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Autistic People Are More Likely to Self-Medicate Mental Health Symptoms

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Key Takeaways

  • A new study found that autistic adults are three times more likely to misuse substances to manage mental health symptoms.
  • Experts say that this may highlight an issue with people trying to mask their autistic symptoms, rather than coping with them.
  • Autistic adults often face barriers when accessing healthcare, including mental health treatment.

Autistic teens and adults are more likely to use recreational drugs and alcohol to manage their behavior and mask mental health symptoms than others, according to a new study by Cambridge University.

Autistic individuals sometimes use camouflaging, a strategy to mask autistic traits, to feel comfortable in social situations.

"There were quite a few people that talked about using substances to try and focus," Elizabeth Weir, co-author of the study and PhD student at Cambridge University's Autism Research Centre, tells Verywell. "Several people specifically said I use it to manage my autism. I use it to connect with other people. I use it to get comfortable."

What Is Camouflaging?

Social camouflaging, or masking, is a strategy used by many autistic people to hide or change the way they act to fit in social situations or work environments.

For the study, researchers surveyed 1,183 autistic and 1,203 non-autistic people aged between 16-90 and asked about the frequency of their substance use as well as their experiences.

Although autistic people were three times more likely to use recreational substances for medicating mental health, they were less prone to substance misuse, researchers found. For example, autistic individuals were less likely to drink alcohol regularly or engage in binge drinking. Respondents also reported factors that would make them susceptible to misuse of substances, such as being tricked or forced into using drugs in childhood.

Weir says the new study also highlights multiple issues with how autistic adults are not receiving proper care from their doctors. Some autistic individuals, for example, may have been taught by their doctors and psychiatrists to mask their symptoms.

Finding ways to cope with a disability or a health condition can be useful. For example, an autistic individual may engage in stimming, like hand-flapping and repeating words, to cope with sensory overload. However, camouflaging can lead to worsening mental health and increased risk of suicide.

What Is Stimming?

The term "stimming" is short for self-stimulatory behavior and is sometimes also called "stereotypic" behavior. Stimming usually refers to specific behaviors that include hand-flapping, rocking, spinning, or repetition of words and phrases. Autistic people stim to help themselves to manage anxiety, fear, anger, excitement, anticipation, and other strong emotions.

Members of the autism community may feel pressured to hide their autistic traits in order to blend in with neurotypical individuals in social situations and at work, a 2017 study found.

"A more pragmatic aspect of this motivation was the desire to obtain jobs and qualifications, which respondents felt were less accessible when they were more visibly 'autistic,'" the researchers wrote.

Leela R. Magavi, MD, a psychiatrist and a regional medical director for Community Psychiatry + MindPath Care Centers, tells Verywell that her patients who camouflage "feel more more burned out and depressed." She adds that individuals who engage in masking early on may not always get adequate help and resources.

"They may struggle with identifying and embracing their authentic self, which could significantly impact self-esteem and even lead to suicidal thoughts," she says.

While autistic people should not feel forced to take medication to seem less neurodivergent, some may benefit from supportive psychiatric care. Magavi says medications that treat "irritability, aggression, anxiety, ADHD, and various other comorbid disorders" can be helpful in some cases.

What This Means For You

Autistic people may feel pressured to mask or "camouflage" some of their traits in social situations. But camouflaging can lead to exhaustion, worsening mental health, and increased risk of suicide.

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  1. Weir E, Allison C, Baron-Cohen S. Understanding the substance use of autistic adolescents and adults: a mixed-methods approachThe Lancet Psychiatry. Published online July 2021:S2215036621001607. doi:10.1016/S2215-0366(21)00160-7

  2. Weir E, Allison C, Baron-Cohen S. Understanding the substance use of autistic adolescents and adults: a mixed-methods approach. The Lancet Psychiatry. 2021. doi:10.1016/s2215-0366(21)00160-7

  3. Hull L, Petrides K, Allison C et al. “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. J Autism Dev Disord. 2017;47(8):2519-2534. doi:10.1007/s10803-017-3166-5