Is Highly Sensitive Person just code for Autistic?
One comes with a considerable amount of stigma—the other does not
Dr. Elaine Aron may have coined the term Highly Sensitive Person (HSP) 30 years ago, but it’s been buzzing around the internet more recently, as many of us go soul-searching to pinpoint possible neurodivergence.
In fact, while there is much overlap between Autism and HSP, they are distinct ways of being. Growing up, like many undiagnosed girls, I was labeled too shy, too sensitive, too intense. Too much. I overreacted to situations and environments, or at least that’s what I was told.
Back then, HSP wasn’t on my radar. I confess to never having heard the term until a couple of years ago. And yet, I was a highly sensitive person (lowercase) all my life. I had no idea this was a thing.
Although Autism and HSP have much in common, one affects around 2% of the population. The other affects around 20% of the general population. One is categorized as a disorder in the DSM-5. The other is little more than a personality trait. One comes with a considerable amount of stigma and bias—the other does not. I think you can guess which is which.
Like Autism, folks with HSP (as the name suggests) are highly sensitive and reactive to sensory stimuli and need time to recover from overwhelming situations and environments. But those with ASD may be hyper- or hypo-sensitive or both, depending.
HSPs are emotionally intuitive and hugely empathetic. While it was once thought that Autistic people lacked empathy, the research is changing, as many of us report experiences of hyper-empathy. Interestingly, both HSP and ASD involve differences in brain processing that can be measured in an fMRI.
That’s where the similarities end. Those with ASD tend to have more singular and intense interests, repetitive behaviours, and difficulty with social interaction and communication.
Given this overlap, I wonder how clinicians tease apart traits to distinguish between HSP and ASD. Learning more about HSP has made me ponder my autism diagnosis. If I had known about HSP earlier, maybe I would not have pursued an autism assessment. After all, my most prominent “symptom” is hypersensitivity to stimuli. I am intense and emotional and highly empathetic. But I also struggle with social cues and interpreting the behaviour of others, and I often face overwhelm in social settings. I have shutdowns and periods of intense interest and hyper-focus, yet I sometimes question whether these have the makings of an autistic interest. My social challenges seemed subtle, or at least subtle enough for me to get by through masking.
I am autistic, I thought, but am I autistic enough? This kind of imposter syndrome persists, though it has dogged me less with each year following my formal diagnosis.
Given the lingering stigma and stereotypes surrounding autism, I can see how many people might prefer to identify as an HSP, particularly if they opt for self-diagnosis. Years ago, I might have done the same. But it wouldn’t have been accurate. My neurodivergence is clear by now, even to me.
Nurturing yourself and accepting who you are is what matters beyond any label assigned to you.
Thank you so much for this topic!! What has resonated with me most out of all the material I have digested over the last couple of years, is that HSP is a TYPE of Autism and that the Autism diagnosis needs more types as it catches up to the realities of how Autism actually shows up in non-sterotypical ways. Add "high-masking for a long ass time" and you're just not going to see the "typical" patterns on the outside with an HSP type. I have encountered people who feel offended by this, but honestly it makes the most sense of my experiences (and my bestie who is also an HSP Autist). I "respond autistically" *especially* about emotional things in the world. It's not just my regular sensory (hearing, sight, smell, touch, taste) system that is hyper-sensitive, I am also hyper-sensitive interoceptively, meaning I can get overwhelmed by other people's energy and feel it acutely in my body. My special interests usually center around people and social-emotional issues. Sometimes I am hyper verbal and sometimes I have mutism. Sometimes I am incredibly social and sometimes I cannot handle being around anyone and cannot figure out how to talk with people. I think in vivid imagery that also cascades through my internal sensory system, which can also be intensely overwhelming. I'm hyper-aware of any dissonance of what I see on the outside and what is felt on the inside about a situation or a person. I need accommodations too! Trying to find a balance between thinking about my particular patterns and if and how I belong to a group of people that share similar patterns and just being a multidimensional person and giving myself all the room to be that.
I'm so glad to have discovered this Substack! Everything you say resonates with my experience and understanding of myself.