Holly Madison on Autism Diagnosis, Behaviors That Have Been Seen as 'Offensive'

Girls Next Door alum Holly Madison says she's "made excuses" for her own behavior since childhood, but gained a better understanding of herself when she was diagnosed earlier this year.

Holly Madison always knew that she was introverted and didn’t always connect with people, but now she has a much better understanding of what’s going on with herself. The Girls Next Door alum shared that she was diagnosed with autism earlier this year.

The 43 year old opened up on the Talking to Death podcast about her diagnosis and how it’s helped reframe her understanding of herself. While she said she’s been “suspicious of it for a while,” the reality star said her mother’s suspicions go all the way back to childhood.

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According to her mother, a young Holly would “zone out a lot,” while she admitted that she’d always struggled socially, “not recognizing social cues, not picking up on things the same way other people did.”

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One thing she didn’t struggle with, though, was making excuses for her behaviors. She first blamed growing up in Alaska, then the “big social change” of moving to Oregon. She just decided she must be a more introverted person.

Now, though, she can understand why she processes and interacts the way she does after being diagnosed with “high executive functioning autism.” Madison was quick to note, “It’s not as extreme as for other people. So I’m not a spokesperson for everybody.”

“They call it a spectrum for a reason,” she added.

On the Call Her Daddy podcast back in 2021, Madison had floated the idea that she was “not neurotypical,” thinking perhaps she had Asperger’s syndrome, a term no longer used and considered part of the larger autism spectrum disorder.

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With her level of autism, she said she “can pretty much go about my life and do things, quote-unquote, normally.”

Even so, she noted that there are ways she inadvertently stands out in social settings. “I think because I’m more quiet, I’ve only recently learned to make eye contact,” she shared. “I’m often in my own thoughts, things like that, so people take that as offensive. They’re like, ‘Damn, you’re not super interested in me, f–k you!'”

She said she doesn’t “have a gauge for when other people are done speaking, so I tend to interrupt a lot, which pisses people off.” She thinks she’s been perhaps rubbing people the wrong way over the years with how she’s interacted with them.

“They think I’m, like, stuck up or snobby or think I’m better than everybody else,” she said.

“Like, I’m just not on the same social wavelength as other people but don’t take it personally,” explained the former Playboy Playmate. “So I like being able to explain that.”

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One place she was able to thrive successfully socially was when she worked at a Hooters restaurant, but Madison has worked out why that was so much easier for her. There was structure and rules.

“They kind of had a persona you were supposed to adopt,” she realized. “There’s so many rules on how you’re supposed to interact as a Hooters girl that I felt like I was able to navigate social situations because I had those rules.”

One takeaway from her diagnosis and reflecting on what that’s meant for her all these years, Madison said that she would ask that people maybe have a little consideration for what others might be living with.

She asked that maybe consider “that everybody operates differently and [when] interacting with anybody, just have a little bit of patience because you don’t know what they’re dealing with or what their level of social function is.”

As for herself, Madison is happy that she’s learned this about herself as it’s helped her to be more patient with herself, and explain to others what’s happening. “I can apologize to people if I interrupt or talk over them and tell them why,” she said.


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