A psychiatrist recently opened Pandora’s box on Reddit with a simple, desperate question: “What is ‘autism’ at this point, anyway?”
The question hit a nerve deep within the mental healthcare community. The author, an experienced psychiatrist, outlined a seismic shift: the reliable, pathological criteria of old have been replaced by a cultural phenomenon.
Now, people who are ‘neurotypical’ in every respect want to claim they are autistic… They are flooding not only TikTok and Instagram but also our practices. It has gotten to the point where I literally ignore a patient claiming to be autistic unless I actually observe autistic traits.
The psychiatrist states that mild social awkwardness (perfectly normal) or a random hobby (suddenly ‘repetitive behavior’) is now cited as proof. His topic exploded, exposing a collective frustration felt far beyond the consulting room.
The ‘Diagnosis-Shoppers’ vs. The Genuinely Missed
Caught between a TikTok trend and a serious diagnosis, clinicians are trying to filter who is really sitting in front of them. A fellow psychiatrist offered a brilliant ‘typology’ of the adults now seeking an ASD diagnosis, which many recognized as a “universal experience.”
The categories reveal a painful spectrum:
- The Genuinely Missed: Often women who went undiagnosed for decades, labeled ‘weird,’ ‘rude,’ or ‘selfish.’ For them, the diagnosis is a revelation, explaining a lifetime of ‘masking’ and misunderstood complaints.
- The Curious Researcher: People with a suspicion, perhaps due to ASD in the family, who are seeking education, not an identity.
- The ‘Look At Me, I’m Neuro-atypical’ Group: The group causing the most frustration. Characterized by a “strong narcissistic streak,” loud on social media, and convinced that “all self-diagnosis is valid.” They often refuse to acknowledge the ‘negative’ or disabling traits of autism.
- The Misinformed Referral: Patients told by a therapist or partner that their normal traits (like a deep passion for a subject) are ‘on the spectrum.’
- The ‘Preferred Diagnosis’: A complex group that would “rather believe they have ASD than the diagnosis they actually have,” such as a borderline or bipolar disorder.
This last category is particularly painful. The stigma on a diagnosis like BPD is immense, while autism (in its pop-culture form) is often seen as ‘quirky’ or even ‘genius.’ This is complicated by the fact that many autistic women are first misdiagnosed with BPD, making the confusion complete.
The Seductive ‘Solution’ of Social Media
This is the “dark side of the acceptance and destigmatization” of mental health.
There may be no desire for therapeutic intervention, but rather a rationalization (or excuse) for normal, strange, and abnormal elements of cognition and self-image.
The diagnosis becomes an identity, an explanation for everything. This leads to what another psychiatrist described as a “kind of stolen valor.” The concern is that this trend “takes resources and attention away from those who clearly need substantial support.”
It trivializes the often invisible, lifelong struggle of people with ‘quiet’ or so-called high-functioning autism, who now have to fight against the image that autism is just a fun ‘quirk’ you discover on TikTok.
This trivialization is a core point. The social media trend isn’t just annoying to some, and even a lot of people; it’s harmful. It reframes autism as a desirable “identity” rather than what it fundamentally is for many: a serious developmental disorder, not forgetting autistics (even the most disabled ones) are people too, with talents.
But this focus on “quirks” actively marginalizes the lived reality of those who face daily, disabling challenges and require significant support, effectively erasing their struggles from the public conversation.
Is the Diagnosis Itself the Problem?
While the frustration with patients was palpable, the discussion also turned inward. Is the diagnostic system itself part of the problem?
One psychiatrist pointed to the removal of the term ‘Asperger’s’ in the DSM-5 (the manual for psychiatrists) as a crucial error.
I strongly believe that completely scrapping that category… was a serious mistake. Autistic individuals who will never communicate verbally… should not, under any circumstances, fall under the same umbrella as people with jobs and relationships who are a bit socially awkward and love Dragonball Z way too much.
Most others disagreed, stating that psychiatry must accept that its diagnoses are “relatively unstable entities.” The criteria for high blood pressure change, so why not those for ASD?
A World on Fire, Searching for a Label
Perhaps the explanation lies outside the consulting room. A sharp socio-economic analysis in the thread offered a grim perspective:
Many young people have only known a world on fire, a world of disinformation, fear, and no guaranteed future… The standards for achieving ‘normative’ success have been raised so high that people must deliver superior performance.
In a society of constant overstimulation, performance pressure, and uncertainty, it’s not surprising that people are searching for an explanation for why they can’t ‘keep up.’ A diagnosis becomes an “excuse not to have to perform” — a shield against a world making impossible demands.
The Psychiatrist’s Impasse
The discussion reveals a deep divide. Clinicians must filter the ‘shoppers’ from the genuinely missed, all while navigating a culture that has reduced a complex neurobiological disorder to a social media trend.
While the original poster wondered if “autism” even means anything anymore, the most poignant question came from a critical colleague.
Why are we spending so much energy keeping the ‘wrong’ people out, when we have no resources or help for the ‘right’ people we do diagnose?
It’s a critique of how the debate gets bogged down in who is or isn’t ‘really’ autistic, while the real problem — the lack of support for adults with autism — remains untouched.
The European Autist 