Autism and mental health conditions​

It is common for people with autism to experience other mental health conditions as well. According to current evidence, between 50 and 70% of people on the autism spectrum experience other mental health conditions too.

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Common mental health conditions

The most common mental health conditions experienced by autistic people are:

  • Depression
  • Anxiety disorders
  • Obsessive-compulsive disorder

People can have more than one of these conditions at the same time.


Understanding anxiety: fight, flight, or freeze

Fight, flight, or freeze are the three ways our bodies respond to perceived threats and danger, whether they are real or not.

The risk of physical harm can make people perceive a threat. Events that can impact on emotional wellbeing, such as fear of speaking in from of work colleagues, can also make people perceive a threat.

When a person perceives a threat, a protection mechanism is triggered automatically. This results in a variety of physiological changes, preparing you to ‘fight’ (confront the threat), flee (escape the threat), or ‘freeze’ (remain motionless in response to the threat).

Physiological changes may include:

  • Increased heart rate
  • Sweating
  • Shaking
  • Difficulty concentrating
  • Tensed muscles

Signs of anxiety

Anxiety can make social interactions harder for people on the autism spectrum. It can also impact on work performance.

Signs of anxiety may include:

  • Frequent absence from work
  • Increased focus on special interests
  • Social withdrawal
  • Problems with thinking flexibly (greater need for structure)
  • Increased repetitive behaviours or actions (for example bouncing their leg, tapping the table),
  • Loud sighs or increased noise when working
  • Banging things around
  • Being overly critical of themselves or others
  • Not being able to do work that they can normally do
  • Inability to focus or concentrate
  • Higher sensory sensitivities
  • Losing patience easily
  • Self isolating

It is important to offer reassurance during times of heightened anxiety. Providing accommodations can reduce anxiety significantly.

Factors that can impact on anxiety at work

  • Meeting new people
  • Change in structure
  • Change in routine
  • Change in expectations
  • Interruptions
  • Can be oversensitive to feedback
  • Perfectionist traits
  • Uncertainty
  • Executive functioning challenges
  • Sensory overwhelm
  • Social gatherings
  • Fear of not doing a good job
  • Lack of clarity

A lack of clarity in the workplace is hard for anyone to manage, but for an employee on the autism spectrum this unpredictability can be especially hard.

Some people on the autism spectrum struggle with self-awareness, so it is hard for them to recognise when they are stressed or anxious.

As a manager of an employee on the spectrum it is important to acknowledge any changes in behaviour. Be aware of what makes your employee anxious and how best to provide support.

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