Autism and posttraumatic stress disorder (PTSD) share some symptoms. Sometimes, people may mistake one for the other. It is also possible for people to be autistic and have PTSD, too.

In fact, some evidence suggests autistic people are more likely to develop PTSD in comparison to the larger population.

The reasons for this are not fully understood, but it could be due to how autism affects perceptions of danger and the prevalence of autism stigma and abuse.

Understanding the similarities, differences, and overlap between autism and PTSD can ensure people receive the right diagnosis and support.

Keep reading to learn more about autism and PTSD, including a comparison of their symptoms, diagnosis, and treatment.

A Venn diagram showing the overlap between autism and PTSD.Share on Pinterest
Infographic by Bailey Mariner

Autism is a spectrum of neurodevelopmental differences that affect communication, social interaction, interests, and behavior. The signs develop in early childhood and have strong links to genetics, meaning that autism often runs in families.

Autism is not a treatable condition; it is a long-term difference in the way people think and perceive the world. It is also relatively uncommon. Experts estimate autism affects around 1 in 68 children in the United States.

In contrast, PTSD is a common and treatable mental health condition people can develop at any age. It occurs as a result of a traumatic event. Traumatic events can include any experience that causes a person to fear for their life or safety.

When a person has PTSD as a result of several traumatic experiences or an ongoing experience, it is known as complex PTSD (C-PTSD).

Vicarious trauma, where a person develops PTSD after witnessing or hearing about someone else’s traumatic experiences, is also possible.

While autism and PTSD are distinct, they share some of the same symptoms and complications. Both may cause:

  • Sensory sensitivities: PTSD and autism can both cause sensitivity to certain noises, smells, or crowded places.
  • Difficulty in social situations: Autism can affect how a person communicates and how they interpret the behavior of people who are not autistic. For some, PTSD can also make socializing stressful if they are afraid of other people or strangers.
  • Repetitive behavior: Stimming is a repetitive behavior that a person uses to manage stress or anxiety. It is a potential feature of autism but can also affect those with PTSD and anxiety. Similarly, repetitive play can also feature among children in either case.
  • Difficulty regulating emotions: People with either autism or PTSD may have more difficulty regulating their feelings than others, which can lead to outbursts of anger, panic, or withdrawal from others.
  • Avoidance: Autistic people and those with PTSD often try to avoid stimuli, places, or people that cause distress.
  • Lack of speech: Some autistic people are nonspeaking, meaning they do not talk. Sometimes, traumatic experiences or anxiety can also lead to a lack of speech. Doctors call this mutism.

It is important for healthcare professionals to know about this overlap, as it can make it harder to accurately diagnose autism or PTSD. This is especially true for children, who may not be able to explain how they feel or what they have experienced.

It is also pertinent information for people with C-PTSD. C-PTSD can cause a broader range of symptoms than PTSD and can be harder to identify because it does not occur after a single, acute event.

Data suggests PTSD is more common among autistic people than nonautistic people.

The authors of a small 2020 study with 59 adults estimated that 40% of the participants likely met the criteria for a PTSD diagnosis. This is significantly higher than estimates for the nonautistic population.

A larger 2021 survey of 687 autistic adults found that 44% met the PTSD criteria.

However, in both cases, the participants were not a random sample, so they are not representative of all autistic people.

Why might PTSD be more common in autistic people?

PTSD may be more common among autistic people because they can experience stigma and are more vulnerable to abuse. A 2023 study notes that previous research has shown autistic people often experience:

  • bullying
  • crime
  • intimate partner violence
  • homelessness

The study also notes that autistic people are more likely to experience interpersonal violence than nonautistic people, while the 2021 survey mentioned above found that 72% of participants had experienced some form of assault.

However, autism itself may also affect a person’s risk of developing PTSD. It may:

  • affect how a person processes sensory information, making events seem more dangerous or scary
  • affect how able a person is to cope with what happened
  • make it more difficult to get social support due to difficulty communicating or socializing

However, developing PTSD is not inevitable, either for autistic or nonautistic people.

Although there are similarities, autism and PTSD do have key differences in their symptoms. For example, PTSD can cause some symptoms that autism does not, such as:

Autism also has some effects that PTSD does not, such as:

  • specific and intense interests
  • difficulty with imaginative play (in children)
  • very logical or literal thinking
  • significant distress when daily routines change, even if only slightly

People who are autistic and have PTSD may have a mixture of symptoms, but those symptoms can also interact with each other in unique ways.

For example, an autistic person’s sensory sensitivities may be even more pronounced as a result of PTSD, as this can cause hyperarousal.

Similarly, avoidance may manifest as a retreat into repetitive behaviors or a focus on solitary activities.

For people who have symptoms that could be autism or PTSD, diagnosis requires a comprehensive evaluation from a psychologist. In children, this may be a child psychologist.

During an evaluation, the healthcare professional will consider the person’s:

  • personal history
  • communication skills
  • repetitive behaviors
  • mental health symptoms
  • daily functioning

In children, the evaluation may also include play, which allows the healthcare professional to see whether there are repetitive themes or difficulty using imagination.

However, distinguishing these conditions can be challenging. For people who already have one diagnosis, it can also be harder to get the second one. This is due to “diagnostic overshadowing,” which is when a healthcare professional attributes symptoms to one condition and overlooks the possibility of another.

Treatment for PTSD involves talk therapy, particularly trauma-focused types of therapy, such as trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing.

Doctors may also prescribe medications to alleviate specific symptoms, such as anxiety, depression, and insomnia.

For autism, any needed interventions focus on alleviating symptoms that interfere with quality of life. It involves different types of support depending on the person but could include:

  • speech and language therapy
  • sensory integration therapy
  • physical therapy
  • social skills training

In cases of co-occurring autism and PTSD, therapists may need to adapt their approach to accommodate the individual’s specific needs. For example, autistic people in talk therapy may need:

  • a greater number of sessions to establish trust
  • a longer or shorter duration to each session
  • regular breaks

There is currently a lack of research on whether existing PTSD treatments work just as effectively for autistic people. People may need to try different approaches to find what works for them.

Anyone who believes they could have PTSD or that they are autistic can speak with a doctor or mental health professional for advice and support. The healthcare professional can explain the next steps and may provide a referral to a specialist.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Autism and PTSD have some overlapping symptoms, including sensory sensitivities, avoidant behaviors, and potential difficulty in social situations. However, they are distinct conditions and have very different underlying causes.

Understanding the overlap between autism and PTSD is essential for an accurate diagnosis. These conditions can also coexist. By understanding how they interact, mental health professionals can create a tailored approach that meets the needs of each person.