Autism and Mental Illness

Autism is not a mental illness, yet some individuals living with autism have a co-occurring mental disorder. The primary mental illnesses that can show up in adults with autism are:

  1. Anxiety Disorders: Anxiety is quite common in the autistic community. Around  40% of individuals with Autism have at least one anxiety disorder in comparison to 15% of the general population. Factors that can lead up to anxiety for people with autism include:
    • vulnerability to stress
    • biological differences in brain structure and function
    • history of social difficulties (leading up to low self-esteem and confidence)
    • problems finding flexible responses to apparent threats.
  2. Obsessive Compulsive Disorder (OCD): OCD is an anxiety disorder that is composed of two parts: the obsessions (thoughts) and the compulsions (behaviors). OCD is often overlooked in individuals with autism because it can be mistaken for autistic behaviors, rather than a separate disorder.
  3. Depression: Young people with autism who develop depression may show these symptoms:
    • An increased lack of interacting with others.
    • Pulling away from others because they are tired trying to conform to social norms they don’t understand.
    • Becoming dejected because they can’t connect with others.
    • May show more self-injury and repetitive behavior if they are unable to communicate their needs.
  4. Attention Deficient/Hyperactivity Disorder (ADHD):  In my experience working with children with autism, especially ones on the high functioning side, this is a standard feature. The children I work with are often distracted, forgetful, and have this endless bound of energy. Furthermore, their infinite energy can be separate from their autism diagnosis.
  5. Bipolar disorder and Schizophrenia: Bipolar disorder and Schizophrenia may be difficult to distinguish for individuals with autism because the disorders also show cycling inflated and deflated moods that are unconnected to life experiences.


There are therapeutic approaches that focus on mental health issues in individuals with autism. Unfortunately, there is little research that takes an existing autism diagnosis into account. Many clinicians prescribed medications “off-label.” Off-label means that medications are used differently than what is approved by the Food and Drug Administration (FDA) Also, some members of the medical community believe that mental illness warrants a separate treatment from autism.

Beth Yurman, a licensed psychologist at Spectrum Services in New York City, says “The big misconception is that symptoms of mental health disorders are just parts of person’s autism.” She adds “Some people think these issues are just part of the disability that they cannot treat or change.” Fortunately, there are researchers out there who are working their best to sort out autism symptoms from mental illness symptoms.

Leslie Deprey and Sally Ozonoff, psychologists, note in Assessment of Autism Spectrum Disorders, that “although the differential diagnosis is difficult, it is essential, as treatment of the [autism] symptoms alone will usually not result in improvement in the other behavioral or emotional problems that exist. Undertreatment or partial treatment can result in significant functional impairment.”

Yurman adds a combination of Cognitive Behavioral Therapy (CBT) and medication can help many people co-diagnosed with autism and mental health issues. CBT may help individuals with autism become aware of their maladaptive behaviors and medication may alter mood and curb impulses.

Useful Things to Consider

Autism is a hard diagnosis and having mental health problems on the side can make it a battle to handle. Valuable things to consider when helping a loved one with autism and mental illness or if you have the co-diagnosis, are:

  • Working with a clinician who is willing to make accommodations.
  • Find a clinician to treat the co-diagnosis rather than just the autism symptoms itself.
  • Find a support group because it helps make the co-diagnosis easier to handle and so that you or your loved one don’t feel alone.

Information from:

Autism After 16

Autism Now

Photo Courtesy: By hepingting – [CC BY-SA 2.0 (], via Wikimedia Commons