Autism and Mental Health

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Autistic people can be at higher risk for anxiety and depression.  All children and adults diagnosed with autism should be screened for anxiety and depression, and should receive treatment for these co-morbid problems if present.  Anxiety is present in the majority of children diagnosed with autism, and depression is present in about half.  There are many findings that suggest that depressions and anxiety have a direct link to autism.  Risk factors increase with age, IQ, and autism severity.  It is important for these individuals to receive treatment to improve their quality of life and well-being. Below, we list common symptoms of depression and anxiety.  If you suspect that you or your loved ones are experiencing these symptoms, please consult a doctor. 

Autism and Depression

Depression is a mood disorder characterized by loss of interest/pleasure and feeling of sadness.  Some common symptoms of depression include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

In autistic people, depression may present with the symptoms listed above, and/or could include stomach aches, fatigue, and restlessness.

Autism and Anxiety

Anxiety is an emotional response characterized by excessive and persistent fear that causes significant distress.  Below are common signs and symptoms of anxiety disorder:

  • Feelings of fear or doom
  • Restlessness
  • Increased heart rate
  • Difficulty concentrating
  • Muscle tension
  • Irritability
  • Changes in appetite
  • Sleep disturbance

Researchers are still exploring the link between anxiety and autism, but they believe that autism and anxiety interact in five important ways:

  • Attention to detail: Autistic individuals tend to be more detail-focused, which can make transitions and changes in routine more challenging.  These changes in routine can result in anxiety.
  • Sensory sensitivities: Some autistic people experience noise, touch, sight, smell, taste, temperature, pain and other sensory factors more intensely, which can trigger anxiety.
  • Social situations:  Increased sensory load and pressure to conform to social rules can increase anxiety in autistic people.   
  • Language: Some autistic people process language differently and can result in anxiety if they find it hard to express their wants and needs or if they are not understood by others. 
  • Task frustration: Autistic people can experience anxiety when working on a challenging task.

Obsessive Compulsive Disorder

Obsessive compulsive disorder (OCD) is one of the most common anxiety disorder seen in autistic people.  OCD is characterized by ritualistic behaviors (compulsions) and recurring/unwanted thoughts (obsessions).  Autistic people are twice as likely to have or develop OCD.

Strategies to Address Anxiety

Clinicians may recommend the following treatments and strategies:

  • Remove stressors 
  • Build new skills.  Problem-solving strategies and coping skills can help people with anxiety to feel more in control and minimize anxiety, whether they have autism or not.
  • Seek out accommodations at school or at work.  Creating schedules and routines, as well as reducing unwanted sensory inputs, can minimize anxiety.
  • Cognitive-behavior therapy and mindfulness-based strategies can help individuals become more aware of thoughts and emotional responses.
  • Medication can help control anxiety while individuals build skills, set up accommodations, or begin therapy.

Treatment Options for Anxiety and Depression 

Autistic people are four times more likely to experience depression compared to individuals without autism.  It is important to understand the signs and symptoms of depression so that appropriate screening and treatment can be given.  Treatment for depression in autistic individuals is the same as for non-autistic individuals.  Selective serotonin reuptake inhibitors (SSRIs) have shown superior efficacy compared to other pharmacological agents.  SSRIs should be given in combination with cognitive-behavioral therapy (CBT) to yield the best outcome. 

Benefits of Exercise

Exercise Effects for Autistic Children

Studies have shown that exercise has a positive impact on the mental health of autistic people.  Doing at least 30 minutes of moderate exercise or 15 minutes of intense exercise per day has shown positive effects on mood states such as anxiety, stress, and depression.

Benefits of Exercise on Mental Health

Here are some exercise ideas to help you lift your mood:

  • Walking, bicycling, or dancing.  Endurance activities increase your breathing, your heart rate, and boost chemicals in your body that may improve mood.
  • Yoga is a mind and body practice that combines physical postures, breathing exercises, and relaxation.
  • Tai Chi is a form of “moving meditation” that involves shifting the body slowly, gently, and precisely, while breathing deeply.
  • Activities you enjoy whether it is playing tennis, kicking a soccer ball, throwing a football, or even gardening can help lift and improve your mood.

Read more about autism and mental health here:

Article by: The Autism ToolKit

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