Autism therapy for adults across Louisiana,
including the ones who found out at forty.
Most of my autistic clients are adults. Some have known since childhood. More learned the word in their thirties or forties, often after a child’s evaluation, or a late night of reading that landed too close to home. Whenever you arrived, you are on time. I have spent much of my career on this work, from a Denver practice known for ADHD and autism treatment to running the Chartwell Center, a New Orleans nonprofit serving people on the spectrum. Sessions are virtual across Louisiana, and the anxiety, depression, and burnout that tend to travel with a late answer are part of the work, not a separate errand.
You were not
missed by accident.
There are solid reasons so many capable adults get here late. The diagnostic criteria for autism were built primarily from studies of boys, which is a documented reason women in particular are identified later and less often.1 The standard instruments were largely normed on children. And if you learned early to perform an easier version of yourself, you have spent decades actively hiding the evidence.
So the question was never whether you were paying attention. You were reading your life just fine. You learned every part except your own.
You learned every part except your own.
Skill this practiced
has a cost.
Masking is the trade most of my clients made before they had a word for it: study the room, run the script, sand off whatever draws attention. Playing a part written for a different instrument, on demand, for thirty years, is a real skill. It worked. That is exactly why it held. It is also expensive, and the research says so plainly: camouflaging is linked to higher rates of depression and anxiety, in some analyses more strongly than the underlying traits themselves.23
Unmasking is not all or nothing, and I will not hand you a slogan about authenticity. It is an accounting you have never been allowed to do out loud: where the mask still earns its keep, where it is quietly bankrupting you, and what you would want in its place.
When capable stops working.
Autistic burnout is what researchers working with autistic adults call the wall that a vacation does not fix: chronic exhaustion, loss of skills you used to have, and a lowered tolerance for input, lasting months, and distinct from ordinary burnout and from depression.4 In that research, recovery came with reduced demands, real support, and unmasking. Not with trying harder. If you are there right now, this is treatable ground, and pushing through is the one strategy guaranteed to make it worse.
What the work looks like.
I am an active therapist, and this work is concrete. We budget sensory and social load the way you would budget anything else that is finite. We work out which accommodations are worth asking for at work and how to ask without theater. We keep the scripts that serve you and retire the ones that only serve everyone else. And we treat what rode in alongside: anxiety and depression are among the most common companions of autism in adults,5 and they respond to treatment here the way they do anywhere.
Two neighbors worth knowing about. If your relationship is where the wiring difference shows up loudest, couples work has its own page. And if ADHD is also in the picture, that combination behaves like a third thing entirely, and it has a page of its own. No diagnosis is required to start; here is how I think about that question.
- Rynkiewicz A, et al. Girls and women with autism. Psychiatria Polska, 2019. doi.org/10.12740/PP/OnlineFirst/95098
- Cage E, Di Monaco J, Newell V. Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 2018. doi.org/10.1007/s10803-017-3342-7
- Somerville M, MacPherson SE, Fletcher-Watson S. The associations between camouflaging, autistic traits, and mental health in nonautistic adults. Autism in Adulthood, 2024. doi.org/10.1089/aut.2023.0018
- Raymaker DM, et al. Defining autistic burnout. Autism in Adulthood, 2020. doi.org/10.1089/aut.2019.0079
- Micai M, et al. Prevalence of co-occurring conditions in children and adults with autism spectrum disorder: a systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, 2023.
Play your own part.
The first consultation is free, by phone or video, and there is nothing to prepare. Virtual across Louisiana, insurance and private pay. What has the mask been costing you lately?