Autism And Psychosis: Make Connections And Find Mental Health Support
Autism spectrum disorder (ASD) and psychosis can sometimes co-occur in complex ways. Autism impacts a person throughout their life, influencing their senses and interactions. Psychosis sometimes occurs later, temporarily disrupting a person's connection to reality. While the two conditions are separate, research suggests they may have some underlying connections in common.
For some Autistic people, experiences that might bear a resemblance to psychotic symptoms aren't unusual, and this overlap can make diagnosis and treatment more challenging. These difficulties are often compounded by misunderstandings about the nature of autism and psychosis. This article will examine the relationship between these conditions and how to find appropriate support while respecting the unique nature of each diagnosis. Online therapy may offer a convenient way to seek professional insight.
Autism and psychosis: Understanding the spectrum of autism and vulnerability to psychosis
In general, autism exists on a wide spectrum but is often characterized by challenges with social skills and repetitive or restricted behaviors, which are considered autistic symptoms. Autism spectrum disorder (ASD) is usually considered a neurodevelopmental disorder, tending to impact the growth and development of the brain. According to the American Psychiatric Association, symptoms can often be seen within the first two years of a person’s life, but many autistic people receive official diagnoses as teenagers or adults. Some research highlights a clinical high risk for developing psychosis in individuals with certain autistic and schizotypal traits, suggesting overlaps with conditions on the schizophrenia spectrum disorders.
Psychosis and autism spectrum disorder
Some characteristics of autism can include those listed below:
- Displaying inconsistent eye contact
- Having an unusual tone of voice
- Experiencing difficulty with conversational back-and-forth
- Displaying a lasting, intense interest in specific topics
- Being particularly sensitive to sensory stimuli
- Having trouble with changes in routine
Distinguishing between autistic reactions and psychotic symptoms in a spectrum disorder
Autistic people often experience sensory overload. This can create challenges in regulating their emotions and may result in meltdowns (an intense response to overwhelm that cannot be controlled) or shutdowns (not being able to move or communicate due to extreme stress or overload).
These intense reactions are usually ways of coping, but they can be confused with symptoms of psychosis or psychotic symptoms like disorganized behavior or catatonia in some cases. An accurate diagnosis can ensure individuals receive the right support and treatment.
When considering the overlap, mental health professionals generally must tread with sensitivity to carefully distinguish between the core characteristics of autism and experiences that might point toward a psychotic disorder. Getting the right diagnosis can ensure proper treatment.
Schizophrenia spectrum disorders and autism may co-occur more frequently than their prevalence suggests. Some systematic review findings and research suggest a potential link between the two conditions. This connection may stem from overlapping clinical and genetic risk factors or similar underlying brain mechanisms, but more research may be needed to clarify the relationship between autistic patients and psychotic experiences.
Recognizing the signs of psychosis in autistic people
Psychotic disorders can manifest in various ways. Here are some potential signs that an autistic person might be developing psychosis:
- Hallucinations: Sensory experiences with no grounding in reality, such as hearing voices or seeing people or objects others don't, with auditory hallucinations as psychotic symptoms being especially common.
- Delusions: Fixed, unusual beliefs that don't align with reality.
- Changes in thinking: Difficulty organizing thoughts, impacting focus, and communication.
- Social withdrawal: Retreating further from social interactions than is typical for the individual.
- Changes in affect: Uncharacteristic displays of emotional expression.
People who might develop psychosis could have toned-down versions of these symptoms called “attenuated symptoms.” However, because autism presents differently in everyone, and the way autism manifests can overlap with symptoms of other mental health conditions, distinguishing between signs of autism and attenuated psychotic symptoms can be challenging. This complexity is especially noted in clinical psychology and highlighted in several systematic review findings, which emphasize overlapping risk factors and diagnostic challenges in comorbid ASD and schizophrenia patients.
Challenges in diagnosing schizophrenia in autistic individuals
Negative symptoms (like a decline in motivation or emotionality) that are common to some neurodevelopmental disorders can mimic signs of schizophrenia or other mental health conditions, making the diagnosis in Autistic individuals more complex. That's why getting an accurate diagnosis from someone who understands both conditions can be helpful. If you or an Autistic person you know experiences any of these changes, you can reach out to a professional for help. Research shows early psychosis intervention often leads to better clinical outcomes.
Mental health treatment approaches for autistic people experiencing psychosis
Managing psychosis and psychotic symptoms in autistic people or individuals often calls for a team approach. Medications can help reduce symptoms, while different types of therapy may offer essential skills and strategies for coping with the challenges that can accompany autistic disorder, also known as autism spectrum disorder.
Effective treatment strategies for managing psychosis and autism spectrum disorder
To help ASD patients and people with autism manage psychosis, a combination of these treatment options may be effective. This approach can give them ways to handle difficult emotions and stay engaged in their interests. Mental health support may often be centered on two main approaches:
- Medication: Antipsychotic medications can help manage hallucinations and other positive symptoms, delusions, and disordered thinking. In some cases, medications used to treat mood disorders might also be helpful. These medications must be prescribed and monitored by a doctor or psychiatrist.
- Therapy: Various therapeutic models can be effective depending on the person, such as cognitive behavioral therapy (CBT), which generally focuses on changing thought patterns and behaviors, or social skills training, which can offer support in developing affective contact, social connections, and coping strategies.
Autism and psychosis tend to be complex, and their overlap frequently requires specialized understanding. With the right support, managing symptoms and thriving in everyday life may be achievable for both an autistic child and an autistic person who is diagnosed later in life.
How to self-advocate
Facing both autism and psychosis can be challenging. Finding the right treatment can seem like another hurdle. You deserve to be understood and supported. Self-advocacy may allow you to speak your truth and seek the kind of support that works best for you.
Even with the best intentions, doctors and therapists can't fully step into your shoes or understand what you're experiencing, but you may have the power to bridge that gap. For example, ASD patients experiencing both autism and positive symptoms of psychosis may need to describe how those symptoms impact daily life. By advocating for your needs, you can build a support system that makes a difference.
Self-advocacy and mental health tips for autistic people
Self-advocacy isn't always a simple feat, especially when you're already overwhelmed. Here are a few tips to help:
- Know your strengths: Everyone has unique strengths. For example, are you organized, persistent, or a good researcher? You can use these strengths to your advantage when looking for information and attending appointments.
- Build a team: You don't have to do this alone. Could a trusted friend or family member lend a hand? Having someone there to take notes, offer moral support, or debrief with you afterward can make appointments less stressful for both you and your care team, especially if you're managing first-episode schizophrenia or negative symptoms of a comorbid disorder.
- Prioritize self-care: Pushing for the help you need can be tiring. Recognizing when you need to take a break can be a sign of strength.
- Educate yourself: Knowledge is power, especially when trying to understand your own needs. The Mental Health Services Administration can help you find treatment and resources in your area.
Finding your voice and building a support system that understands autism, including the needs of an autistic person, and any psychosis or psychotic symptoms you may be experiencing, can take time. By learning to self-advocate, you can ensure that your unique needs are met and your voice is heard.
Finding mental health support for autism and psychosis
Facing an additional diagnosis of psychosis on top of autism can seem like a lot to handle, but you aren't alone. Help and resources are available.
- Mental health professionals: Therapists or psychiatrists with expertise in autism and psychotic disorders can provide guidance to autistic people.
- Support groups: Connecting with others navigating similar experiences, both online and in your local community, can offer support and reduce feelings of isolation.
- Advocacy organizations: Organizations focused on autism and mental health often provide a wide range of resources and information, and help to find local support.
- Family and friends: You can lean on those close to you for understanding and support.
Managing autism and psychosis can be a journey. You may need time and self-compassion to overcome the challenges you're facing. With the right treatment, support, and understanding, you can find ways to improve your well-being and build a life you love.
Online therapy for autistic people
For ASD patients or autistic people who are also managing psychosis, experiences like sensory overload, changes in routine, or getting ready to leave the house can create challenges in keeping to a regular therapy schedule. Online therapy can remove some of the barriers associated with in-person therapy, like transportation and sensory discomfort, potentially making it easier to consistently attend appointments. This consistency can lead to better rapport with your therapist and more progress toward your goals. However, if you’re currently experiencing acute psychotic symptoms or negative symptoms, you may need to seek support in person.
Clinical research shows that online therapy can be just as effective as traditional in-person therapy for treating individuals with psychosis. Data from these studies indicates you can get the same accurate diagnoses, effective treatment, and high-quality care while receiving more convenient mental health services.
Autism spectrum disorders, like other neurodevelopmental conditions, are normally seen as a part of neurodiversity. In general, this designation means autistic brains are built differently, not that something's wrong with them. Diversity in the way brains are structured can provide a unique set of strengths and challenges. Every journey with autism and psychosis may be different, but yours can be filled with success.
Takeaway
What are the four common characteristics of a person with autism spectrum disorder?
According to the Diagnostic and Statistical Manual, four common autistic traits include social cognitive impairment, restricted and repetitive behaviors, sensory sensitivities, and atypical and repetitive behaviors. These autistic traits may typically be observed in individuals with autism or autistic spectrum disorders and can be referred to as clinical symptoms in diagnostic settings. Autistic people may also show challenges and difficulties with social interactions, and some studies highlight significant differences in how these traits manifest depending on the individual with pervasive developmental disorders or coexisting conditions, such as intellectual disability.
What do autistic people struggle with?
People diagnosed with autism spectrum disorders in early childhood often demonstrate atypical behaviors that can be odd, disturbing, or dangerous. An autistic child may require a strong routine and stringent schedules to help manage these symptoms. Social interactions can be difficult, as autistic people may have difficulty regulating tone and voice and understanding common social cues. Co-occurring medical disorders and mental health disorders are common as well, including anxiety disorders, sleep disturbances, and immune or gastrointestinal dysregulation. According to research in clinical psychology, ASD patients may also fall under overlapping diagnostic categories, especially when traits associated with schizotypal traits or Asperger syndrome are present.
What personality disorder has psychotic symptoms?
Psychotic disorders are a class of personality disorders in which individuals develop psychotic symptoms. These include conditions classified under schizophrenia spectrum disorders, such as schizophrenia (formerly known as dementia praecox), childhood-onset schizophrenia, schizophreniform disorder, schizoaffective disorders, delusional disorder, brief psychotic disorder, psychotic disorder due to another medical condition, or due to medication. Individuals at clinical high risk may also show positive symptoms or negative symptoms that indicate developing psychosis.
Is psychosis related to mental health?
Yes, psychotic experiences and psychotic symptoms are part of a mental disorder. Psychotic patients experience at-risk mental states that make them vulnerable to endangering themselves or others, and in some cases, these symptoms may be linked to conditions such as early-onset schizophrenia or childhood-onset schizophrenia.
What mental illnesses are considered psychotic?
Psychotic disorders include schizophrenia, childhood-onset schizophrenia, schizoaffective disorders, schizophreniform disorders, delusional disorder, brief psychotic disorder, substance/medication-induced psychotic disorder, psychotic disorder due to another medical condition, or shared psychotic disorder. Some of these may present with positive symptoms such as hallucinations or delusions, and negative symptoms like emotional flatness or lack of motivation.
Can autism mimic schizophrenia?
According to a systematic review published in the Journal of Autism and Developmental Disorders (autism dev disord), researchers found that there is a link of clinical significance between ASD and schizophrenia. While they are not always comorbid disorders, they share a common genetic chromosomal deletion that scientists conjecture could lead to either one. More robust research is needed to back this hypothesis.
Both conditions (formerly known as mental illnesses) have positive symptoms, negative symptoms, and cognitive symptoms, and early autistic traits can sometimes mirror symptoms found in schizophrenia patients, and both can include intellectual disability. Some diagnosed with childhood schizophrenia are reconsidered by psychiatrists and physicians to have ASD and share similar socialization difficulties. Children who have parents with schizophrenia are considered at clinically high risk for developing ASD as well.
Because of their similar features, the PANSS Autism Severity Score (PAUSS) was developed as a tool for professionals to identify autistic features in psychotic patients with psychotic symptoms or developing psychosis in adulthood.
How do you treat autism and psychosis?
Psychosis traits in autistic children or autistic adults can be difficult to treat due to the complexity of the disorder. It can also be difficult to sort out diagnoses, as prodromal symptoms in childhood-onset schizophrenia can look like autism for weeks to years. Until the first episode of psychosis (also known as early-onset psychosis), providers may not realize that autistic disturbances are actually schizophrenia disturbances. Once they recognize psychosis, they will continue to assess psychosis and start to treat symptoms with antipsychotic medications, especially if negative symptoms such as withdrawal or flattened affect are present.
Are hallucinations a symptom of autism?
Hallucinations are not a core feature of autism; however, they can show up as a symptom in some autistic patients, especially those with comorbid psychosis or other psychotic symptoms. Some studies suggest that certain autistic spectrum disorders may present a clinical high risk for developing psychosis, particularly during teenage years or the early adulthood stage. While not typical for most autistic people, hallucinations may occur in cases involving first-episode psychosis or when psychotic features overlap with autism.
What does high-functioning autism look like in adults?
As with many developmental disorders, autistic symptoms can be experienced on a spectrum. High-functioning adults and children with ASD were once diagnosed with Asperger’s Syndrome (Asperger syndrome is an outdated term, but one with which some people still identify). Autistic adults with high-functioning ASD may have social challenges or be described as “awkward” by others. They can have trouble working in groups or understanding give and take in conversation. They may be unusually sensitive to both physical and emotional stimuli. Finally, they may be fixated on repetition or routine, a phenomenon often noted in behavioral equivalents described in clinical psychology literature.
What does bipolar look like in autism?
Bipolar disorder and ASD share traits and, according to research, may also share some genetic roots. Irritability, slow social responsiveness, and excited talking are common symptoms of bipolar disorder and autism. They may be symptoms of either one or both. A professional will have to determine which and to what degree the individual is affected by these disorders, especially when autistic symptoms or ASD traits overlap with affective disorders.
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