimized, or did not fully understand in the moment. We worked through a very large number of detailed back-and-forth questions (well over 50 across multiple areas) designed to explore and differentiate topics such as:  
•	childhood development and social experiences,  
•	sensory sensitivities and sensory-seeking behaviors,  
•	masking/social performance,  
•	communication and social processing,  
•	executive functioning and possible ADHD overlap,  
•	burnout and exhaustion patterns,  
•	routines/predictability,  
•	emotional processing,  
•	relationships and attachment patterns,  
•	identity/self-perception,  
•	and possible distinctions between ASD-related traits versus anxiety/depression or trauma-related adaptations.

Reasons I Continue to Explore the Possibility of Autism / AuDHD

I am not trying to force myself into a diagnosis. I am trying to understand whether my lifelong patterns are better explained by ASD, anxiety/depression alone, or some overlap.

Developmental / Childhood History

As a child, I developed seemingly normally early on, but around age five I became much quieter and more withdrawn socially. I spent a lot of time alone in my imagination and often preferred solitary activities. While other children played together at recess, I often wandered alone catching ladybugs or living in my own internal world.

I remember frequently feeling misunderstood by adults. Literal questions or attempts at clarification were often interpreted as “talking back,” arguing, disrespect, or attitude when I was genuinely trying to understand. Over time I learned it was safer to say less because speaking often led to conflict or correction.

I was described as:
- too emotional,
- too dramatic,
- too much,
- too talkative,
- overly sensitive.

Before I became heavily self-monitoring, I was very expressive. I would sing, dance, talk constantly, and become deeply immersed in imaginative worlds. I remember being repeatedly criticized for this behavior and eventually becoming much more suppressed and self-conscious. I feel like I gradually learned to monitor and contain myself socially.

Social Processing / Relationships

Social interaction does not feel automatic to me. Conversations feel actively managed rather than naturally intuitive.

While talking with people, I am often simultaneously:
- analyzing tone and facial expressions,
- monitoring whether I seem “normal,”
- scripting responses while listening,
- trying to determine the correct timing to speak,
- adjusting my responses based on reactions.

I replay conversations afterward constantly.

I feel like I learned social interaction largely through observation, decoding, pattern recognition, and trial/error rather than instinctively understanding social rules. Social rules feel variable depending on the individual person rather than internally obvious.

I often feel like I am “performing” socially, especially in public, work, or unfamiliar situations. The more polished, upbeat, charismatic version of myself feels heavily masked and cognitively effortful. I consciously force facial expressions, emotional expression, small talk, and socially expected responses even when they do not come naturally in the moment.

I notice that I mirror other people’s energy, speech styles, humor, or interaction styles to make social situations smoother and more acceptable.

I feel safest socially around people where I do not have to constantly monitor myself. My husband and some of his online friends are examples of this. I feel relief when I can speak or not speak without fear of ridicule or judgment.

I deeply want connection but often find maintaining relationships difficult and exhausting. Friendships have often felt confusing, unstable, or very hard to sustain naturally. Many people throughout my life have drifted away without explanation, which has been painful and confusing.

Sensory Experiences

I have longstanding sensory sensitivities including:
- clothing texture aversions (microfiber, cotton, tags, sock seams),
- smell sensitivity,
- bright light sensitivity,
- crowd/noise overwhelm,
- food texture issues,
- discomfort with sticky sensations.

Food textures are a major issue for me. One unpleasant bite of meat can completely destroy my appetite. I also tend to hyperfixate on foods and eat the same things repeatedly for long periods.

When overstimulated, I often experience:
- inability to think clearly,
- panic,
- irritability,
- overwhelm,
- physical stress response,
- urge to isolate/escape,
- exhaustion,
- shutdown.

I strongly prefer calm, low-light, quiet environments.

Sensory-regulating behaviors/preferences include:
- repetitive movement,
- swaying/spinning in chairs,
- head movements when stressed,
- trampoline use for regulation,
- loud music in certain moods,
- large blankets,
- weighted stuffed animal,
- immersive reading,
- creating calm sensory environments.

Masking / Identity

I feel like much of my life has involved adapting myself to become more acceptable and understandable to others.

If I did not feel pressure to appear “normal,” I would:
- stop forcing facial expressions,
- stop forcing conversation,
- stop heavily monitoring reactions,
- stop filtering myself so intensely before speaking.

The exhausting part of socializing feels less like “people themselves” and more like the constant adaptation and performance required around people.

I often feel more like myself:
- alone,
- immersed in interests,
- researching,
- creating,
- organizing,
- imagining,
- regulating physically,
- with one trusted person,
- in quiet companionship.

Executive Functioning / Cognitive Patterns

I experience significant difficulty with:
- task initiation,
- decision paralysis,
- time blindness,
- transitioning between activities,
- remembering tasks without external systems,
- overwhelm when trying to organize where to begin.

I frequently rely on:
- reminder apps,
- calendars,
- alarms,
- sticky notes,
- structured systems.

I can become mentally frozen despite fully understanding what I need to do. One example was wanting to clean my house, knowing every step internally, but becoming so overwhelmed I froze, cried, and could not initiate the task.

I also experience hyperfocus and can lose track of time almost completely when immersed in interests.

Routine / Predictability

Unexpected changes are very difficult for me primarily because of:
- unpredictability,
- loss of mental preparation,
- cognitive overwhelm.

I strongly prefer mentally preparing for events and scenarios ahead of time. Even “spontaneous” activities are usually internally pre-planned.

I tend to:
- take the same routes while driving,
- keep maps open even for familiar places,
- prefer familiar routines,
- rely on predictability to reduce overwhelm and cognitive load.

Burnout / Exhaustion

Social and professional functioning has become harder and more exhausting with age, not easier.

I can often continue functioning outwardly while internally feeling completely depleted, usually through necessity/adrenaline.

After prolonged stress or social demand, I experience:
- increased shutdowns,
- worse sensory sensitivity,
- reduced tolerance,
- more isolation,
- more irritability,
- inability to mask as effectively,
- deep exhaustion that sleep alone does not always fix.

I often need hours to decompress after overstimulating or socially demanding situations and sometimes days to feel fully recovered again.

Emotional Processing

I often experience emotions intellectually and analytically before fully processing them emotionally.

At times emotions become so overwhelming internally that I lose access to words or become flat/monotone.

I often isolate when overwhelmed because additional social/emotional/sensory input becomes intolerable.

I do not feel my anxiety existed first. I believe much of it developed secondarily after years of social misunderstanding, criticism, invalidation, unpredictability, and fear of upsetting others or “getting things wrong.”

Core Reflection

One of the strongest recurring feelings throughout my life has been feeling fundamentally different from other people in a way I struggled to explain.

I do not know with certainty whether ASD is the correct explanation, but after reflecting deeply on my developmental history and internal experiences, I feel that autism/neurodivergence explains many of my lifelong patterns more cohesively than anxiety/depression alone.