Mood Disorders and People With Autism

Asian woman depressed and leaning on cushion

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The diagnostic criteria for autism spectrum disorder (ASD) do not include mood disorders such as anxiety, depression, or obsessive-compulsive disorder. But many people with ASD are overwhelmed by these mood disorders, perhaps even more than by the symptoms of autism itself.

For example, according to the non-profit Autism Speaks: "Some studies have found that as many as 27 percent of those with autism also have symptoms of bipolar disorder. By contrast, its prevalence in the general population is around 4 percent."

Another article states, "Research suggests that autism shares a genetic basis with several major psychiatric disorders. These include attention deficit and hyperactivity disorder (ADHD)), depression, bipolar disorder, and schizophrenia. Other research suggests that just over two-thirds of children with autism have been diagnosed with one or more psychiatric disorders. The most common include anxiety, obsessive-compulsive disorder (OCD) and ADHD."

Are the Statistics Accurate?

While these numbers are staggering, they may not be quite accurate. That's because so many of the signs of autism, such as a preference for solitude, unusually strong responses to sensory input, social communication challenges, and idiosyncratic speech patterns, make it very difficult to make an accurate diagnosis of a mood disorder. Yes, for example, people with autism may talk rapidly or talk to themselves, but is that an indication of a manic episode, or just a manifestation of autism?

It can also be difficult for an autistic person to express his or her emotions in a typical manner. For example, autistic people (even very high functioning people) are much more liable to have emotional outbursts than their typical peers. But does that mean they are actually experiencing more intense negative emotions? The answer isn't always clear, making it hard to come up with a truly accurate estimate of the incidence of mood disorders among people on the spectrum.

Possible Causes of Mood Disorders

Assuming that there really is a high level of mood disorder among autistic people, one reasonable explanation might be that the life experiences of people with autism lead to depression and anxiety. People with autism cope every day with sensory overloads, social rejection, teasing, bullying, and a whole host of other issues which are, by anyone's estimation, depressing and anxiety producing.

And indeed, experts Dr. Tony Attwood and Dr. Judy Reaven agree that Asperger syndrome (also called high functioning autism) can create a more stressful life, leading to mood disorders.

But there may be more to it.

According to Dr. Attwood, one of the world's experts on Asperger syndrome, perception and regulation of emotions really is a central element of AS. In addition, he says, "We now have neurophysiological evidence that the amygdala [a part of the brain] is different, and it's involved with regulation of emotions...[In Asperger syndrome] genetics and physiology come together; 2 of 3 teens with AS have a secondary mood disorder such as anxiety, depression, and/or anger."

Dr. Judith Reaven of the University of Colorado at Denver Health Sciences Center confirms that children with autism spectrum disorders, in general, are at high risk for developing anxiety disorders. "Clinicians and researchers believe that we are looking at not just cases of increased stress, but true anxiety symptoms and disorders in this population," she says.

"This is a new field without a lot of good data yet, but there is evidence to suggest that these anxiety symptoms and disorders are not just related to having autism or just because the individuals with autism spectrum disorders are vulnerable to bullying, teasing, etc., but these symptoms develop much in the same way anxiety develops in the general population — as a result of environmental, biological factors. We believe this to be true because some of the anxiety symptoms we see are very clear examples of specific fears and phobias, or classic OCD symptoms, or generalized anxiety symptoms, that we feel can’t be explained by increased stress alone."

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