Mental Health

Even though mental illness can be more common for people with autism than in the general population, the mental health of people on the spectrum is often overlooked. Here we look at anxiety, OCD and depression. By Dr Anastasios Galanopoulos, Dr Dene Robertson, Ms Debbie Spain and Dr Clodagh Murphy. This information is drawn from an article that first appeared in the Mental Health supplement of Your Autism Magazine, Vol 8(4), Winter 2014.

Reproduced by kind permission of The National Autistic Society “ www.autism.org.uk.

Anxiety disorders


Anxiety disorders are very common amongst people with autism. Roughly 40% have symptoms of at least one anxiety disorder at any time, compared with up to 15% in the general population. Understandably, this can lead to sadness or depression “ one reason why a mixture of anxiety and depression is common.
It is thought that a combination of factors, leading to vulnerability to stress, is likely to explain why anxiety disorders are so common in people with autism. Biological differences in brain structure and function, a history of social difficulties (leading to decreased self-esteem and a tendency to think of threats as greater than they are) and problems with finding flexible responses to apparent threats are all likely to contribute. Many people on the autism spectrum may have difficulty describing the symptoms they experience. A sudden change in behaviour could mean they have developed an anxiety disorder, even if there is no complaint of the typical symptoms.

Treating Anxiety Disorders


Most of the time we learn to cope with difficult situations, whether or not we have autism “ often by “sitting it out” and learning that we have not come to harm from the situation that worried us.However, if we have an anxiety disorder, we are more likely to try to escape from the difficult situation. This leads to a greater fear of the same situation and an even earlier escape the next time it occurs. In other words, anxiety tends to build on and reinforce itself. It is important to try to break this vicious cycle, and this is why cognitive (to do with thoughts) and behavioural psychological treatments are often as important in treatment as medication. Usually these treatments involve forming a working relationship with a therapist, building up any necessary skills, and deciding to work through a set of challenges (involving exposure to an aspect of the feared situation) one step at a time that are anxiety-provoking but not intolerable. This way both the mind and the body learn that the feared situation isn’t as dreadful as was thought, and this leads to a gradual reduction in anxiety. Such an approach is often very effective. The Canadian Mental Health Association website has further information about anxiety disorders, for more info click here 

Obsessive Compulsive Disorder (OCD)


OCD is an anxiety disorder. If someone has OCD, it means that they experience repetitive thoughts and behaviours that are upsetting to them. OCD occurs in about 2-3% of people who don’t have autism and is more common in people with the condition. It is thought that our genes (DNA) and our psychological predisposition can make us vulnerable to developing OCD, which can run in families. OCD can be distressing, exhausting and can get in the way of everyday life for the person who has it and their families. However, it is treatable.

There are two main parts to OCD: obsessions (thoughts) and compulsions (behaviours). OCD can be overlooked in people with autism as it may be mistaken for repetitive behaviour. However it is very different. If you think that you have OCD, let your GP know about your concerns. They will help you think about what to do and can refer you for a specialised assessment to help work out what may be OCD (or not) and what may be autism. Although there is increasing awareness of OCD, it is still under-recognised and therefore under-treated. If you have autism and think that you may have OCD, it’s best to get an assessment and treatment by a team that specialises in both autism and OCD.

The Canadian Mental Health Association website has more information on OCD, treatment and how to help a loved one, for more information click here  

Depression

It is very common to have times in our lives when we feel a bit sad or low. But when these feelings last for more than a few weeks and get in the way of day-to-day functioning, this can indicate a period of depression. This is no different in a person with autism to someone without the condition. It is estimated that at least 20% of the population will experience a period of depression at some point but it is even more common in people with autism. People who are depressed can experience a range of symptoms which vary from person to person in their combination, and can be mild or severe.

It may be especially hard for depressed people with autism to seek help because they might find change daunting and anxiety-provoking, feel worried that they will be blamed, or feel unsure about how to describe their symptoms. Anxiety and depression can also make people more generally introverted, withdrawn and isolated. All people with depression may have difficulty sharing their thoughts and feelings. But because people with autism can have difficulty labelling their feelings, it can be especially hard to communicate symptoms or concerns. 

Read more about the treatment and management of depression on the Canadian Mental Health Association website for more information click here  

Resource

Bridge the gAPP 

Is an online resource designed to support mental wellness in our province, the website and mobile app were developed by the Department of Health and Community Services. Depending on what you are looking for you may want to visit Bridge the gAPP for youth (ages 13-18), Bridge the gAPP for adults (18+) or visit the service directory to connect to local services right here in Newfoundland and Labrador. Check out their website here