Autism Spectrum and Mental Illness: Misdiagnosis or Co-Occurring Condition?

By Nomi Kaim

On their way to receiving an Autism Spectrum diagnosis, many people find themselves labelled with a variety of other conditions. These may include, but are not limited to, Attention Deficit/Hyperactivity Disorder (ADHD), Major Depressive Disorder, Bipolar Disorder, Obsessive-Compulsive Disorder (OCD), Generalized Anxiety Disorder, Post-Traumatic Stress Disorder (PTSD), Schizoaffective Disorder, Borderline Personality Disorder and Narcissistic Personality Disorder.

After an Asperger/Autism diagnosis is made, these mental health conditions often fall away, as their presumed symptoms are understood as actually being part of the Autism diagnosis. Executive Functioning challenges and Sensory Processing issues can be viewed as part of the Asperger/Autism rather than as distinct diagnoses. Anxiety and Depression may diminish as an individual increases in self-understanding, gains greater acceptance, and obtains access to needed supports.

On the other hand, some people diagnosed with Asperger/Autism suffer from distinct and debilitating mental health conditions. Anxiety and Depression, in particular, seem to occur at a higher rate among individuals with Asperger’s/Autism than in the population at large. While we can’t say why for certain, these illnesses may emerge as bi-products of living one’s life Autistic in a non-Autistic world, struggling to fit in. A number of other conditions, from OCD to Bipolar Disorder, may also co-occur. Individuals living with both Asperger’s/Autism and mental illness must be recognized and treated for each distinct neurological or psychiatric condition that they have. In the treatment of co-occurring mental illnesses, it is important that the person’s Asperger’s/Autism be recognized as the “neurological backdrop” upon which the mental illness(es) developed.

According to Daniel Rosenn, MD, “Getting the label(s) right is important for many reasons, not the least of which is that diagnosis often drives treatment planning, selection of medication, educational programming [and employment], and the way we conceptually and emotionally view our [loved ones or ourselves].”

At AANE, we have found that when people receive their Asperger/Autism diagnosis and join the AANE community, it often becomes easier to cope with any co-occurring conditions they might have.