Autism Stigma Behind Depression, Anxiety

According to the World Health Organization, depression is the disease causing the greatest public health burden in the United States, and the third-greatest burden worldwide. Anxiety disorders affect just over 18 percent of the US population, and 6.7 percent of the population suffers from Major Depressive Disorder.

But if someone is on the autism spectrum, the percentages are much higher. About 40 percent of people with autism have symptoms of an anxiety disorder, and they’re at greater risk for depression, especially if they’re characterized as high-functioning. But, according to a new British study, the prevalence of mental health disorders in those with autism has more to do with social stigma than an innate connection.

The new study found that social stigma around autism was linked to a staggering 72 percent of the study group’s psychological distress. “The only thing we were surprised by was how potentially strong a relationship there was. To put it colloquially, it blew our minds,” study author Monique Botha said.

Photo: Photo: Adobe Stock/Antonioguillem
Photo: Photo: Adobe Stock/Antonioguillem

The study

The study surveyed a group of 111 people with self-identified high functioning autism and found that discrimination, internalized stigma, and concealment of their condition predicted poorer mental health, even when controlling for exposure to general stress.

The research team wanted to challenge the idea that autism and mental health disorders are inevitably linked. Survey questions explored six areas of stress: victimization and discrimination, “outness” (or how often a person reveals they have autism), everyday discrimination, expectation of rejection, physical concealment of their condition, and internalized stigma.

Researchers weren’t surprised to find that social stress has a negative impact on emotional and psychological health; they were surprised to find by how much. According to the study’s author, around six percent of the general population experiences psychological distress, but more than half of study participants experienced psychological distress, which is a strong indicator for depression and anxiety.

Photo: Adobe Stock/phoenix021
Photo: Adobe Stock/phoenix021

“We hope this study will help change the way we think about autism and mental health, and make us think long and hard about the way we treat autistic people in society,” Botha said.

Eric Butter, director of the Child Development Center at Nationwide Children’s Hospital in Ohio, was skeptical of the results because the study’s used people who self-identified as having autism rather than a more rigorous diagnostic approach. Still, Butler said it makes sense that people with autism experience exclusion that affects their mental health.

“It’s really important to recognize that people with autism are people first. They are just as likely to experience being alienated, separated, lonely, and all the possible consequences of being inappropriately and unfortunately excluded from a social environment,” Butter said. Butter was not directly involved in the study.

Photo: Adobe Stock/imtmphoto
Photo: Adobe Stock/imtmphoto

Study implications

In children with autism, depression and anxiety disorders are often mistaken as symptoms of autism, and because there are symptoms that overlap the conditions, mental health disorders in those with autism are hard to identify and under-diagnosed. But co-occurring anxiety and depressive disorders severely compromise quality of life for those with autism and contribute to the increased risk of suicidal thoughts and attempts in the autism population.

The new study, even if the results are viewed skeptically, brings light to the fact that autism and mental health disorders and their detriments don’t occur in a vacuum. Lack of acceptance and social stigma contribute to these disorders. So while proper diagnosis and treatment is vital, societal acceptance of those on the spectrum could go a long way in decreasing co-occurring disorders and increasing quality of life.

Photo: Adobe Stock/dubova
Photo: Adobe Stock/dubova

As the prevalence of autism increases, we’ve seen wonderful displays of autism support: autism-friendly theme parks, autism-friendly airline programs, and even autism-friendly dentists. But simple, everyday acceptance seems to be lagging behind institutional support.

People with autism benefit from autism-friendly programs, but society needs autism-friendly people. We need greater autism acceptance in the workplace, less stigma, and increased patience with and openness to people who interact with the world differently than neurotypicals.

If neurotypicals can learn to communicate with those on the spectrum and see people with autism as people rather than “autistics,” society will not only reap the benefit of a richer neurodiversity, but create a safer, healthier world for those on the spectrum and their families.

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