Autistic Mental Health: A Support Guide

Mental Health: More than Our Diagnoses

Mental health is much more than just a list of conditions, the symptoms they create, or medications used to treat them. Mental health is defined by the World Health Organization (WHO) as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.”

As recently as 2020, the WHO and the greater medical community truly began to recognize the complex, individualistic nature of mental health and how it affects not just the individual person but our whole society. Now knowing the benefits of expanding equitable and accessible mental health care both the WHO and the greater medical community are working on expanding mental health services into previously neglected communities.

Specific populations are at higher risk of developing mental health conditions, such as People of Color, those who have a lower income level, and/or those who have poor access to mental health services. This higher risk is also prevalent in people of certain genders and sexual identities, and in the case of other co-occurring disabilities. The Autistic population is one of the groups that is disproportionately affected and has barriers around their mental health every day.

Is Autism a Mental Health Condition?

The short answer is no, autism is not a mental health condition or disorder, nor is it an illness. Autism Spectrum Disorder is a neurodevelopmental disability that affects how a person perceives, processes, and interacts with the world around them – a world that, most of the time, is not created in a way for Autistics to thrive.

So, if autism is just a way to view the world, then why do we need to pay specific attention to an Autistic person’s mental health?

One way Autistics get through their days is by unknowingly attempting to blend in by imitating those around us or fictional characters. This technique has been called “camouflaging” or “masking.” Masking is the most popular and current term used out of the two. All people adopt this tactic when growing up, but for Autistics, it can lead to more long-term and harmful consequences. Late-diagnosed Autistics in particular have a hard time unmasking later in life and undoing negative effects such as depression, anxiety, and potential increase in suicidal behaviors. This article from the National Autistic Society goes into more detail around masking and the negative effects on an Autistic person’s mental health and well-being.

Being Autistic can come with a higher risk for a multitude of physical and mental health conditions. Three main mental health conditions that are often reported by Autistics are depression, anxiety, and C-PTSD (complex post-traumatic stress disorder). Some of us also have chronic pain and chronic fatigue syndromes that can also affect our mental health.

Now that we understand mental health and how important it is, let us look at some ways to support ourselves or the Autistic people in our lives.

Types of Therapy for Autistic People

Whether it is to help an Autistic person better understand how their brain works, meet certain goals, or support co-occurring mental health conditions. Therapy can be a critical piece of the holistic healthcare many Autistics need. I have listed some of the most common therapies used within the holistic mental health care system for both allistics (those who are not Autistic) and Autistics.

Some therapies can help support Autistic people with multiple challenges. For example, cognitive behavioral therapy can help with understanding specific social rules that can often perplex many Autistics, while also supporting stress reduction and overall resiliency within their lives.

Cognitive Behavioral Therapy (CBT)

CBT is often used to help with anxiety and managing emotions. It can easily be adapted to help both adults and children who are Neurodivergent by incorporating social aspects and the often-unwritten rules that can dominate our society. These rules and social aspects can often cause severe stress and anxiety for Neurodivergent (ND) individuals. CBT therapy can also be adapted to meet the needs of those with learning disabilities by using different forms of communication and levels of support needs.

Applied Behavioral Analysis (ABA) is similar to CBT, but focuses on behavioral change (versus CBT’s focus on the cognitive or emotional reason around a behavior). By solely focusing on task completion and behavior modification, ABA therapy removes the holistic and life-long supportive focus available within CBT.

Eye Movement Desensitization & Reprocessing (EMDR)

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. It can include being guided in lateral eye movements or holding items that alternate vibrating in each of the client’s hands, resulting in the bilateral stimulation of a person’s brain and mind to help the brain heal from the past trauma.

Using EMDR to help Autistics process and heal from trauma and symptoms of C-PTSD and PTSD is still considered a new area of clinical study. There are case reports that show EMDR therapy is helpful for managing and potentially healing complex trauma in Autistic individuals. A good place to start learning more about EMDR, for ND adults specifically, is reading the EMDR International Association’s interview with one of the leading therapists who works with Autistics using EMDR.

Art & Music Therapy

It is well known in the scientific world that engaging in art and music activates our brains like nothing else can. The goal here is not to be the next Monet or Madonna, but to express ourselves, our emotions, and our personalities through art. It can also engage both sides of our brains, build neural pathways, and support fine motor skill development. For those who are non-verbal or have limited verbal communication abilities, art, and music often provide a moment of deep expression, understanding, and visibility.

Speech, Occupational, Play, & Physical Therapies

Using a fidget toy can be helpful for Autistic mental health

These types of hands-on therapies can be utilized to help ND children and adults to better thrive in their worlds. They range from improving balance to using communication devices. These therapy modalities are amazingly helpful. If you or your child are in the public school system and are diagnosed with an ND condition, you could possibly have access to an Individual Education Plan (IEP). This can create an interdisciplinary team and create a support network for the individual, which often includes these therapies.

Mindfulness Practices

For people with trauma, mindfulness can actually have an adverse reaction, including increased anxiety, trauma responses, or disassociation. A great book on trauma-informed mindfulness is “Trauma-Sensitive Mindfulness: Practices for Safe & Transformative Healing” by David Treleaven.

Mindfulness has become a buzzword for some, a cure-all for others, and a red flag for many. I want to dispel the myths and separate this amazing healing modality from the toxic positivity culture that has seemingly monopolized it. I am not saying that mindfulness will “cure" or “fix” anyone, nor do I want it to. Think of mindfulness as a support system that is simple and inexpensive, if not free.

Mindfulness can also build a bridge from our brains to our bodies. For many Autistics, there can be a barrier around connecting physical sensations to the needs that our brains are asking to be met. By providing specific tools, mindfulness can allow an Autistic person to identify specific physical sensations and connect them to specific needs such as hunger and thirst.

Guided body scans are a great example of a mindfulness tool that can help address physical discomfort before the discomfort in the person’s body can cause behavioral issues, like a meltdown or shutdown. The Calm app is an amazing meditation app that I feel is ND-friendly and worth the annual subscription. They also provide bedtime stories and mindfulness sessions for kids on this app.

Using Probiotics for Mental Health

Humans have an enteric nervous system (ENS) located in our gut. It is a place where neurotransmitters are made and utilized. Our ENS is actually part of our peripheral nervous system. Like the CNS, the ENS can produce neurotransmitters and utilize them. Moreover, the gut and brain communicate bidirectionally via the gut-brain axis. This means that our gut health is literally part of our nervous system and mental health!

A simple yet effective way to support our gut health and in turn our ENS is with probiotics, either from fermented foods, supplements, or medical probiotics.

If you are considering trying a probiotic to support your gut and brain, look for supplements that are “GMP” certified, quality tested, and guarantee a clinically relevant number of colony forming units (CFUs) per serving. Since probiotics are not regulated by the FDA, it can feel a little hard to know what you are getting. These qualifiers take a lot of the mystery out of it and show the effort by the company to create a safe and effective product.

It is worth mentioning that there are special strains of probiotics called psychobiotics. Some of these probiotic strains may affect our neurotransmitters, such as dopamine, which is commonly known as our reward neurotransmitter. Autistics and those with ADHD are thought to have difficulties with the reuptake of dopamine. By balancing dopamine and serotonin levels in the brain, it may be possible to decrease stress and feelings of overwhelm, and support a balanced mood.

If you want to try a psychobiotic, and it is approved by your doctor, Neuralli is a psychobiotic that I use myself and recommend.

Neuralli is a medical probiotic that provides nutritional support for dietary needs related to ASD

Embracing Your Brain as a Neurodivergent

It is not surprising that neurodivergent individuals have a higher risk and incidence of anxiety, depression, and trauma disorders. Studies have shown that not having enough healthcare providers properly trained to identify Neurodivergent conditions directly attributes to these high levels of co-occurring mental health conditions. ND individuals are also often underdiagnosed and under-supported, since there are some symptoms, or specific life challenges, that can occur in both ASD and these mental health conditions.

This underdiagnosis and overall lack of understanding by others limit involvement in surrounding communities, working, and having a sense of belonging. One survey showed that 85% of adult Autistics are unemployed and have a college degree. Out of the Autistic adults that were employed, 81% worked part-time and around 19% worked full-time – not to mention the over 400,000 Autistics that in April 2022 were found to be “discouraged” workers. This means that they left the workforce believing there were no jobs for them. In 2022, Canada found that over 1/3 of all disability claims in the general public were due to mental health reasons.

I list these quick statistics to show the far-reaching effects that unsupported mental health can have, by highlighting the importance it holds for each of us and hoping to motivate you to care for your mind, body, and emotional state.

No matter the type of therapy, nutritional support, or supplements, having a neurodiverse-affirming focus of care is everything. Instead of getting hung up on symptoms, blending in with society, and functionality, clinicians and family members need to focus on the Autistic person's quality of life and supporting them in bettering their mental health.

If you or someone you know is experiencing mental health challenges or a crisis, here are a few phone numbers and corresponding support.