Understanding Mental Health in Autism: What Every Parent Needs to Know

When we think about autism, we often picture differences in communication, social interaction, and ways of processing the world. But what’s equally important to understand is that many autistic children and adults also experience other mental health challenges, such as anxiety, ADHD, or low mood. This is called comorbidity or having a dual diagnosis.

At Blossom, we see every day how these overlapping experiences shape how someone feels, learns, and connects. Understanding the research helps us (and parents) recognise what’s typical, what might need extra support, and how to best respond with care and confidence.

How common is it?

Recent research has found that it’s quite common for autistic people to also experience mental health conditions. Here’s what studies have shown:

• ADHD (Attention-Deficit/Hyperactivity Disorder): Around one in three autistic children also meet criteria for ADHD. This can look like challenges with focus, attention, or managing energy levels.

• Anxiety: Between one in four and one in three autistic children and adults experience significant anxiety. Sometimes this shows up as difficulty with transitions, sleep, or social situations.

• Depression and low mood: Rates of depression are higher in autistic individuals than in the general population, particularly during adolescence and adulthood.

• Psychotic experiences: Less common, but some autistic people report experiences like hearing voices or feeling detached from reality. These experiences need careful assessment to understand what’s really going on.

The key message from research is that having more than one diagnosis is the rule, not the exception. Many people experience more than one of these challenges at the same time.

Why does this happen?

There isn’t one simple reason, but a few things seem to contribute:

• Differences in how the brain processes information and emotion. The same neurological differences that shape autistic strengths can also make regulation more challenging.

• Stress and misunderstanding. Many autistic people face social stress, sensory overload, or environments that don’t meet their needs. Over time, this can affect emotional well-being.

• Diagnosis gaps. Sometimes, anxiety or ADHD is missed because the signs are attributed to autism itself. For example, a child who avoids new situations might be seen as “rigid,” when they’re actually feeling anxious.

The good news is that when we understand these overlapping factors, we can respond in ways that truly support the person, not just the label.

What this means for parents and caregivers

If your child is autistic and you notice ongoing worry, restlessness, or changes in sleep, appetite, or mood, it might help to talk with your support team about whether another condition could be present. Getting a clear picture doesn’t mean “more labels” , it means better understanding and more tailored strategies.

Here’s what research suggests helps most:

• Ask for comprehensive assessments. Make sure evaluations look beyond autism to include things like anxiety, ADHD, and mood.

• Choose providers who understand both autism and mental health. The best outcomes happen when support teams can see the full picture.

• Keep communication open. Share what you observe at home and what’s happening at school or in the community. Each perspective adds a valuable piece to the puzzle.

• Focus on strengths. Many supports for ADHD or anxiety can build on what your child already does well; their interests, routines, and unique way of learning.

Supporting well-being at home

You don’t need to wait for a formal diagnosis to start making a difference. Small changes in daily life can have a big impact:

• Build predictable routines, especially around transitions or sleep.

• Encourage sensory breaks and calm spaces when things feel overwhelming.

• Practice co-regulation,  modelling calm breathing, gentle movement, or quiet time together.

• Celebrate small wins and progress, not just milestones.

• Collaborate with your child’s team to make strategies consistent across settings.

When families and professionals work together, mental health support becomes proactive instead of reactive which focuses on understanding, not just managing behaviour.

Why this matters

Recognising and addressing mental health in autism isn’t about “fixing” someone, it’s about giving them the tools and environment they need to thrive. When anxiety is understood, ADHD is supported, and mood changes are taken seriously, children and adults can access their full potential.

As research continues to grow, one message remains clear: autistic individuals deserve mental health care that truly understands them; care that is flexible, respectful, and rooted in collaboration.

At Blossom, we’re here to support families navigating these experiences. Our team designs individualised plans that look at the whole person, their strengths, challenges, and emotional well-being to build confidence and connection that lasts.

References (for parents who love research!) Lai, M.-C. et al. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. The Lancet Psychiatry. Hossain, M. M. et al. (2020). Prevalence of comorbid psychiatric disorders among people with ASD: an umbrella review. Vaquerizo-Serrano, J. et al. (2021). Autism Spectrum Disorder and Clinical High Risk for Psychosis: A Systematic Review.

Understanding the connection between autism and mental health helps us see the full story, not just the diagnosis, but the person behind it.