Research on social interaction in autism has characterised autistic people’s communication as impaired, placing the responsibility of interaction difficulties on autistic people. However, with newer theories of interaction such as the Double Empathy Problem (Milton, 2012), research is increasingly accounting for the reciprocal nature of interactions. While empirical support for the Double Empathy Problem is growing, there is still little research on its implications for autistic people’s psychological well-being – which is the focus of this study. 25 autistic adults (12 men, 13 women, aged 22-65 years old) participated in focus groups and interviews. Data were analysed using thematic analysis.Two themes were identified: 1) Misunderstandings are ubiquitous across the lifespan; 2) Misunderstandings have consequences across all areas of life. Participants agreed that misunderstandings were pervasive, while acceptance within non-autistic society was exceptional. Participants reported that these misunderstandings had a negative impact on all aspects of life, which in turn had serious consequences for their mental health.These results support previous research on double empathy and autistic interactions and provide further insight on social motivation in autism. Future research should explore the mechanisms underlying the relationship between double empathy and mental health, such as camouflaging (Mitchell et al., 2021).