Disorders Related to Autism
Having an autism diagnosis may also come with comorbidities, such as physical, mental, or emotional symptoms.
If you or someone you know is on the autism spectrum, it is important to be aware that autism can coexist with various health conditions.
It is highly probable that an individual with autism will have at least one additional condition that results in physical, mental, or emotional symptoms. According to a study, up to 95% of children with autism have a co-occurring condition, and nearly 75% of individuals with autism may have another neurodevelopmental disorder or mental health condition.
In general, the conditions that are commonly associated with autism can be categorized into the following groups:
- Mental health conditions
- Medical conditions
- Genetic conditions
It can be challenging to distinguish between the symptoms of autism and those of co-occurring conditions. However, having a clear understanding of how a specific condition impacts an individual with autism can aid in its management. This applies to both autistic individuals and their caregivers.
Mental health conditions and autism
Studies indicate that it is frequent to develop a comorbid mental health condition if you have autism. Additionally, autistic individuals are more prone to experiencing another mental health disorder than those who are not on the autism spectrum.
Occasionally, the way you communicate and behave on a daily basis as an autistic person can lead to the development of mental health conditions.
Anxiety
Research suggests that around 50% of people with autism also experience anxiety, which can manifest as persistent worrying, phobias, and other anxiety symptoms such as fear of loud noises or spiders.
Autistic individuals may find it challenging to self-regulate and calm themselves down once anxiety is triggered, even if they don’t have a diagnosed anxiety disorder.
Depression
According to a literature review conducted in 2018, approximately 37% of autistic individuals have been diagnosed with depression at some point in their lives.
Additionally, other studies have shown that autistic people are four times more likely to suffer from depression than those who are not autistic.
Autistic people who experience depression may not necessarily exhibit typical symptoms of sadness, but instead may experience insomnia or restlessness.
Additionally, autistic individuals with depression have a higher likelihood of experiencing suicidal thoughts and engaging in suicidal behaviors compared to those who are not autistic.
Previous experiences of bullying or feelings of loneliness can also contribute to depression in some cases.
Detecting depression symptoms early can aid in seeking appropriate support and addressing the effects of depression.
Suicide prevention
If you or someone you know is considering suicide, you’re not alone. Help is available right now:
- Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
- Text “HOME” to the Crisis Textline at 741741.
Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.
Bipolar disorder
Autistic individuals are more likely to experience bipolar disorder than the general population. Bipolar disorder comes in various forms, such as bipolar I and II disorders, and is characterized by changes in mood, including mania, hypomania, and depression.
Psychotic symptoms like hallucinations and delusions may also occur in individuals with bipolar disorder.
However, these symptoms can sometimes be mistaken for autism. Tailoring a treatment approach to the specific needs of autistic individuals may be the most effective way to manage bipolar disorder.
Eating disorders
Studies have indicated a correlation between autism and eating disorders, with autistic women having a higher risk of developing such conditions than autistic men.
There have been several studies that have found a correlation between autism and anorexia nervosa, and it has been suggested that up to 30% of people with anorexia may also have autism or autistic traits.
Autistic people are also known to experience Avoidant/Restrictive Food Intake Disorder (ARFID), which can lead to difficulties in eating certain foods and even malnutrition.
This disorder could be linked to sensory issues with different types of food for autistic individuals.
Due to the unique needs of autistic individuals, traditional treatment methods for eating disorders may not be effective. Therefore, clinicians are developing treatment plans that cater to the needs of autistic people with eating disorders.
Obsessive-compulsive disorder (OCD)
One recent study reported that 5% of young people with autism also had OCD. When both autism and OCD coexist, they can have a more significant impact on a person’s social skills than when they appear alone.
Some evidence suggests that a significant number of individuals with OCD may also have undiagnosed autism.
Since both conditions share some similar behavioral patterns, such as the preference for certain rituals, it can be challenging to differentiate between the two.
Some common symptoms of OCD include feeling the need to do things in a specific way, repeating certain actions or behaviors, experiencing anxiety, and having persistent and recurring thoughts.
A study discovered that OCD can result in increased hoarding tendencies in individuals on the autism spectrum.
Medical conditions and autism
Autistic individuals are more likely to have certain medical conditions than those in the general population.
These conditions include sleep disorders, seizure disorders, and gastrointestinal issues.
A review of literature found that medical conditions were present in autistic people in a range of 10% to 77% of cases.
Sleep disorders
Around 13% of individuals on the autism spectrum have been found to have sleep disorders. Some of the symptoms they may experience include difficulty falling asleep, waking up multiple times during the night, staying awake for prolonged periods during the night, and waking up very early in the morning.
According to research, sleep disorders such as insomnia can affect up to 66% of autistic children. In addition, autistic individuals may also have other conditions that can interfere with their sleep, including gastrointestinal problems, ADHD, and anxiety.
Taking medications for these conditions can also affect sleep, such as stimulant meds for ADHD that can cause insomnia or medication-induced constipation that can cause cramps and disturb sleep.
Seizure disorders
Epilepsy or seizure disorder is characterized by recurring seizures, and it is more prevalent among autistic individuals than the general population, affecting about 12% of them, according to research.
Autistic individuals with an intellectual disability may have a higher risk of developing epilepsy. Autistic women may also have a higher likelihood of experiencing seizures compared to autistic men.
Studies suggest that autistic children with seizures may have a higher risk of developing sleep difficulties and behavior problems than those without seizures.
It is important to diagnose and treat epilepsy promptly as untreated epilepsy can lead to other health issues.
Gastrointestinal (GI) issues
GI symptoms like constipation and diarrhea are prevalent in a considerable number of autistic individuals. According to a literature review, on average, 46% of autistic people suffer from GI problems.
The reason behind constipation and other GI issues could be various factors such as side effects of specific medications, sensory or behavioral issues, eating disorders such as ARFID, a sluggish intestinal tract, metabolism-related issues, and anatomical or gut microbiota differences.
It is often a combination of several factors that causes constipation in autistic people. GI symptoms can contribute to behavioral patterns such as hyperactivity, aggression, and self-harm, which may indicate that GI symptoms are causing pain or discomfort.
This is especially true for autistic individuals who have difficulties with verbal communication.
To add to the list of potential causes for diarrhea in autistic people, some of them may experience it due to lactose intolerance, food allergies, or celiac disease.
Dietary restrictions are often used to treat GI symptoms, although medications or surgery may be necessary in some cases.
Genetic conditions and autism
Autism spectrum disorder is often associated with certain genetic conditions, such as Fragile X syndrome and tuberous sclerosis. While these conditions have their own specific symptoms, they can also exacerbate certain communication and behavioral patterns associated with autism.
Fragile X syndrome (FXS)
Although ASD is primarily diagnosed based on behavioral patterns, FXS is a genetic condition caused by mutations in the fragile X gene. When an individual with FXS also displays symptoms of ASD, it is attributed to the genetic mutation causing both conditions.
Fragile X syndrome causes:
- intellectual disability
- delayed development
- specific behavior patterns such as hyperactivity
Fragile X syndrome is a genetic disorder that can cause a range of symptoms including:
- Intellectual disability
- Learning difficulties
- Language and speech delays
- Anxiety and hyperactivity
- Autistic-like behaviors
- Physical features such as a long face, large ears, and a prominent jaw
- Sensory sensitivities
To be more precise, the Centers for Disease Control and Prevention reports that about 46% of boys and 16% of girls with Fragile X syndrome have autism spectrum disorder.
Due to the established association between Fragile X syndrome and autism, it is common for clinicians to recommend genetic testing for children with autism in order to screen for Fragile X syndrome and other genetic disorders.
Tuberous sclerosis
Tuberous sclerosis is an uncommon genetic condition that results in the growth of noncancerous tumors on important organs of the body. Studies indicate that approximately 50% of individuals with tuberous sclerosis meet the diagnostic criteria for autism spectrum disorder.
Tuberous sclerosis can cause a wide range of symptoms depending on where the tumors develop in the body. Some possible symptoms include:
- Seizures
- Skin abnormalities such as raised and discolored patches
- Developmental delays
- Behavioral problems
- Intellectual disability
- Autism spectrum disorder
- Problems with the kidneys, heart, or other organs
Tuberous sclerosis is linked to autism and may even be a cause of it.
Tuberous sclerosis symptoms can also worsen some behavior patterns associated with autism, especially if the tumors grow in the brain or cause pain.
Autism and other neurodevelopmental disorders
Neurodevelopmental disorders are conditions that affect brain function and are often diagnosed in childhood. Autism is an example of a neurodevelopmental disorder.
Other neurodevelopmental disorders that are commonly associated with autism include intellectual disability.
Since the symptoms of ASD and other neurodevelopmental disorders tend to emerge around the same time, it is not uncommon for a child with autism to also meet the criteria for another neurodevelopmental disorder.
More than 50% of children with autism may have another co-existing neurodevelopmental disorder.
Attention deficit hyperactivity disorder (ADHD)
ASD and ADHD often co-occur and have overlapping symptoms, which can make it challenging to distinguish between the two disorders. Some symptoms that are common in both include:
- Difficulty with impulse control
- Inattention
- Hyperactivity or restlessness
- Social difficulties
- Emotional regulation challenges
- Sensory processing issues
However, ASD is typically characterized by more pronounced social difficulties and repetitive behaviors, while ADHD is characterized by more pronounced problems with attention and hyperactivity.
Children who have both ASD and ADHD may also be more likely to experience:
- Sleep disturbances
- Aggressive or impulsive behavior
- Difficulty with social interaction
- Challenges in school
- Sensory processing issues
- Motor coordination difficulties
To be more precise, some studies have suggested that around 30 to 80% of people with autism may also have ADHD.
Intellectual disability
Intellectual disability and autism diagnoses have a lot of similarities, but they are different conditions.
Although it was previously believed that 70% of autistic people had an intellectual disability, research suggests that it’s closer to 30%. Intellectual disabilities can affect reasoning, planning, and abstract thinking.
Since both conditions can impact communication, it’s not always easy to determine which diagnosis is more appropriate or if both are applicable.
According to the DSM-5, if an intellectual disability can better explain the symptoms than autism, then autism should not be diagnosed.
What’s next?
To be autistic increases the likelihood of having other secondary conditions that could affect mental or physical health, genes, or development. It’s important to seek medical attention from a pediatrician if you suspect your child has autism or another condition.
Pediatricians are usually well-informed about developmental differences and can help with diagnosis and support planning.
For autistic individuals, it’s also encouraged to consult with a trusted doctor or other individuals if they believe they have another condition.
While identifying overlapping conditions can be complicated due to their complex interactions, recognizing and comprehending the symptoms can empower individuals to take control of their well-being.
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