Like every young person, young people with autism can have good mental health. However, some young autistic people struggle with mental health difficulties, such as depression, anxiety disorders, and obsessive-compulsive disorder.
If your child is autistic and lives with a mental health disorder, they are not alone. According to Austica, as many as seven in ten autistic people may have mental health problems.
At the Wave, we offer transformative recovery programs for mental health concerns, specifically tailored to young people. Our select team of expert staff from around the world are fully trained to meet the needs of neurodivergent people to help the reach their goals and build stable futures.
Talking About Autism
Some autistic people prefer to refer to themselves as “autistic” rather than having “autism”, to emphasise that autism is not a condition but a way of seeing and interacting with the world.
While the medical community use the term “autism spectrum disorder” to refer to autism, autism is not a mental health problem, condition or disorder like other mental disorders.
Autism and ADHD – Exploring the Relationship
Many young autistic people also live with attention-deficit hyperactive disorder (ADHD), a mental health condition that affects concentration and focus. Studies show that 30-50% of people diagnosed with autism show symptoms of ADHD, while two-thirds of people with ADHD may show signs of autism.
ADHD and autism also share certain features. For example, an autistic person and someone with ADHD may both have difficulty focusing or concentrating. However, other features are distinct – ADHD symptoms do not include repetitive behaviours or avoiding eye contact.
Because of this, a careful and in-depth assessment is often necessary to provide an accurate diagnosis for a young person. In some cases, mental health professionals may diagnose a young person with only one of the conditions, and in other cases both.
Scientists are still unsure about the connection between ADHD and autism. In fact, until 2013, the American Psychiatric Society excluded the possibility of the co-occurrence of ADHD and autism. Some research suggests that genetics may play a role – one study found that a rare gene may be linked to both ADHD and autism, explaining why they often co-occur together.
Can Teens and Young Adults Have Both Autism and Bipolar Disorder?
Bipolar disorder is a type of depression characterized by periods of high (manic) and low (depressed) mood. It’s usually diagnosed in adolescence or early adulthood.
An autistic person can live with bipolar disorder. Research suggests that people with autism and bipolar may share some of the same gene expression patterns.
It can be hard for young people on the autistic spectrum to effectively communicate and express their needs. This can make it more difficult to notice and accurately diagnose a mental illness like bipolar. In these cases, visiting a specialist is especially important to ensure the young person receives the support and care they need to feel better.
Helping Young People With Autism Manage Anxiety
According to the National Autistic Society, 40% of autistic individuals may be affected by anxiety, including autistic young people. Unfortunately, many autistic children and adolescents are unable to access the support they require because demand outweighs the availability of specialist treatment.
Seeking effective, tailored support is the best way to help autistic young people to manage an anxiety disorder or symptoms of anxiety. Research has found that parental training can also help reduce stress and anxiety for both parents and children.
Specialist mental health centres can offer parental training, educating parents about the nature of anxiety and providing strategies to help manage symptoms. These include:
- identifying sensory needs of the autistic child and the effect that certain environments have on their anxiety, such as loud noises and sensory overload
- removing/reducing the cause of anxiety
- using a calm box, sensory toolkit, or sensory activities
- using muscle relaxation exercises
- teaching about emotional regulation
- using diaries to record triggers and instances of anxiety, and developing positive ways to approach situations in the future
- exposure therapy, involving gradual, safe, and controlled exposure to a trigger of anxiety
- celebrating all successes
Studies by the National Autistic Society suggest that these strategies can help autistic children and young people feel empowered to recognize and manage their own anxiety.
Exploring Autism and OCD
As many as 17% of people with an autism diagnosis may live with obsessive-compulsive disorder (OCD). OCD is a mental health condition characterised by obsessive, intrusive thoughts and compulsive behaviours. Compulsive behaviours, such as hand washing or counting, may offer temporary relief from intrusive thoughts, but the thoughts quickly return, sometimes more intensely than before.
Some of the co-occurrence of autism and OCD may be because of misdiagnosis: certain traits of autistic people, such as repetitive behaviours, are also symptoms of OCD. However, in many cases, autism and OCD do co-occur – young people with autism are twice as likely to receive an OCD diagnosis later on in life.
Shared Biology
Some research suggests that people with autism and OCD share certain brain features. Some studies have found that they have an unusually large caudate nucleus, a structure within the striatum region of the brain that is involved in regulating motor function and reward.
Animal studies also point to the striatum region as a possible source of some of the behaviours associated with autism and OCD. Researchers have found that disrupting interneurons (molecules that inhibit electrical impulses in the brain) in these areas can produce repetitive behaviours, anxiety, and twitching – traits displayed by autistic people and those with OCD.
Unique Treatment Approaches
When accessing treatment for obsessive-compulsive disorder, autistic young people can face unique challenges. They may struggle to engage with cognitive-behavioural therapy, a standard treatment for OCD which involves identifying unhelpful thought and behavioural patterns and turning them into more positive ones. Young people with autism often have difficulties picturing situations and imagining different outcomes, making CBT and other talk therapies ineffective.
Some professionals are developing special forms of OCD for autistic people. These may involve personal variations, such as adjusting language, involving family members in sessions, or giving children rewards. Every young person is unique and responds to treatment differently – this is all the more true with autistic people. Treatment for OCD needs to reflect a young person’s nuanced and changing symptoms and needs with flexibility and creativity.
The Wave – A Place for Transformative Experiences
For young people struggling with their mental health, autism can make accessing effective treatment more difficult. Not every mental health provider is fully trained to support neurodivergent people and their unique needs.
The Wave is different. Our transformative programs draw in experts from around the world, with extensive training in adolescent mental health and neurodivergence. Every young person’s experience is fully individualized, from the initial assessment to recreational activities, skills development, and clinical therapy sessions.
Our unique treatment experiences aim to support young people to build stable, secure futures where they can thrive. Alongside clinical support, we help young people develop skills, achieve qualifications, and become world citizens. We celebrate different cultures, provide enriching activities, and use our natural surroundings to offer grounding and healing. We celebrate every success of young people, helping them feel valued and to grow.
This is our final blog in our autism series. Over the last few weeks, we have published A Guide to Helping Young People With Autism Manage Anxiety, Can Teens and Young Adults Have Both Autism and Bipolar Disorder? and Autism and ADHD – Exploring the Relationship. If you have any questions about our programs, autism, and mental health, contact us today. We treat every interaction with the utmost respect and confidentiality. Give us a call or leave us a message and we will respond as soon as we can.
Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).
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