Autism is so often misunderstood that the Autism Self Advocacy Network (ASAN) has “nothing about us without us” as their motto. Because of misunderstandings about autism, autistic individuals may face unique barriers to mental health support. This research highlights the need for greater acceptance of autism so that those dealing with mental health challenges can have their needs met.

The Study

In an online survey, a sample of 1,183 autistic and 1,203 non-autistic individuals aged 16–90 years self-reported the frequency of their substance use, while 919 participants also gave more detailed feedback of use. Although autistic adults were less likely than non-autistic individuals to use substances like alcohol or drugs overall, autistic adults were almost 9 times more likely than non-autistic peers to report recreational drug use to manage symptoms of mental illness. The study also discussed social camouflaging—changing behavior to mask symptoms of autism in social situations—as a reason why autistic individuals are drawn to substance use. Alcohol and drugs can alleviate anxiety and allow autistic individuals to change their behavior in order to fit in.

Autistic Individuals Deserve Equitable Care

Psychologist Marcia Eckerd, PhD, says, “People do not think of autistics as having feelings, but nothing could be further from the truth. They have deep feelings. When autistic adults self-medicate their anxiety, depression, sensory problems, and hopelessness, they’re four times more likely than non-autistic users to be at risk for dependence, addiction, and suicide.” It is why Eckerd highlights how the research emphasizes the failure of the current social and medical system to meet the urgent unmet needs of autistic individuals, who resort to substance use to self-medicate pain. Eckerd says, “Autistic people use alcohol and drugs to tolerate mental health problems like anxiety, depression, and emotional overload. Without access to mental health care, they’re at greater risk of a downward spiral of mental health issues and a higher rate of suicide.”

Greater Autism Acceptance is Needed

New York-based autistic psychotherapist Sharon Kaye-O’Connor, MSW, LCSW, says, “The study touches on the important point that masking and camouflaging autistic traits can have disastrous effects on the mental health of autistic folks. Autistic masking can lead to autistic burnout.” There is a greater need for acceptance and understanding, as O’Connor recommends a move away from the ideology that autistic traits are something that should be hidden or changed. “Some autistic people may self-medicate to cope with the stressors of living in a neurotypical world that wasn’t built with their needs in mind,” she says. O’Connor says, “When facing barriers to autism-informed mental health care, some autistic people may find themselves trying to manage their struggles on their own. Some autistic people may self-medicate due to difficulty accessing autism-informed health care. Finding mental health care providers who understand the autistic experience of the world remains challenging.” The autistic experience is so often misunderstood and misinterpreted that O’Connor highlights how meltdowns may be mistaken for tantrums or “bad behavior” while sensory issues can be misread as anxiety and autistic burnout may be confused with depression. “There is an immense need for greater understanding and acceptance of autistic differences,” she says. O’Connor explains that many autistic folks may find themselves attempting to manage their struggles on their own until there is a greater professional and community understanding of the autistic experience. “The gaps in the current knowledge highlight the importance of autistic voices in furthering the understanding of autism and the nuances of autistic life,” she says.