Mental health difficulties can be under-recognised in autistic people, especially if someone struggles to explain feelings or if distress shows up as behaviour, shutdown, anger, or withdrawal.

A good starting point is always: What is the environment asking of the person, and what support is missing?

1) Anxiety

Anxiety is one of the most commonly reported difficulties. The world can feel unpredictable, overwhelming, and full of sensory and social demands.

• Signs: excessive worrying, restlessness, avoidance, irritability, physical symptoms (headaches, stomach aches)
• Support: predictable routines, sensory breaks, calming strategies, reassurance, and adapted talking therapies (e.g. CBT)

2) Depression

Depression can be difficult to spot if someone masks or finds it hard to describe low mood. It may look like withdrawal, loss of interest, changes in sleep, or reduced motivation.

• Signs: persistent low mood, loss of interest, sleep/appetite changes, low energy, difficulty concentrating
• Support: emotional support, routine, manageable goals, and therapies such as CBT or ACT (adapted where needed)

3) ADHD (co-occurring)

ADHD commonly co-occurs with autism. Difficulties with attention, impulsivity, and restlessness can affect stress, self-esteem, and relationships.

• Signs: distractibility, forgetfulness, impulsivity, restlessness
• Support: structure, clear routines, behavioural strategies, and sometimes medication (managed by a clinician)

Mental health impacts overall wellbeing, relationships, education, employment, and daily functioning. When mental health needs are recognised early, people can build coping strategies and reduce escalation into burnout or crisis.

• Early support improves long-term outcomes
• Reduced stress improves regulation and communication
• Better understanding reduces shame, conflict, and isolation

Therapy and counselling

• Talking therapies can help (especially when adapted for autism)
• Therapy may focus on coping strategies, anxiety management, and emotional regulation

Medication

For some people, medication can be part of managing anxiety, depression, or ADHD. Medication should always be prescribed and monitored by a healthcare professional.

Supportive environment

• Structured routines and clear expectations
• Reduce sensory overload where possible
• Safe spaces and breaks
• Self-care support: sleep, food, movement, downtime

Parent/carer support

Families and carers often need support too. Training, peer support, and guidance can help reduce stress and improve consistency at home.

If you or someone you support is struggling, seek help early. A professional who understands autism can offer more tailored support and avoid misunderstandings.

• Start with your GP or existing support team
• Keep notes of triggers, changes, and what helps
• Ask for adjustments in appointments (more time, written summaries, quieter space)

If someone is at immediate risk of harm, use your Crisis & support tool in the app or call emergency services.