Holly Madison Speaks Out About Her Autism Diagnosis and How It Affects Her Life

Earlier this year, Holly Madison confirmed something she had long suspected: She is on the autism spectrum.

The Girls Next Door alum, also known as the former head girlfriend of late Playboy founder Hugh Hefner, recently spoke out about living with the developmental disorder.

"I've been suspicious of it for a while," Holly said on the Dec. 8 episode of the Talking to Death podcast, "because my mom told me that she was always suspicious that that was a thing."

The Down the Rabbit Hole author told host Payne Lindsey that her mother had told her that she would "zone out a lot as a kid." Holly also said she "always kind of had trouble socially, not recognizing social cues, not picking up on things the same way other people did."

"But I just made excuses for it. I thought it was because I grew up in Alaska, and then around middle school, moved to Oregon and I thought, 'Well that was just a big social change.' So I'm just very introverted. Like, that's kind of always how I wrote it off," the 43-year-old said. "But I went and got diagnosed earlier this year, so now I know."

Holly continued, "And obviously, I'm highly functioning. It's not as extreme as it is for other people. So I'm not a spokesperson for everybody—they call it a spectrum for a reason."

In 2021, Holly said on the Call Her Daddy podcast that she had long suspected she was "not neurotypical" and thought she had Asperger's syndrome, a diagnostic term that was reclassified as an autism spectrum disorder in 2013. The Playboy Playmate said on Talking to Death that she was formally diagnosed earlier this year after undergoing several evaluation sessions remotely through Zoom.

"The doctor told me that I have high executive functioning," she said, "which means I can pretty much go about my life and do things, quote unquote, normally."

It was important for Holly to share her diagnosis publicly so people could understand her better. 

"I feel like throughout my life, people have not really liked me or have been like, rubbed the wrong way or been offended. They think I'm like, stuck up or snobby or think I'm better than everybody else," she said. "I also don't really have a gage for when other people are done speaking, so I tend to interrupt a lot, which pisses people off."

Holly said she felt she was never "really well-liked" during many social situations in places like school or at the Playboy Mansion. College, she said, was the first place she felt she was about to successfully interact with people. Then there was the job at Hooters in Los Angeles.

"I felt like I was able to make friends there and able to be successful because when you worked at Hooters, at least back in the day, they kind of had a persona you were supposed to adopt—when you're going around waiting on tables, you're only at a table for a short period of time, you're kind of bopping around and then you're like interacting with the other servers for very short periods of time," she said. "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."

Like many people on the autism spectrum, Holly often finds it difficult to be flexible about the way she perceives others.

"She said I have a hard time understanding why other people might think differently," Holly said about her doctor, "or do things differently than me."

However, despite this challenge, the former reality star has learned to navigate social situations that may come more easily to her neurotypical peers. Step one: Make eye contact more often.

"I was never making eye contact before at all," she said. "I can apologize to people if I interrupt or talk over them and tell them why."

Holly said that this "helps other people be more understanding" with her and not take her behavior personally. And that goes both ways.

"I have a little bit more patience now," she said, "and I don't take things as personally."

Look back at the lives of the Girls Next Door stars, then and now:

Kendra Wilkinson was one of Playboy founder Hugh Hefner's three live-in girlfriends when the show premiered in 2005. Fans were so invested in Wilkinson that she got her own spin-off show, Kendra, on E! after leaving the series in 2009.

Her subsequent WE tv series, Kendra On Top, which followed her journey as a mother of two, son Hank IV (born Sept. 11, 2009) and daughter Alijah (May 16, 2014), and her marriage to NFL player Hank Baskett, who she swapped vows with at the Playboy Mansion on June 27, 2009. 

The couple split up in 2018 and their divorce was finalized the following year. In her latest chapter, Kendra's got a real estate license and starring on her own Discovery+ series, Kendra Sells Hollywood.

From investigating the mansion's possible haunted past to planning Hef's birthday, Bridget was No. 1. Her skin was ready to be shown on the Travel Channel's Bridget's Sexiest Beaches and she had cameos in the likes of Entourage, The House Bunny and Curb Your Enthusiasm.

Marquardt's interest in the paranormal has come full circle as host of the podcast Ghost Magnet, featuring interviews with celebs who've experienced the unexplainable and other deep dives into various unsolved mysteries. Once part of an iconic trio, she happily paired off long ago with partner Nicholas Carpenter.

Holly Madison had a successful career after her tenure at the Playboy Mansion, including competing on Dancing with the Stars before getting her own show, Holly's World, that centered around her career in Las Vegas, including her Peepshow residency.

She published a revealing memoir about her time in the Playboy Mansion, Down the Rabbit Hole: Curious Adventures and Cautionary Tales of a Former Playboy Bunny, in 2015, chasing that it with 2016's The Vegas Diaries: Romance, Rolling the Dice and the Road to Reinvention.

The longtime PETA advocate is mom to daughter Rainbow (March 5, 2013) and son Forest (Aug. 7, 2016) with ex-husband Pasquale Rotella. 

In addition to participating in the scathing A&E docuseries Secrets of Playboy, she described having a complicated relationship with her Girl Next Door co-stars on a 2021 episode of the podcast Call Her Daddy. "Bridget and I have always been close," she said. "We've always been friends since day one. She is [the sweetest]." When asked if she had a relationship with Kendra, Holly tersely replied, "No."

While all of the ladies of The Girls Next Door had a special place in Hefner's heart, Crystal Harris actually married the Playboy mogul in 2012, the then-86-year-old's third trip down the aisle. They remained together until his death in 2017. 

After Holly spoke out about her relationship with her co-stars, Crystal was quick to pick a side. "I was at the mansion for a DECADE almost four years ago now and these ladies and their drama were there years before that," she wrote on her MeWe account. "So much time has passed. I side with Kendra here."

"Not sure why these women who shared an incredibly uncommon and rare experience (that will never be repeated in our lifetimes) can't get along?" she continued. "Maybe for the same reasons Holly and Bridget despise me for absolutely NO reason. I hope one day we can all get along and compare experiences."

Crystal also became an advocate for Lyme disease awareness after announcing she'd been diagnosed with the illness in 2016.

After the first generation of The Girls Next Door girlfriends left, twins Kristina and Karissa Shannon moved into the Playboy Mansion in 2009. During the remaining seasons, they celebrated their Playboy Summer Issue in Vegas, went camping in the backyard with Hef and prepared for bit parts in Sofia Coppola's Chateau Marmont-set movie Somewhere.

After the show wrapped, Kristina and Karissa joined the ninth season of Celebrity Big Brother and opened a salon together, Glam Beverly Hills.