Highly Sensitive, Autistic, or Both? by Julie Bjelland, LMFT

Many highly sensitive adults, particularly women, first found relief in understanding high sensitivity as a trait.

It explained so much. The deep feeling. The emotional overwhelm. The need for recovery time. The strong nervous system responses. The way life could feel more intense than it seemed to feel for other people.

For many, this understanding has been meaningful and supportive. For some, high sensitivity may still feel like the clearest way to understand their experience, and that matters too. For others, it may describe only part of the picture, and questions about autism may begin to arise. For some, both high sensitivity and autism may feel relevant to their lived experience. In a recent survey I conducted inviting questions about autism, one theme became especially clear: many highly sensitive adults, particularly women, are trying to understand how high sensitivity and autism relate to their lived experience.

Part of the reason this can feel so confusing has to do with timing. The concept of high sensitivity as a trait was developed in the 1990s, before we had the broader and more nuanced understanding we now have of how autism can present in women and high-masking adults. At that time, autism was still widely understood through narrower, more externally visible, and male-centered models. We know much more now about internalized presentations, masking, and the powerful role of gendered social conditioning in shaping how autistic traits are expressed, hidden, and interpreted.

We also understand far more now about autism as a neurotype, meaning a natural pattern of brain wiring and nervous system functioning. That shift is changing everything. It opens the door to understanding autism through perception, processing, sensory experience, nervous system differences, and lifelong adaptation, rather than mainly through obvious external traits.

That wider understanding helps explain why some highly sensitive adults first recognized themselves through high sensitivity and only later began to wonder whether autism might also be relevant. For others, autism may never have even been on the radar because the definitions they were given felt too narrow, too externally focused, or too unlike their lived experience to recognize themselves in it.

Over the years, I have heard from countless women who identified deeply as highly sensitive and later began questioning whether autism might also be part of their story. This can feel confusing, disorienting, validating, or all three at once, especially if you do not match the outdated stereotypes of autism you were taught.

Many women were never taught that autism can be deeply internal and not observable by others.

Many were never taught that autistic women may appear socially capable while carrying enormous hidden effort underneath. Many were never taught that someone can be highly empathic, emotionally attuned, and still be autistic. Many were never taught that reading social cues intensely is a very different experience from moving through social life with ease.

This is one of the reasons so many women have been missed.

For some people, high sensitivity may continue to feel like the clearest description. For others, autism may offer a broader understanding of lifelong patterns that high sensitivity alone did not fully explain. And for some, both may feel meaningful in different ways.

For many autistic women, there may be a lifelong sense of being different, even if it is hard to explain why. There may be extensive internal monitoring. A need to study people, rehearse, analyze, and compensate. A tendency to become overloaded by the amount of social, sensory, and emotional information coming in. A need for more processing time, more predictability, more clarity, and more recovery than others seem to need.

Many autistic women do not primarily struggle because they miss social information. They may instead be taking in too much of it.

They may notice tone shifts, facial expressions, energy changes, power dynamics, hidden meanings, and emotional undercurrents all at once. Rather than seeming socially unaware, they may feel flooded by everything they are taking in. In groups, this can mean becoming quiet, feeling exhausted quickly, disliking small talk, having difficulty speaking quickly enough, or being unable to sort through everything in real time.

Another misunderstanding is the old idea that autistic people lack empathy. That stereotype has caused tremendous harm. Many autistic women are deeply caring, emotionally affected by others, highly conscientious in relationships, and intensely aware of what other people are feeling. The struggle often centers around overload, mismatch, nervous system strain, communication differences, or trying to process too much at once.

Many women have also spent decades adapting so well on the outside that their inner experience becomes invisible. They learn to perform ease. They learn to push through. They learn to override their body. They learn to look fine while paying for it with burnout, anxiety, chronic stress, health problems, exhaustion, or collapse later.

This is why this conversation matters.

It is about understanding your actual needs more accurately.

It is about giving yourself permission to consider that your inner experience may hold important information.

It is about making room for a wider lens of self-understanding than many women were ever offered.

Many autistic people are also deeply sensitive, empathic, and intensely aware of others. Some may find that both descriptions help make sense of their experience. The goal is to become more honest, compassionate, and precise about what your nervous system and neurotype have needed all along.

You do not have to match a narrow stereotype to deserve understanding.

You do not have to prove your struggle through visible collapse.

You do not have to dismiss your own experience because you can make eye contact, feel deeply, understand people, or appear capable.

Sometimes the most important question is, “What has living without a fuller understanding of my neurotype and nervous system been costing me all these years?”

That question opens the door to a much deeper kind of self-understanding.

When we gain a fuller understanding of our neurotype and nervous system, life often begins to make more sense. We can meet ourselves with more accuracy, more gentleness, and more self-compassion. We can begin to honor our needs in ways that create more ease, more clarity, and more room to be fully ourselves.

And for many women, including me, it changes everything.

Want more information about autism in women and sensitive adults?

Explore my autism resources, research, free quiz, and assessment options.

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Author bio

Julie Bjelland, LMFT, is a psychotherapist, author, and founder of the Sensitive and Neurodivergent Community, podcast, and blog. She specializes in high sensitivity, neurodivergence, and adult-discovered autism, with a particular focus on autistic women and late discovery. She is the author of the forthcoming book Autistic Women: A Clinician’s Guide to Neurodiversity-Affirming Identification and Support and creates courses, articles, and free classes that help sensitive and neurodivergent people understand their nervous systems with more self-compassion, clarity, and empowerment. Learn more at JulieBjelland.com

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