Autism spectrum disorder (ASD) is not a mental health condition; however, individuals with ASD are highly likely to have a co-occurring mental health diagnosis.
Common comorbidities of autism
Common comorbid mental health conditions of ASD include attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, and depression. Compared to the general public, individuals with ASD are also more likely to have a mental health disorder; however, the exact rates remain unclear due to limitations in research, such as sample size or diagnostic criteria, and underdiagnosis, especially for those whose ASD affects their verbal communication abilities.
ADHD
ADHD is one of the most prevalent co-occurring diagnoses in individuals with ASD. NIH-indexed research shows that a meaningful proportion of individuals with ASD also meet criteria for ADHD, often in the 30%+ range depending on the population studied. Many traits of ADHD and ASD present similarly and a significant percentage of children with ASD also meet the diagnostic criteria for ADHD.
Anxiety
A meta-analysis of 15 studies estimated that 33% of individuals with ASD experience elevated anxiety symptoms, yet only 20% receive a diagnosis with a specific disorder. Researchers have theorized that heightened anxiety in individuals with ASD may stem from their unique information processing and the social pressure to behave in certain ways, though the exact cause is unclear.
Depression
A review of multiple studies examining depression in young individuals with ASD found that prevalence rates can vary widely across populations. The research also highlights that depressive symptoms may be more severe or difficult to identify in individuals with ASD, and notes a significant gap in evidence-based interventions specifically tailored to this population.
Mental Health Awareness Month
May is Mental Health Awareness Month, which has been recognized since 1949 in the United States. This year’s observance is themed “Turn Awareness into Action,” challenging individuals to go further and take actionable steps toward personal and collective change. Mental Health America (MHA) recommends implementing small action items into your daily life to boost your mental well-being. Building routine, practicing mindfulness and setting boundaries are some ways you can prioritize yourself day-to-day, which over time can help you better manage larger challenges that arise.
Mental health tips for individuals with ASD
For individuals with ASD, however, mental well-being is likely more complicated in comparison to neurotypical individuals, especially when in conjunction with a specific mental health condition. ASD presents different needs and challenges that may not be effectively managed by the same recommended action items for neurotypical individuals. So, we’ve adapted MHA’s action items to better support the unique needs of individuals with ASD. A parent or loved one of someone with ASD can also help implement the following action items.
Create and maintain a predictable routine:
As opposed to relying solely on mindfulness-based approaches, proactively managing sensory triggers can be a more effective way to ground and calm individuals with ASD. Many individuals with autism experience heightened or reduced sensitivity to sensory input—such as lights, sounds, textures, smells, and taste—which can lead to sensory overload and distress in everyday environments (Autism Speaks sensory overview).
Sensory triggers and tools may include:
- Bright lights – Wear sunglasses or hats to block the light
- Loud noises or environments – Wear noise-canceling headphones
- Uncomfortable clothing or textures – Cut tags off clothing and choose soft fabrics
- Strong smells – Use unscented laundry detergent and carry a comforting scent cloth to block unwanted smells
- Unwanted touch – Use a compression item such as a weighted blanket for calming pressure and implement social breaks and alone time
- Unfamiliar taste – Keep safe foods available especially when trying new foods
- General – Use a fidget tool to stay grounded and direct mental energy away from the sensory trigger
Set boundaries around camouflaging:
Camouflaging, sometimes called masking, means hiding or suppressing certain undesirable traits to better fit in. Many individuals with ASD camouflage to appear neurotypical and be more socially accepted; however, it is exhausting, requires a great deal of energy which can lead to burnout. Prolonged burnout is a driver of mental health issues for individuals with ASD. Set times where you can take a break from camouflaging or communicate with trusted loved ones about your need to not camouflage around them.
Moving forward
Understanding the mental health challenges and needs of individuals with ASD is essential for taking action and fostering acceptance. Small, intentional changes can make a lasting impact on your loved ones with ASD.
