Can Diagnostic Overshadowing Lead to Autism Misdiagnosis?

PostedNovember 13, 2025

UpdatedNovember 13, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Yes, diagnostic overshadowing of autism happens when clinicians attribute autistic traits to more obvious conditions like anxiety or depression. This often results in missed opportunities for proper support, especially when surface issues take priority over deeper developmental context.

People with complex mental health presentations may appear emotionally distressed, so professionals might focus on those symptoms and disregard signs of autism. Often, misdiagnosis causes include assuming that repetitive behaviours or social withdrawal stem from a mood disorder rather than underlying developmental differences.

How Overshadowing Affects Accurate Identification

Mental health overlap:

Conditions such as PTSD or bipolar disorder can share characteristics with autism, like social disconnection or emotional rigidity. When mental health issues dominate the clinical picture, core autistic patterns may be overlooked.

Subtle developmental indicators:

Let’s say someone rarely makes eye contact, expresses literal speech, or follows strict routines, these are telling autism symptoms. Without knowing a person’s lifelong tendencies, such clues may be ignored or misunderstood.

Holistic assessment is essential:

A clear diagnosis requires a deep dive into developmental history, routines, sensory sensitivities, and social communication. Relying only on current mental health concerns without that context often leads to overlooking autism entirely.

Accurate evaluation should combine mental health understanding with neurodevelopmental insight. If you or someone you know has been struggling with a mental health label but still senses something is missing, it’s worth exploring further.

Visit providers like Autism Detect for personal consultations that balance emotional well-being with developmental clarity.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to misdiagnosis and differential diagnosis.

Beatrice Holloway, MSc

Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.