July 18, 2025
Late-Diagnosed Autism and the Hidden Reality of Skill Regression and Autistic Burnout
Send us a text We explore one of autism's most misunderstood phenomena: skill regression and autistic burnout in late-diagnosed adults. Clinical psychologist Lic. Irma Lira shares her expertise and personal journey of discovering her autism in adulthood. Key Topics: Warning signs that lead to late autism diagnosisAutistic burnout vs. general exhaustionSkill regression: When abilities temporarily disappearIdentity reconstruction after diagnosisWhy self-diagnosis is a valid starting pointWhy Th...
We explore one of autism's most misunderstood phenomena: skill regression and autistic burnout in late-diagnosed adults. Clinical psychologist Lic. Irma Lira shares her expertise and personal journey of discovering her autism in adulthood.
Key Topics:
- Warning signs that lead to late autism diagnosis
- Autistic burnout vs. general exhaustion
- Skill regression: When abilities temporarily disappear
- Identity reconstruction after diagnosis
- Why self-diagnosis is a valid starting point
Why This Matters: Research shows late-diagnosed individuals—especially women and people of color—face massive gaps in understanding and support. Many experience "autistic burnout": physical, emotional, and cognitive exhaustion that can temporarily erase skills once taken for granted.
About Our Guest: Lic. Irma Lira brings a dual perspective as both a clinical psychologist and a late-diagnosed autistic woman. Her insights bridge professional knowledge with lived experience.
Connect with Irma:
- APROSAME: aprosame.com
- Instagram: @malobkuxtal
Key Takeaways: Your experience is valid. Late diagnosis can be healing. Regression isn't permanent. Community and self-care are fundamental for recovery.
Resources: Full transcripts in English/Spanish, research citations, and additional support resources at neurorebelpodcast.com
Contact: neurorebelpodcast@gmail.com
NeuroRebel: Where we challenge narratives, embrace complexity, and celebrate authentic neurodivergence.
Thank you for listening to Neuro Rebel — the bilingual podcast where we flip the script on what it means to think differently. I’m your host, Anita: autistic, gifted, and a retired law professor on a mission to bring rigor, empathy, and a dash of rebellion to conversations about neurodiversity.
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WEBVTT
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Picture this, you're 45, maybe 50.
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You've built a career, maybe raised children, navigated decades of relationships and professional challenges.
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You've always known you were different.
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But you've also been told you're successful, high functioning and doing just fine, then something breaks not dramatically.
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More like a slow unraveling skills you've relied on for decades.
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Start to feel unreliable, your ability to navigate social situations, to organize your thoughts, to tolerate everyday sensory experiences.
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All of it begins to slip away like water through your fingers.
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You're told it's stress, burnout, maybe a midlife crisis, but you know it's something deeper.
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Welcome back to Neuro Rebel.
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The podcast where we refuse to accept simple explanations to complex neurological experiences.
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I'm Anita, your host, late diagnosed autistic adult who discovered that sometimes our greatest professional accomplishments can mask our most profound personal struggles.
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For those joining our community for the first time.
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This is where we bring academic rigor to lived experience, where we challenge the sanitized narratives about neurodivergence and where we explore the realities that don't make it into feel good social media content.
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We're bilingual, we're bicultural, and we are unapologetically committed to the truth even when it's uncomfortable.
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Today we're confronting one of autism's most misunderstood phenomena.
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Skill regression and late diagnosed adults.
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This isn't about children losing language.
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This is about competent adults who suddenly find themselves unable to perform tasks that once felt automatic.
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It's about the devastating experience of watching your cognitive ability seemingly deteriorate often without understanding why.
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The research tells us that late diagnosed individuals, particularly women and people of color, represent a massive gap in our understanding of autism across the lifespan.
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We know that many of these individuals experience what researchers are now calling autistic.
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Burnout, a state of physical, emotional, and cognitive exhaustion that can lead to what appears to be skill regression, but is actually protective shutdown.
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Yet, despite affecting potentially millions of people, the experience remains largely invisible in mainstream autism discourse.
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Why?
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Because it doesn't fit the narrative of autism as a childhood condition, because it challenges our assumptions about adult competency, and because the people experiencing it have been too exhausted to advocate for themselves.
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Today I am honored to speak with psychologist.
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I, a clinical psychologist who understands this phenomenon.
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Both from a professional and a deeply personal perspective.
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As someone who received her own autism diagnosis later in her life, Ima brings a unique dual lens to our conversation, the clinical expertise, to understand the research and the lived experience, to know what it feels like when your world quietly falls apart.
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We will explore the emotional archeology of renaming a lifetime of experiences through the artistic lens.
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The professional challenges of being a mental health professional who discovers she needed the very support she provides others.
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And the practical realities of rebuilding life after diagnoses, including learning to recognize and prevent the cycles of burnout that can trigger skill regression.
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This is a conversation about resilience.
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But not toxic, positivity kind.
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This is about the messy, complicated work of untangling decades of masking and self-advocacy that begins not with inspiration, but with understanding..
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So settle in, grab whatever helps you feel grounded and let's explore the hidden landscape of late diagnosed autism with someone who's navigated both professionally and personally welcome, Ima, we are so excited to have you here in the Neuro Rebel podcast.
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I can't tell you how excited we are to have the opportunity to chat with you today about some really interesting topics.
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So welcome all our listeners.
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Ima Lida, a clinical psychologist here and play Del Carmen.
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Thank you Anita, for the opportunity of being here.
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This is a very special subject for me, not only as a therapist, but as a neurodivergent person.
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Thank you so much.
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So today, as I mentioned, the topic is going to be what the implications are resulting from this late diagnosis.
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So tell us a little bit about what is late diagnosis?
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What, what does that mean?
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Late diagnosis, is when you as an adult find out for yourself most of the time that you have neuro divergent condition, like when life gets hard or maybe you are struggling with a job or finding a job, or you recently lost a person that was important to you it can feel like a deep state of depression, but sometimes it's just burnout and autistic burnout or neurodivergent burnout feels different than a neurotypical burnout because it's your life's energy is so depleted that it is so hard to push back.
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It's not like, oh, I'm taking a week off so I can recover.
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Like taking a vacation is not gonna improve what you're filming.
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so how does one arrive at the moment where you say, you know, I need to find out professionally.
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I need to get a diagnosis.
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How does that happen in your experience in clinical practice?
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Well, for a lot of people they go into therapy for these things that we've been talking about, like life crisis and usually when you go to a therapist and they are knowledgeable in the subject, they can.
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Let you know that you need an evaluation.
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They can make an evaluation or an assessment, or you can go to a psychiatrist or a neurologist.
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But in my experience, not only knowing that you have the condition, but also helps knowing how the condition is manifested in you.
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If you are having, doubts now social media is a good.
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Source of information, at least for self-diagnosed, to say like, maybe this sounds a little bit like me, but if you have suspicions that you might be in a condition, going to a professional always helps.
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One of the interesting things I found out is that almost 80% of late diagnosed adults and beyond adolescents are women.
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I mean, what's going on there?
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Tell us a little bit about this bias and this gender bias that now they've identified as the female phenotype for Neurodivergence.
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What's going on there?
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Well, I'm gonna tell you first, as a therapist, I work clinically with, autistic patients, but mostly men.
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The manifestation in men and women is super different, not only when they're children, but also when they're adults.
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Also another aspect that contributes a lot to all the misinformation that there is about autistic women.
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Like 30 years ago, people wouldn't even think that there would be an autistic women.
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But, uh, nowadays that we have more information, we can know that autistic women mask a lot or neurodivergent women mask a lot.
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And that has also to do with how we are socialized when we're children.
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We are taught that we need to be quiet, respectful, delicate not to be moving around a lot or playing a lot, or just jumping everywhere.
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You need to stay tight and look at people in the eyes and smile.
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All of those aspects that you may perceive as an autistic child or as an A DHD child or gifted are kind of.
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Start to repress.
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So women are great actress, neuro women.
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I think we're the biggest actresses because we're suppressing and repressing most of our needs in terms of steaming or in terms of what is, uncomfortable or even disgusting.
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As the saying goes, I have been many people in this lifetime.
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By the time we reach the diagnosis, we don't really know who we are anymore because of a lifetime of masking.
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What is your opinion with respect to this gender bias and this female phenotype?
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The research suggests that this has happened because the studies of autism and other new neuro divergences have been performed primarily by observing male.
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Subjects and male children.
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So women have largely been excluded from the process, which have led to professionals who are not up to date on autism themes.
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It's very unfortunate that we have to go through this because female bodies are so different than male bodies in everything like chemically.
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Hormonally, like even the response to pain is so different in a male than a female.
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So by studying, conditions or illness or pathologists in men, they're living out 50% of the population's needs.
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So what do you think is, one of the biggest systemic problems, if you will, with this issue of late diagnoses and women in particular with respect to mental health professionals?
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Is it a lack of education, training knowledge?
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Where is the gap in your, in, in your opinion?
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I think also the ideas that we have about gender, are influencing how doctors treat us because historically we are thought and women like that was so wrong.
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So when women approach, physician that is not knowledgeable in this subject, think they're exaggerating.
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There's a lot of, also autoimmune disease in autistic women like fibromyalgia and lupus and arthritis, like things that have a high level of pain and they are often dismissed.
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Or if they go to a psychiatrist, they get multiple diagnosis before even thinking about, could you be autistic?
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Could you be neuro divergent?
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They tell you that you have, bipolar disorder or borderline personality disorder or severe depression, but they never seem to think that we might be in the spectrum or that we might be gifted or that we might be, with a DHD.
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Yes.
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I can vouch for that.
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I have a suitcase full of misdiagnoses.
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I was diagnosed at 52, so up until that time I definitely was many things to many people and it's really, really unfortunate.
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What is your suggestion to begin repairing the systemic bias?
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I think it has to be an effort in many levels, including the personal responsibility as a health provider.
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Like you need to be actualized, like you need to study, you need to see the new paradigms in neurodivergency and what's going on in life.
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Like when I went to school, I studied my base psychoanalysis, so, it was.
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Seen as a misconnection between mother and child.
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So basically your mother was at fault instead of being, a genetic, trait that runs around in families like.
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I don't know.
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Like curly hair or blue eyes.
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Right?
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Right.
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Exactly.
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I mean, we don't talk about blue eyed people as having a pigment de deficiency, right?
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We just don't, so why do we talk about different thinking styles as having a deficient form of thinking as very curious?
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Language has a lot to do with it.
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I think that's where I agree with you.
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The neurodiversity paradigm is critical.
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Understanding through a new lens what all these, let's call'em modern, for lack of a better term, because we've always been there.
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This is a brand new thing.
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We can look at these issues.
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Chronic stress and autistic burnout and triggers skill regression.
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Skill regression is a problem, right?
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With late diagnosed adults.
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I, I, I understand.
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Tell us a little bit about that.
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What is skillion and why does it manifest in late diagnosed neurodivergence?
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Well, since we're talking about masking, most of our social skills are.
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Masking skills, like we learned to socialize following cues or imitating, but it's not like it's assimilated or comprehended.
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It's like replayed, like we are playing a part.
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So all of those skills, and also for some of us, our brains don't work in the same way of, executive functions.
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So.
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It's difficult to organize, to plan to, even if you were able to organize and were able to plan to follow on the steps of your plans.
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It's difficult because it has to do with your or, organic functions, but also with your level of stress.
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So environment plays a key role because they can make you go super.
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Regret super bad or they can help you get out of burnout.
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Um, we now know that you're not a little bit autistic or a lot of autistic or A DHD or gifted or you just have different, needs of support.
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And those needs of support can vary throughout life.
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Like it's not like if you are given a diagnose and you have a level two of native support.
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It doesn't mean that it's gonna stay there.
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Maybe you went to have your diagnose when you were going through a crisis and you were in burnout.
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To be able to get out of there is not gonna be a seven week vacation, but also a joint effort with therapy sessions and sometimes medication, but also with help from the environment because.
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We're gonna have good days and bad days, but if our environment or like expect regression is gonna stay there because it creates a constant state of distress and feeling insufficient or feeling inadequate and, and is this a, is a direct consequence.
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I mean, it, it's interesting what the complex psychological interplay here that as a consequence of in late diagnoses that well.
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As a consequence of obtaining a late diagnoses, a lot of people go into burnout or experience skill regression, or it triggers skill regression.
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Why do you think that is?
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Well, I don't think it like, because you got the diagnose, you got this, but probably by the time you got the diagnose, you were so into a burnout state.
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That you are gonna have to take time to get out of it.
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I'm still able to do all those things, but if I'm thinking I, maybe I can't or that I don't understand social situation that well, then the next time that I'm faced with one, I'm gonna feel super incompetent.
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Where it's not like, so having, moral support, but also having a place in therapy where you can just.
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Find, talk about it and order things around helps a lot to be able to feel more secure with yourself or more with more self-esteem so you can get out of that skill regression.
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So here's where therapy becomes critical, right?
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Uh, for people navigating the late diagnoses, um, path.
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Seeking assistance and help from therapy.
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I personally found it incredibly helpful.
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What would you recommend or how would you recommend people approach this issue?
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I recommend that you approach a therapist that also is knowledgeable in the paradigm and types of therapy.
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They are not there to change you or who you are.
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Like cognitive therapy that sometimes is there to change certain behaviors.
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It's probably not the best way because you need to make peace with yourself.
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Having a diagnosis, an adult sometimes leads to grieving process where you have to, let the person you thought you were go to to be able to, be created and be accepted.
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So it's kind of like the debt of the ego or the debt of the stealth that no longer serves you, like take away the mask, but first, before doing it with others, you have to do it with yourself.
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So you have to kind of grieve that person that you were.
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Ideally, a process would be where you can be understood, where you feel safe to talk about these things, where you're not pressured with a timeline or with a lot of tasks, because this requires like a deep dive into the self and also that are based in to stem self emotional regulation.
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Because many of our problems come what from, eh?
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Having to process all this information and then all the emotional information that comes with it.
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So all of that, or need to have skills to be processed in order with these emotional regulation processes where you can just feel your feelings and then give them name and then link them to actions.
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There's definitely a grief process involved in this post-diagnosis at the late stage.
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Talk a little bit about that process.
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What is the dual like?
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I mean, why do we experience as a, in a way, as a death of the former self?
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Well, since you were crying, you weren't aware that you had this false self.
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To begin with, now that you see the false selves and also see the cost that it takes for you to sustain that self, you wonder, do I have to keep doing this?
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Am I really this way?
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Do I want to keep this kind of relationships so it involves all of the areas in our life, how we deal with our jobs, how we deal with our loved ones, how we deal with ourselves, and then the levels of.
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The demand that we have towards us.
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So you kind of have to let go of everything that you knew about yourself.
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So it's kind of, not even reconstruction, but just like the Phoenix bird, you have to let it all burn and then from the ashes rice again, right?
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It's an incredibly stressful and painful process for many people.
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I know it was for me.
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How did you live the process, of finding out you had these three conditions all at once?
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Two of which are completely opposed to each other and their needs and demands.
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Share with us and our listeners what you as a clinical psychologist, as a professional.
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As a human being, what that process was like for you?
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It was definitely a difficult one.
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I started this process, but I was working a lot.
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I like to work a lot, but at some point I had kidney problems, so I was going through physical pain a lot and at the same time in all this.
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That I started knowing a lot of, autistic women, adult autistic women, most of them diagnosed, late in life.
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And they were all sharing their experiences, not only through the diagnose, but also in childhood.
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And I kind of always knew that I had a DHD.
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But never how it manifested in me.
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So I started with, the autistic diagnose.
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I knew that accompanying the process with compassion and patience was what needed.
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But then confronting that process with myself was a completely different task because right now I had to start treating myself like that, but I felt like, I didn't have any skills.
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I had a lot of self-doubt.
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I couldn't, or I feared going out in public, feeling exposed, talking to people.
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I've always been able to do all these things.
00:22:56.946 --> 00:23:02.406
But after my physical health got better, I went to have, tests for A DHD.
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I had these three things that are kind of pulling me in different directions because.
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The need for order there and the need for structure that comes with the autism.
00:23:12.906 --> 00:23:22.957
It's completely destroyed by the chaos from adhd, and I have complex adhd, so it means like I'm inattentive, I hyperactive.
00:23:23.394 --> 00:23:33.814
Knowing that I was gifted help a little bit because I felt since I regressed a lot, I'm having since, a couple of years from now, more difficulties reading and concentrating.
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So I was feeling, I don't know, like it, it impacted my self-esteem.
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So right now I'm in the process of self-accepting and self-assurance and.
00:23:47.223 --> 00:23:48.544
Feeling good about myself.
00:23:48.544 --> 00:23:55.983
At the beginning, I didn't want anyone to know that I was autistic because I thought people was going to look at me differently.
00:23:56.223 --> 00:23:59.854
And right now I'm like, Hey, I'm here and I'm proud.
00:24:01.144 --> 00:24:02.044
Good for you.
00:24:02.284 --> 00:24:03.574
We need more of that.
00:24:04.993 --> 00:24:09.193
What has helped you recover from the burnout and from the post-diagnosis?
00:24:10.044 --> 00:24:12.713
I mean, like once you figure out, it's like, oh my God.
00:24:12.713 --> 00:24:16.074
Now what, what has helped you reintegrate yourself?
00:24:17.874 --> 00:24:21.564
Well, it's been a long journey, but definitely sleeping.
00:24:22.284 --> 00:24:23.453
That's a game changer.
00:24:23.548 --> 00:24:31.898
I don't think I've ever slept like I'm sleeping now, so sleeping changed, everything, especially like in your nervous system.
00:24:32.394 --> 00:24:42.114
But also like going inside and looking at myself and going back to my childhood experiences with, with a different look, with more compassion.
00:24:42.144 --> 00:24:49.203
Talking about it with my friends, talking about it with colleagues, receiving empathy from them, asking for help.
00:24:49.203 --> 00:24:50.854
That was a game changer too.
00:24:50.913 --> 00:24:51.874
It cost me a lot.
00:24:53.403 --> 00:25:00.483
I've been very independent since a very young age, so being able to feel vulnerable was.
00:25:01.759 --> 00:25:05.838
Definitely a big one, but I have the best friends that I could have.
00:25:05.868 --> 00:25:17.308
I have my son, I have my partner, so I have a lot of people that are rooting for me and that helps a lot speak freely with your loved ones, of who you are and what you need changes too.
00:25:17.548 --> 00:25:25.824
Also, I had to kind of look at the way I was working and started putting someone there, there start changing a few things.
00:25:26.683 --> 00:25:29.398
Yes, start changing some patterns.
00:25:30.479 --> 00:25:41.308
One of the things that you do very well in your, nonprofit, he focuses on empowering neurodivergent adults in society, education in the workforce.
00:25:41.759 --> 00:25:48.269
Tell us a little bit about what is happening at the corporate level, especially with late diagnosed adults.
00:25:48.719 --> 00:25:50.009
In the workforce.
00:25:50.394 --> 00:26:02.124
What is happening there and why did you choose to specialize in that area or one of your many specialties, but in particular the training and education in that context?
00:26:03.653 --> 00:26:16.193
Well, these projects started after many experiences with patients, but there was one patient that really marked me, 25-year-old, woman who her.
00:26:17.348 --> 00:26:22.719
Life's dream is to be independent and self-sufficient, and she hasn't been able to do so.
00:26:23.259 --> 00:26:32.019
So in the quest of doing that, she went to an a job interview at one of these stores that sell like Chinese products.
00:26:32.304 --> 00:26:37.719
And the girl that was interviewing for, um.
00:26:38.634 --> 00:26:44.153
Was kind of stressing her out with all these questions and looking profoundly at her.
00:26:44.453 --> 00:26:48.324
They didn't allow her to be accompanied by her mother in the interview.
00:26:48.324 --> 00:26:49.733
So that stressed her too.
00:26:50.064 --> 00:27:03.173
And when she started to, to struggle replying to her questions, instead of having compassion or empathy, she started treating her like she was deaf or worse.
00:27:03.773 --> 00:27:05.693
So that definitely.
00:27:06.788 --> 00:27:10.509
Gave her a crisis and she just run away from the interview.
00:27:11.048 --> 00:27:31.409
So that kind of break my, broke my heart because I think although I, I have, always been able to be independent and self-sufficient and being able to work, so it did really put me into the direction of I need to do something to, to change this.
00:27:31.409 --> 00:27:33.588
And the power that I have is.
00:27:34.578 --> 00:27:43.128
Whatever I can just share with them whatever knowledge I can share so they can see that this girl would've been like the best manager of the store.
00:27:43.159 --> 00:27:46.068
Just don't put her in the front with people.
00:27:46.278 --> 00:27:57.919
But she would've been like the best in inventory and in ordering the store because she's so, or Orate and is, she's so neat that she would've been a great employee and she all.
00:27:58.338 --> 00:28:06.348
Only wanted an opportunity to feel sufficient and to feel valued and to contribute to her family finances.
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So I think it's very important.
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