“Those on the Autistic Spectrum are more likely to experience mental health problems, yet are less likely to receive beneficial treatment.“
Obsessive Compulsive Disorder (OCD)
A coping method for a lot of people on the Autistic Spectrum is ‘being in control’. Control methods such as planning and routines can help those on the spectrum feel calmer and more able to cope day-to-day.
However, control can be taken too far and it can also be easily lost. In either circumstance it can severely effect the individuals mental health.
Repetitive behaviors can be used as a tool to keep calm for those with ASD – such as stimming and special interests. But, if you have an OCD diagnosis, this is when the repetitive behaviors can become upsetting.
An example given on the National Autistic Society’s website is… an autistic person or someone diagnosed with OCD may repeatedly flick a light switch on and off. The autistic person may be doing this because they like the sound of the switch and the visual feedback when the light flashes on and off. The person with OCD may be doing it because they believe that unless the light switch is flicked on and off 15 times, something bad will happen to them.
The overlaps between autistic traits and OCD symptoms may lead some professionals to dismiss OCD symptoms as autistic traits, leading to under-diagnosis of OCD in autistic people.
I have never been diagnosed with OCD but I definitely have repetitive behaviors, (health professionals have always put this down to my Autism). Everything in my house has its place, if something is not in its place then I will not settle. This makes me a nightmare to live with. One time when I lived at home my Mum cleaned my room thinking she was doing me a favor. She moved all my items around so she could dust my shelves. When I returned from school nothing was where it should have been and I went into a meltdown. Even if an item is a cm out of line, I will notice.
I also get stuck in my own head with words. This is a strange one but I have read about it being related to Autism and repetitive behaviors. Sometimes, I will read a word and it will go round and round in my head. YOU YOU YOU YOU YOU YOU, on and on it goes until I say it enough times in my head or type it out on a keyboard. My brain seems to be random with which words it chooses and it can change day-to-day.
I have read many studies where the statistics show that eating disorders are often diagnosed in those with Autistic traits, the most common being anorexia; ASD can be found as a trait in food and counting calories. This can easily become a problem if it develops into an intense interest and/or obsession.
Some individuals with ASD struggle to listen to what their bodies are telling them, such as a feeling of hunger or fullness. I experience the latter, I never know when I have ate enough. I have been known to eat what is put in front of me until I am ill.
Sensory difficulties relating to food textures, smells, tastes and appearance can lead to a lack of appetite. You often hear of people with ASD eating the same meals everyday. It is usually very ‘bland’ food such as chips or a plain pizza. This is because they are foods which have little texture or taste to them so do not disturb the senses.
Eating the same foods avoids change and having to try something new which can be daunting for those on the spectrum. Reverting back to that need for control, food can be used as a tool to control. Routines and rules around food are very difficult to change. Food is one thing which is a certain, you are able to control what goes in and out of your body. I was an extremely fussy eater when I was younger and would only eat the same set of meals, it was put down to me being a child acting up… we now know it was because I am Autistic.
I believe every human will experience feelings of anxiety at some point in their life. It is a natural human emotion but for those who are Autistic if it is not addressed it can be debilitating.
The National Autistic Society lists the following as potential reasons for anxiety:
- differences in sensory processing for example, being over or under-sensitive to noises, lights and smells – I am prone to feeling anxious in loud and bright environments.
- finding it hard to predict or adapt to certain sensory situations – if my plans change then I become so anxious I can find it difficult to function, (such as being unable to speak) until I have wrapped my head around the change.
- difficulties with communication and social interactions – if I am attending a social event with people I have never met I will feel anxious during the build up to the event.
- having alexithymia (difficulties identifying and describing your own and other people’s emotions) – it is more difficult to regulate emotions if you cannot identify what you are feeling – I have never experienced anxiety from this but I do struggle to understand how others are feeling and sometimes how I myself am feeling.
- worrying about uncertainty and change or transitions, which comes with a fear of the unknown. You may like predictability and routines, and experience high levels of anxiety if things change – my biggest anxiety trigger is the fear of change.
All of the above are factors which as humans we are expected to deal with everyday. As someone with an ASD diagnosis’ the above are also factors which are challenging and can be distressing. For myself, it got to the point where the hardest part of my day was getting out of bed in the morning due to crippling anxiety which led into feelings of depression. I spoke openly about it to my Mum who encouraged me to go and see the doctor. I was prescribed anti-anxiety and antidepressant medication. The medication, which I am still taking today, has been incredibly beneficial to me. Whilst, I still get overwhelmed and experience feelings of anxiety it no longer effects my quality of life. The medication along with my own coping methods developed through a better understanding of myself and my limitations have made me feel much happier and content.
If anyone is feeling like they are struggling with their mental health then, from my own experience, I would recommend speaking to a family member, friend, health professional or anybody you feel you can open up to and trust.
At least 20% of the population will experience depression at some point but it is even more common in those with an Autism diagnosis.
There are many reasons you may experience depression. I suspect for those with ASD many feelings accumulate from being aware that you are different to your peers – I can relate to this one.
Unfortunately, when you are younger being different can also lead to bullying and being left out of social groups which all lead to depressive feelings and thoughts. When you have ASD you struggle to understand social ques and the different ways people can act towards you. I always found it most upsetting that I didn’t understand why I was being singled out.
As awful as it is to read all the evidence suggests that autistic people are at a higher risk of suicidal thoughts and suicide due to depression, among other mental health problems.
If you are worried about somebody you know who is on the Autistic Spectrum a great place to look for information is the National Autistic Society’s web page on Mental Health. Their web page contains links to different mental health problems which are common to those with an ASD diagnosis. The web page also provides useful facts and advice on how to help those who are struggling.
Always remember to speak up, asking for help is the most useful tool when it comes to our mental health. Choose someone who you feel comfortable around and open up about how you are feeling. I hope if you are struggling you are able to get the help you need, always remember you won’t be the only one experiencing mental health problems. Mental health issues are as common as getting a cold and the surrounding stigma needs to be normalised.