Did you know that October is Mental Health Month? Did you also know that seven out of every ten autistic people experience mental health challenges?

People on the autism spectrum are more likely to experience poor mental health than their neurotypical peers. For example, depression and anxiety are 70% higher in the autistic population and one in four people with an eating disorder also meet the diagnostic criteria for autism. Combined with a lack of support options tailored to the needs of autistic people, mental health challenges can often persist for longer and be more severe.

In this post, we’ll take you through the factors that can cause and exacerbate mental health challenges for autistic people. We’ll also share some of the signs that a person with autism might be struggling and how you can effectively support yourself or a person on the autism spectrum that you know:

• Risk factors
• Signs of mental ill-health in autistic people
• Support options
• Where to next? (Further support and emergency helplines)

Risk factors

Although mental health challenges can impact people of any age, stage or background, some of us are at a greater risk of experiencing mental ill-health. There are a range of factors that cause neurodivergent people, particularly those on the autism spectrum, to be at greater risk:

Sensory processing issues

Many autistic people experience issues with sensory processing that can heighten anxiety and other mental health challenges. Environments such as shopping centres and medical facilities, with their bright lights, loud noises and unfamiliar faces, can be hugely stressful for someone who is autistic. Consistent exposure to these overwhelming places without adequate support can lead to meltdowns or even burnout. A person with autism might also choose to avoid these places for fear of sensory overload, causing social isolation and other issues.

Executive functioning

Difficulties with executive functioning can make day-to-day activities much more challenging, not to mention things outside of the ordinary that inevitably happen from time to time. Many people with autism struggle with executive functioning, which impacts attention, memory, impulse control, multi-tasking, inhibition and problem solving. As a result, fulfilling everyday responsibilities and navigating life’s challenges can be much more stressful, which can contribute to burnout and other long term mental health struggles.  

Rigidity of thinking and reliance on routines

Autistic people are heavily dependent on strict routines for emotional stability. When these set routines and ways of thinking change, particularly with little notice, an autistic person can feel incredibly overwhelmed. When a person is affected so deeply by changes and unpredictability, they are at greater risk of poor mental health.

Social and communication challenges

People on the autism spectrum experience varying levels of social and communication challenges. These can cause someone difficulty identifying that they’re struggling and articulating this with those around them. It can also make it difficult for a person’s loved ones or support network to notice these struggles. Not feeling heard or understood can then impact mental health challenges further.

Bullying, harassment or discrimination

Out of all of the groups that make up the neurodivergent population, autistic people are the most likely to be bullied. Whether that’s at school, in the workplace, online or in other spaces, bullying, harassment and discrimination have detrimental effects on an individual’s health, self-esteem and overall wellbeing.

Signs of mental ill-health in autistic people

It can be difficult to identify someone who’s struggling with their mental health, and for people with autism, it can be even more difficult due to factors mentioned above. However, there are some universal signs that often indicate someone is experiencing mental health challenges. If you’ve noticed that you or someone you know is exhibiting these behaviours over a period of two weeks or more, and these behaviours are out of character, it might be time to seek support:

• Frequent feelings of worry, nervousness, and anxiety
• Frequent feelings of sadness and depression
• Increased irritability, anger and emotional outbursts
• Sleep problems
• Sudden weight or appetite changes
• Withdrawing from people and activities they usually engage with and enjoy
• Reduced performance at school, work, university or in other areas of life
• Engaging in risky behaviours such as substance abuse
• Expressing or demonstrating feelings of guilt or worthlessness
• Changes in feelings and/or behaviour that cannot be explained otherwise

Support options

Although poor mental health is not ‘visible’ in the same way that physical health problems are, a person struggling still requires professional and evidence-based support that acknowledges their unique needs, challenges and strengths. Finding this support can be challenging, but it’s an important first step in striving towards a better quality of life:

Face-to-face support

Traditional forms of mental health support are often conducted face-to-face and delivered by a health professional, such as a psychologist, psychiatrist, GP (with relevant training) or mental health nurse. This could take the form of talk-based therapy, group therapy or other psychological support. Face-to-face support can occur locally, but you may need to travel further to find the services that best suit your needs and circumstances.

Online support

Sometimes, face-to-face support isn’t accessible for a variety of reasons, and that’s where online support can come in. Delivered wherever you feel most comfortable (e.g.,your home), online support is often more flexible, affordable and might be less socially overwhelming for autistic people. This support could include:

• Phone counselling
• Online counselling 
• Chat rooms and support groups

Although online therapies can be more convenient, it’s important to ensure your provider and their service is safe and legitimate. Check out our page on what makes a good support service or our other articles on quality services and support for autistic people.

Positive relationships

We all need human connection, whether we’re on the autism spectrum or not. Having the support of others is paramount to our social wellbeing, which in turn supports our mental health. Here are some tips for forming and maintaining vital positive relationships:

• Find like-minded people who share your passions, goals or experiences. Interacting with people that are similar to us can make socialising less daunting and enable you to form friendships with people who better understand and support you.
• If you predominantly interact with people online, try to slowly introduce more face-to-face socialising into your life. This could be seeing family and friends more frequently or even meeting up with online friends in person.
• Increase your time spent socialising slowly so as not to overwhelm yourself. Ensure that you’re also taking time to rest, relax and enjoy your own company to avoid burning out.
• Consider joining social groups, support groups or social skills programs, particularly those created for autistic people.

Self-care

Although self-care isn’t a substitute for professional mental health support, it can help us care for other areas of our health and more easily navigate our day-to-day lives. Examples of self-care strategies that can support our mental health include:

• Adequate sleep (sleeping enough, sleeping consistently, getting up and going to sleep at a reasonable time)
• Exercising regularly (daily if possible)
• Eating well
• Journaling
• Mindfulness and meditation
• Spending time in nature
• Fostering positive relationships with those around us
• Fostering a positive outlook on life

The important thing to keep in mind with all these support options is to keep your expectations realistic. Improvements in your mental health aren’t going to happen overnight. They’ll take effort over a considerable period of time. Focus on keeping an open mind and moving forward slowly; it’s better than not moving forward at all.

Where to next?

Navigating mental health challenges can be challenging for an autistic individual and their loved ones, but it’s not impossible. Although some problems can seem too large to tackle when you’re going through them, there’s always something that can be done, or someone who can listen.

For further information about therapies and supports for autistic people and their loved ones, visit the links below:

• School years
• Teens & young adults
• Adults
• Parents & carers
• Looking after yourself (adults)
• Looking after yourself (parents/carers)

You can also visit this page by the NSW Government which contains a comprehensive list of mental health services and support contacts (most are accessible throughout Australia).

If you or someone you know is in crisis, please contact the following helplines immediately:

• Lifeline (13 11 14)
• Emergency Services (000)