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Autistic Mental Health

Writer's picture: Marcie WilliamsMarcie Williams

Updated: Oct 5, 2023

By Marcie Williams, LPCC



The autistic community and co-occurring mental health.


Co-morbidities between autism and mental health are prevalent in the autistic community. In fact, about 75% of autistic individuals are diagnosed with at least one co-morbid mental health issue. There are several factors that contribute to the disproportionate likelihood that an autistic person will receive a co-morbid mental health diagnosis.


Neurological and Developmental Factors


Differences in the brain structure of an autistic person may impact emotion regulation, sensory processing, and social interactions. This can in turn impact functioning and lead to an increased risk of mental health conditions. Functional impairments can impact relationships, the ability to complete daily tasks and hygiene routines, prevent or delay completion of the requirements to finish schooling, and maintain employment. When a person is successful in these areas, it helps them to maintain positive mental health. If an autistic person is struggling in any of these areas, they will need support tailored to their needs to help them feel confident and to achieve success. It is important to manage expectations related to capabilities and let each individual take the lead in determining what success looks like for them.


Sensory Overload and Stress


Many autistic individuals experience sensitivities or differences in the way they process sensory information in the environment. They may be hypersensitive (causing high reactivity) or hyposensitive (an underreaction to sensory stimuli). Sensory challenges can cause chronic stress and anxiety. The body’s senses can become so overloaded, they lose the ability to cope. Oftentimes, due to language deficits, the autistic person is not able to identify or explain the source of sensory issue so many times they do not get the resolution they need. This can look like behavioral issues when in fact it is a form of communication.


Social Challenges and Isolation


You may have heard that autistic people “don’t seem interested in friendship or social connection.” What is interpreted by neurotypicals as an autistic individual appearing cold, uninterested, or even aloof, is more often the result of neurological differences. These differences can hinder an autist from interpreting a normative social cue as it was intended, but it in no way means they aren’t interested in social connections.


These neurological differences create the “double empathy” problem, a term coined by Dr. Damian Milton. He suggests that “double empathy” occurs when two neurologically different individuals with differing styles of communication and understanding have trouble connecting with each other. Many times, this difference results in neurotypical peers either avoiding their autistic peer or leaving them out of social situations. Because neurotypical peers tend to outnumber their neurodiverse counterparts, this can lead to social isolation, feelings of loneliness, and a lack of social support for the autistic person. It is important to educate others about autistic communication styles, help to foster healthy relationships, and assist them in finding their “tribe,” other neurodiverse individuals they can connect with.


Bullying and Stigma


Autistic individuals are at a higher risk of becoming the victims of bullying, discrimination, stigma, and marginalization which can have detrimental effects on mental health. The negative impact of such experiences can lead to the development of conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD). Bullying also impacts a child’s ability to learn.


Recognizing what is happening and protecting your child in these circumstances becomes critical. There are many ways a parent carer can help a child who is being bullied. Some of these are to ensure they have a strong support network around them, pay close attention to changes in your child’s behavior, keep lines of communication open with them and the school, teach them what bullying looks like, and help them to develop personal safety skills including advocating for themselves. Take action immediately if you suspect your child is being bullied. There are legal protections and provisions for students for students with disabilities who are being harassed.


Executive Functioning Difficulties


Executive functioning refers to a set of cognitive processes responsible for self-regulation, planning, organizing, and problem solving. Difficulties in these areas can contribute to challenges prioritizing and completing daily tasks. This can lead to increased stress, anxiety, and overwhelm.


Individual capabilities and needs will be different. It’s important to manage expectations. Traditional methods (found all over the internet), that are used to improve executive functioning may not work and in fact may cause more stress for autistic individuals. It might be more effective to determine what the person values, their special interests, and whether there’s a way to lean into that to help them develop executive functioning skills. It might be more effective in the long-term to build healthy habits into the day than to focus on a routine with multiple steps that can become confusing and overwhelming.


Diagnostic Challenges and Delayed Access to Supports


Diagnostic assessment can be challenging to secure. Costs, long wait periods, and minimizing of symptoms in some cases, can lead to significant wait times for diagnosis. Delay in assessment results in the inability to gain access to appropriate early interventions, creating stress for parents.


Later diagnosed autistic individuals experience their own array of challenges due to having their diagnosis overlooked. Persons of color and women are especially prone to receiving a late diagnosis or no diagnosis at all. These individuals often either learn to engage in significant masking causing increased stress, overwhelm and burnout, or are inappropriately diagnosed with behavioral disorders. Receiving an incorrect diagnosis, results in inappropriate interventions that can only exacerbate the issues.


Working together to change perspectives.


The more we understand the precipitating factors for mental health issues, the better chance we have at intervening to help the autistic person thrive. We live in a world where our understanding of autism is very young and tends to still be defined and described in terms of deficits. This perpetuates stigma and marginalization and can lead to mental health issues and poorer quality of life. As parent carers and adult autistics, we can work together to educate others about autism, redirect the focus from a deficit’s perspective, and highlight its unique and positive aspects.

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