"Totally masked" AS doesn't make sense

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Rett syndrome was previously classified under the autism spectrum in the DSM-IV but was removed in the DSM-5. The primary reason for this reclassification is that Rett syndrome has a well-established genetic cause, distinguishing it from autism spectrum disorder (ASD), which is diagnosed based on behavioral criteria.

https://www.rettsyndrome.org/about-rett ... etics-101/


Autism itself still lacks this "well-establish genetic cause", there's many studies out there showing that multiple genes may be associated with Autism but there's so many variations and exceptions that none of these discoveries led to an accurate medical test.

Like for example according to this study: https://time.com/5770539/autism-genetic-link

So the association is still very broad and not definitive, that means that the diagnosis of Autism (sadly) will remain in the psychiatric field for a long time it seems and not in the medical field.

In other term, Autism/AS = symptoms of Autism/AS; like all psychiatric conditions; one can't exist without the other.
That becomes more tricky the midler it is.

Autism is defined by its behavioral manifestations, and these symptoms are necessary for a diagnosis.

So if one is "totally masking their autism" and "going under the radar" (and it becomes so natural for the masker) to the point that neither parents, family, friends, nor expert psychiatrists can see it, then it is simply not autism, or maybe it was at some point but it's no longer there (since Autism = its symptoms).

I would say that masked autism is autism, but it is buried and simmers underneath the surface.

Although for diagnostic purposes, it might as well not exist.

I don't think a lot of people can mask so well that it becomes undetectable. I'm in my fifties, and I'm as good at masking as anyone, good enough that I now have to inform my coworkers about my limitations or they don't see them.

Even so, a psychiatrist can pick it up in a few minutes.

But in principle, yes, we are defined by how we are different. Our thoughts don't interact with our environment the way others do and subsequently don't result in the same choices, but ...

When we quite literally fake it til we make it, we're still faking it, and the exhaustion does set in after a few decades. When that happens, it's been my experience that the occasional meltdown and chronic anxiety still provide clues.

The extent to which one has to adapt can often be the extent to which one is impacted by autism. The issue of Masking and autism is very nuanced.

I know artistically inclined folk in the spectrum have a greater ability to mask. Also, I know some very right brained folks in the spectrum have enormous ability to mask well.

My experience of being systematically abused, mocked and humiliated at an early age for my unusual ways rendered me very creative indeed in masking. My childhood was akin to an apprenticeship; an early learning in how to appear normal as if my life depended on it. Which it did. The fruits of which were devastating.

In addition to all the above, it's important to understand that the autism spectrum is very diverse and the higher functioning one is the higher the ability one has to mask.

I feel that. Nicely put.