BPD or Autism? Understanding the Overlap in Women
You feel everything—deeply, intensely, all at once. You want connection… but also feel totally overwhelmed by it. Your emotions feel like they’re always at a 10, but you can’t always explain why.
So you wonder:
“Is it BPD?” “Is it autism?” “Is it both?”
As a therapist who works with neurodivergent and highly sensitive clients, I can tell you: these questions are more common than you think—especially among women and people assigned female at birth (AFAB).
Let’s talk about the overlap between BPD (Borderline Personality Disorder) and autism in AFAB folks—and why it’s so important to move away from labels that limit you and toward insight that helps you understand yourself.
Why the Confusion Happens
Autism and BPD can look strikingly similar on the surface:
Big emotional responses
Difficulty with relationships
Sensory overwhelm
Intense fear of abandonment
Masking or people-pleasing
But underneath those shared traits are different roots—and understanding them can shift everything.
How Autism Can Present in AFAB Individuals
Autism in girls, women, and AFAB folks is often:
Masked: Social scripts are copied. Eye contact is learned. Emotions are internalized.
Quietly intense: Meltdowns might happen in private. Special interests may be socially acceptable (books, animals, psychology).
Emotionally overloaded: Not because of mood swings—but because the world feels too loud, too fast, too much.
🛋️ In therapy, we explore: What are you doing to appear “normal”—and how much does that cost you?
BPD Traits in Women and AFAB Folks
BPD often involves:
Rapid mood swings (triggered by relational dynamics)
Fear of abandonment
Impulsive or self-harming behaviors
Idealizing/devaluing others
Chronic feelings of emptiness
🛋️ Therapist note: BPD is rooted in emotional injury, trauma, or invalidation—not neurological wiring. But both autism and BPD can co-exist.
The Masking Problem (And Why So Many Go Misdiagnosed)
Many AFAB people with autism get misdiagnosed with BPD because they’ve learned to mask. They’ve learned:
How to read the room
How to perform empathy
How to smile even when overstimulated
But eventually, that mask cracks—and what comes out can look like emotional dysregulation. When really? It’s burnout. Sensory overload. Autistic exhaustion.
🛋️ In therapy, we ask: “Is this a meltdown… or a trauma response?”
Can You Have Both?
Yes. Some people are autistic and have BPD. Especially if undiagnosed autism led to years of misunderstanding, rejection, or trauma.
But sometimes? What looks like BPD is really undiagnosed autism that’s never had space to breathe.
If you feel like you’re living your whole life in fight-or-flight… you’re not broken. You’re likely under-supported and misread.
What This Means for You
If this post has you nodding or crying or feeling called out—in a good way—you’re not alone.
Whether it’s BPD, autism, or both—what matters is this:
You’re not “too much.”
You’re not faking it.
You don’t need to fit into a label to be understood.
🛋️ Therapy is where we make sense of it all—where we peel back the layers of misdiagnosis, trauma, masking, and sensitivity to find the real you underneath.
Therap for BPD and Austism
You don’t have to figure this out alone.
You’re allowed to be complex, sensitive, reactive, observant, overwhelmed, quiet, loud, shut down, and still worthy of understanding.
Whether your path includes an autism diagnosis, BPD, both, or neither—you deserve care that sees beyond the surface.
If you’ve been told you’re dramatic… unstable… confusing… broken—please know this:
You are not a problem to fix. You are a story waiting to be fully heard.
And I’m here to help you hear it.
