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An elderly lady staring at a model of a human brain.

Research claims autistic people are more likely to suffer from mental illness

One of the most prevalent myths when it comes to autism is the belief that it is a form of mental illness. There is much debate on the classification of autism among psychiatrists, doctors and neurologists. Officially, autism is generally accepted as a mental condition, rather than an illness, and many autistic people consider the implication that autism is a disease offensive. For example, the activist organisation Autism Speaks classifies autism as "a group of complex disorders of brain development".

What characterises autism? Many people still persist in thinking about people on the autistic spectrum in terms of the genius savants of fiction; colourful and quirky characters such as Dustin Hoffman's portrayal in Rain Man. But the truth is different. Autism is a pervasive, persistent developmental state where an individual struggles with non-verbal communication and social interaction. In particular, some autistics have problems with interpreting language literally and may find metaphors and figures of speech difficult to comprehend. These issues end up manifesting themselves in different ways. For example, some autistics may find speech challenging, develop tics or "stimming" behaviour, find it difficult to hold eye contact or communicate with strangers or dislike physical contact with people or stimuli they find threatening.

However, this isn't to say that autistic people don't suffer from mental health issues. On the contrary, in fact: recent research suggests that they might be far more vulnerable than neurotypical people. Since autistics are already unfairly stigmatised in society as a result of their condition, this news is very concerning indeed.

A number of brain scans on a computer monitor. Credit: Getty

A recent study entitled "Health Concerns and Health Service Utilisation in a Population Cohort of Young Adults with Autism Spectrum Disorder", published in the Journal of Autism and Developmental Disorders in September of this year, determined that young adults on the autism spectrum were far likelier to have been diagnosed with one or more psychiatric condition, (including depression, anxiety and attention deficit hyperactivity disorder) than neurotypicals or those who had other developmental disabilities.

The study examined administrative data from the medical and psychiatric records of young adults aged between 18-24 who had autism. Researchers then compared this with the health profiles of their peers who lived without autism. The study determined that autistic people were approximately five times more likely to have a diagnosed mental health issue on their record than neurotypical individuals, and were also twice as likely to suffer from a mental health issue compared to people with alternative developmental disabilities.

Commenting on her discovery, Yona Lunsky (a senior scientist at the Centre for Addiction and Mental Health in Toronto), who co-authored the study, stated: "When it comes to mental health diagnoses and use of psychiatric services, there's a really strong need for the entire developmental disabilities community, but it's an even bigger need for folks on the autism spectrum ... I think sometimes people will dismiss something as being part of autism when, in fact, it's not. There are people with autism who don't have psychiatric issues. We weren't doing the study to look at mental health. It's just what emerged. Unmet needs have a social cost, so we want to be able to recognise both physical and mental health needs for everyone and get them the right care."

Six-year-old Gwendoline, an autistic child, works with Professor Gilbert Lelord while under his care at Bretonneau hospital in Tours, France. Credit: Getty

Other research appears to correlate with her findings. A 2016 study conducted by the National Institutes of Mental Health compared the rate of mental health issues in approximately 8,300 youths who had been diagnosed with Asperger's syndrome (aged three to 17 years old) to around 83,000 control group youths who were not on the spectrum. Patients with autism were more likely to have received a psychiatric diagnosis of attention deficit-hyperactivity disorder, oppositional defiant disorder, anxiety, depression, or another serious mental illness.

Why are autistic people at risk? It could be that physicians and psychiatrists are guilty of conflating an autistic person's behaviour. Things which would be red flags for a mental health issue in neurotypical people might be overlooked by professionals and lumped in as an autistic trait instead of a symptom of something far more debilitating. This issue is thus left unresolved and untreated under the assumption that it is part of their autistic behaviour, and so the issue in question will compound itself until it's either impossible to manage or has adversely affected the patient's life.

There is also much speculation that stigmatisation, bullying and social isolation in childhood could lead to these issues; the enormous societal shaming of autistics by neurotypicals, and their unwillingness to understand the intricacies and peculiarities of their behaviour, could well lead to insecurity, social isolation and low self-esteem. This, in turn, means that a person on the spectrum is divorced from a vital support network, and thus stressors bear much more of a negative impact on their mental state. A history of social difficulties, the exhaustion and cognitive fatigue brought about via attempts to navigate social situations and exposure to triggering stimuli are all things which can lead to mental health issues and anxiety.

A model of a transparent human skull with brain inside. Credit: Jesse Orrico

The difficulty autistic people have in finding employment could also lead to them developing mental health issues. According to a survey conducted by the National Autistic Society, only 16 per cent of participants were working full-time, while only 32 per cent of respondents were working at all, compared with the 47 percent of otherwise disabled people and 87 per cent of non-disabled, neurotypical people also surveyed. Autistic people may find it hard to get hired in jobs which require a lot of social interaction and might find making a good impression in a job interview nearly impossible. The fact that so many recruiters seem content to discriminate against autistic people leaves them ultimately jobless: and the inevitable reliance upon welfare benefits can lead to eventual feelings of worthlessness or depression.

So how can we ensure that autistic people are protected from mental illness? It's clear that the burden of responsibility lies with society, not with those who were born with a particular condition. The public needs to be educated about autistic people and be made aware of their issues so that we can better distinguish between a mentally healthy autistic person and someone suffering from a mental illness. Finally, we need to do everything we can to ensure that autistic people are accepted and that their struggle is rightfully validated and punish any abuse or discrimination against people who are on the spectrum. Only then will we see any real change.