By Sarah Johnson
People with autism process the world differently than others around them. Due to this difference in perception, autism has proven itself to cause psychological suffering that can often go unnoticed. One of the main causes of the psychological struggle brought about by autism stems from the lack of ability to communicate and understand basic emotions. Those with the disease often see a smile as merely an open mouth- a tear as nothing more than a drip of water. As Dr. Mehmet Oz put it in a recent show focused on autism, “autism robs the child of their emotional foundation. It’s a disorder that makes it impossible at times for the child to communicate. Even the smile is just too confusing.” The seven universal emotions: anger, disgust, fear, happiness, sadness, surprise and contempt, are thought to be a bridge that connects different ages, peoples, and cultures; however, those with autism see no difference between a face of disgust and a face of happiness. Because the concept of emotion is so hard to grasp for those with autism, many basic social cues and emotions are easily misunderstood or not understood at all. This difficulty constructs social and communicative barriers that make it hard to connect with others in public places- be it school, work, or the grocery store. This results in immensely frustrating and irritating social interactions. This frustration can be lessened with early intervention and proper support, like providing a loving and caring home environment. While learning to properly interpret vocal, emotional, and social cues is not impossible for those with autism, it does take a significant amount of work. Picture boards or flashcards displaying different emotions can be used to memorize and eventually learn the different emotions and facial expressions.
In addition to having trouble with understanding emotions, those with autism often find themselves stuck in sensory overload. Due to the hyper-functionality of the autistic brain, those with the disease are not able to filter out sensory information. In response to this barrage of information, those with autism often miss out of the chance to connect with those around them and form a shared understanding of the world around them since they retreat into their own minds. Since autistic individuals are often thought to remember, feel, and perceive too much, they often react by shutting down and withdrawing into their own world as to not have to face the often painful and overwhelming bombardment of noises and spectacles surrounding them. This sensory overload is often dealt with by the employment of repetitive physical behaviors like flapping hands, rocking back and forth, and banging one’s head against an object. These behaviors are attempts to bring some order and control to their unpredictable current situation as well as to regulate sensory problems. On the contrary, many with autism suffer from hypo-sensitivity. This can be seen in unusually high pain tolerance and the constant need for stimulation. However, the psychological problems that come along with the world that is too painfully intense to bear can be mitigated through sensory integration techniques. This method is a neurobiological process that refers to the integration and interpretation of sensory stimulation from the environment by the brain. Focusing on the three basic senses–tactile, or touch, vestibular, or the inner ear, and proprioceptive, or the muscles, joints, and tendons- this therapy promotes and facilitates attention and awareness.
In addition to the typical challenges that come along with autism, this disorder can often manifest itself in a plethora of smaller disorders. Some of the most common additional diagnoses are Attention Deficit Hyperactivity Disorder (ADHD) and anxiety. In fact, recent studies suggest that 1 in 5 children on the autism spectrum also has ADHD and 30% struggle with an anxiety disorder such as social phobia, separation anxiety, panic disorder, specific phobias, and Obsessive Compulsive Disorder. In addition, between 67% and 70.8% of individuals with autism would meet criteria for an additional mental health disorder; however, just 1 in 10 children with autism and ADHD receive medication to relieve the ADHD symptoms. Classic problems with ADHD, including hyperactivity, impulsivity, and inattention can actually stem from autism or a combination of the two disorders. Those with autism express anxiety or nervousness in many typical ways, like sweating or acting out, but have trouble communicating how they feel. Often, outward manifestations are the most obvious and may be especially prominent among those with ASD. These symptoms can include a racing heart, muscular tensions, and stomachaches.
In addition, psychosocial factors like peer rejection, low levels of social support, and academic difficulties may contribute to the development of comorbid, or simultaneously be occurring, psychiatric conditions. Individuals with autism may be at increased risk of developing comorbid conditions due to their social and communication deficits and behavioral patterns. Cognitive and processing limitations also play a role in the development of more than one psychiatric condition. Since problem-solving and coping skills are often less developed in autistic individuals, this increases their risk for adverse psychosocial experiences and thus the development of comorbid psychiatric conditions. There are, however, some road blocks in diagnosing these conditions in individuals with autism. Particularly for autistic individuals who suffer greatly from communication or intellectual disabilities, the symptoms of these comorbid conditions may look or manifest themselves differently than they do in typically developing individuals. Since many diagnoses, such as those for anxiety and depression, rely largely on a subjective component- having the patient describe what they are feeling and why- it can be hard to come to a diagnosis for individuals with autism who also have, say, depression. However, the identification and treatment of comorbid disorders, if possible, is recommended as it is associated with better long-term outcomes than treating core symptoms of autism alone.
While there are numerous and varying sources of psychological struggles associated with autism, treatment options are available, and the psychological pain can be lessened.