Mental health/behaviour conditions

Mental health and behavioural conditions

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Obsessive compulsive disorder (OCD)

General anxiety

Depression

Bipolar

Oppositional defiant disorder (ODD)

Eating disorders

Psychosis

Conduct disorder

Overlap

What can general anxiety look like?

What can autism look like?

• Being less socially motivated.
• Having a preference to work independently.
• Making friends more easily when centred on a shared interest.
• Finding it challenging to intuitively read neurotypical social cues.

• Having special or specific interests.

• Self-soothing through the use of routines and repetitive behaviours.
• Qualitative differences in non-verbal behaviours.
• Feeling a sense of discomfort starting conversations.
• Experiencing discomfort at parties or in large crowds.
• Experiencing difficulty interacting with strangers.
• Experiencing sensory sensitivities.
• Withdrawing.
• Avoiding social situations.
• Not liking unexpected changes to plans.

• Differences in eye contact.
• Having a sense of fear and worry, typically associated with social events.
• Experiencing physical manifestations of anxiety (such as trembling, a racing heart, shortness of breath and nausea).
• Desiring to be social but having anxiety deter acting on the desire.
• Experiencing discomfort and fear at the possibility of being the centre of attention.
• Ruminating on social situations.
• Catastrophic thinking.

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Overlap

What can depression look like?

What can autism look like?

• Increased sensory sensitivities.

• Feeling easily overwhelmed.

• Difficulty managing wellbeing during periods of increased social and sensory demand, like the holidays.
• Differences in non-verbal communication. For example, non-verbal behaviours could be limited or exaggerated or not well integrated.

• Chronic exhaustion and fatigue.

• Withdrawing from social situations.
• Feeling a lack of motivation.
• Experiencing concentration challenges.
• Experiencing executive functioning challenges.
• Reducing, or slowing down physical movements.
• Tearfulness.
• Becoming emotionally upset more easily.
• Feeling a sense of emptiness.
• Fatigue.
• Benefitting from rest, sensory detox time, unmasking and time exploring their special interests.

• Experiencing an intense sense of worthlessness/hopelessness.

• Having negative thoughts about themselves, the world and the future.
• Experiencing a persistent depressed mood lasting at least two weeks.

• Losing a sense of pleasure.
• Seeing changes in sleep and eating patterns.
• Suicidal thoughts or behaviours.
• It can be transient, it can come and go depending on influencing factors.
• Reduced, or diminished non-verbal behaviours.

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Overlap

What can OCD look like?

What can autism look like?

• Insomnia.
• Repetitive thinking/rumination.

• Engaging in repetitive behaviours.
• Having distinct sensory profiles.
• Experiencing difficulty tolerating uncertainty.
• Both are considered neurological conditions - similar neural circuits in the brain are involved.
• Acting on compulsions. For example, engaging in repetitive behaviours, such as rituals.
• Both demographics show high rates of substance use.

• Experiencing difficulty with neurotypical social-communication patterns.
• Self-soothing through repetitive behaviours, routines and stimming.
• Engaging in repetitive behaviours that aren't tied to obsessions (fears).
• Engaging in repetitive behaviours for pleasure or self-regulation (stimming).
• Special interests.

• Experiencing persistent and unwanted thoughts, urges, sensations and images (obsessions).
• Using repetitive behaviour (compulsions) functions to reduce the anxiety associated with their obsessions.
• Perfectionism.
• Having a direct relationship between their compulsions and obsessions.
• Using repetitive behaviour to manage a specific fear. For example, hand washing to manage the fear of contamination.

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Overlap

What can bipolar look like?

What can autism look like?

• It often develops in the late teens/early adulthood.
• Distinct mood episodes fluctuating between mania and depression.
• Mania-rapid speech, engaging in high-risk behaviours, general irritability, being overly joyful and experiencing a limited need for sleep.

• Extrasensory perception.
• Psychotic symptoms may present during mania.
• Difficulties with impulse control.
• General disinhibition.

• Present since birth (may not be diagnosed until later).
• Experiencing difficulty with neurotypical social-communication patterns.
• Having special interests.
• Self-soothing through the use of repetitive behaviours and routines.
• Experiencing sensory sensitivities.
• Mood changes are associated with social fatigue, changes in environment or sensory overwhelm.

• Distractibility.

• General difficulties identifying, recognising and regulating emotions.
• Frequent mood shifts.
• Energy fluctuations.
• Episodes of excessive talking.
• Pacing and psychomotor agitation.
• Episodes of mood elevations.
• Elevated rates of self-harm, substance abuse and suicidality.

• Experiencing difficulty concentrating.
• Experiencing a sense of irritability and agitation.

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Overlap

What can psychosis look like?

What can autism look like?

• Dissociation.
• Impacted executive functioning abilities.
• Rigid thinking.
• Differences in non-verbal communication, particularly facial affect.
• Social withdrawal and reduced communication

• Increased risk of suicide.
• Social difficulties.
• Higher rates of depression, self-harm, substance use and anxiety.
• Differences in eye contact.

• Sensory sensitivities.

• Disorganised thinking.
• Unusual speech patterns.

• Engaging in repetitive behaviours and routines.
• Echolalia.
• Finding social reciprocity difficult.
• Having special interests.

Signs of autism typically appear in early childhood.

• Experiencing reality confusion.
• Differing forms of hallucinations.
• Paranoid and delusional thought patterns.

• Racing thoughts.
• Racing speech.

Signs of psychosis typically appear in adolescence and can be treated.

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Overlap

What can eating disorders look like?

What can autism look like?

• An autistic person may ritualistically count calories or compulsively exercise, even if weight loss isn’t the intended goal.

• Particularities about certain textures, smells and tastes.
• Special or intense interests can extend to calorie counting, "clean eating" or food group elimination.
• Displaying a preference for foods that can deliver a consistent taste, texture and feel, or that have become a part of their daily rituals.

• Strict adherence to rules.
• Difficulties with abstract thinking, or Theory of Mind (at a low BMI).
• A sense of rigidity.
• Repetitive tasks like counting calories, restricting intake, tracking steps, or avoiding certain types of food can become ritualistic.
• All-or-nothing thinking.
• Ongoing, repetitive behaviours that cause significant distress when interfered with.
• Difficulties with identifying emotions (alexithymia) and understanding physical sensations.
• Picky eating, or restrictive food intake disorder, may present as a result of sensory processing differences.

• Someone with an eating disorder may count calories due to poor body image and a desire to lose weight or to feel a sense of control.
• An extreme and damaging focus on weight and body image.
• Managing anxiety and unhappiness through their eating disorder.
• Poor self-esteem and a negative view of self.
• Excessive exercising.
• Purging.
• Binge eating.

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Overlap

What can ODD look like?

What can autism look like?

• Frustration.
• Demand avoidance.
• Difficulties with social interaction and communication.
• Rejection of others' rules and agendas where they don’t fit with the young person’s.
• Demand avoidance, which can also overlap with pathological demand avoidance (PDA), can often be mistaken for ODD.
• Where ODD is an ongoing pattern of disobedient, hostile and defiant behaviour toward authority figures, PDA is an extreme avoidance of everyday demands and an anxiety-driven need to be in control.

• An autistic person may argue or find it hard to comply due to difficulties with rigid thinking styles, their sensory environment or social fatigue.
• Any irritability and defiance displayed typically isn't for its own sake but rather an instinctive response to a frustrating situation.
• Rigidly applying the rules as they interpret them.

• Someone with ODD may present as uncooperative to try to have a need met, be it attention, reassurance or acknowledgement.
• Intentionally causing emotional and physical harm to others.
• Defiance and argumentativeness driven by the desire to oppose authority.
• Displaying anger, annoyance and irritability.
• Outbursts.

• Arguing, or non-conforming with caregivers and others.
• Boundary pushing.
• A resistance to rules.

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Pathological demand avoidance

What can conduct disorder look like?

Overlap

What can autism look like?

• Typically presents with more inwardly directed problems, such as sleep disorders, obsessions and compulsions.

• A lower threshold for annoyance.
• Challenges with the perception of their own role within a conflict and their ability to withstand teasing.
• Difficulties understanding relationships.

• Challenges in expressing emotions.
• Challenges in managing conflict.
• Difficulties navigating social situations.
• Non-compliance.
• Dysregulation of emotions.
• Following their own rules.

Conduct disorder typically emerges in children under the age of 16, but can be diagnosed in adults as well.Common signs can be:

• Initiating physical fights.
• Bullying or threatening others.
• Causing harm.
• Running away from home.
• Missing school frequently.
• Displaying little or no remorse for poor behaviour.
• A lack of concern about behavioural consequences, particularly as they pertain to others.

• An absence of concern about performance at school or work.
• Rule breaking.
• Repeatedly being dishonest.

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OCD is characterised by persistent distressing thoughts, ideas, or sensations that cause significant fear and anxiety (obsessions), followed by specific behaviours such as handwashing and door checking (compulsions) intended to reduce the obsessions. It must impact daily functioning and take up significant portions of a person’s life.

Depression is more likely among autistic people, but researchers aren’t yet sure why. The constant adaptations autistic people have to make living in a neurotypical world may play a role in causing depression. It’s also possible that certain characteristics of autism are risk factors for depression.

The relationship between autistic traits and disordered eating is not yet well understood. However, a trait called alexithymia is thought to be an essential link between the two conditions. This is when a person struggles to understand, or describe their feelings. For some, an eating disorder is the outcome, not the cause.

Disclaimer

The categories these conditions have been grouped under are to convey information effectively. We acknowledge and respect that individuals may view their condition(s) differently from how they're grouped here. The information provided in this resource represents common patterns or trends. However, these are generalisations and will not resonate with everyone's individual experiences.

We encourage you to see this resource as an introduction to the many conditions, delays, and syndromes that overlap with autism - not an exhaustive list.

Research shows that while individuals with conduct disorder have difficulties with social interaction and the perceptions of others, their problems are considered to arise from atypical social learning and events in their life, rather than the result of intrinsic developmental differences, like with autism.

The DSM-5 defines oppositional defiant disorder as “a pattern of angry/irritable mood, argumentative/defiant behaviour, or vindictiveness lasting at least six months”. One of the ways to tell the difference between ODD and autism is to understand what's motivating the child to act out.

Bipolar is one of the conditions that co-occur with autism at higher rates (than compared to the general population). Bipolar, like autism, is considered a form of neurodivergence. It is characterised by distinct mood swings between mania and depression. Moods may cycle quite rapidly or be more prolonged and distinct from one another.

Psychosis is typically characterised by a loss of contact with reality and delusional beliefs or hallucinatory experiences. There’s an overlap between psychosis and autism, such as withdrawing from friends and family, showing less emotion, having a flat affect and having social communication differences. There’s also an overlap between language use and the perception and understanding of self and others.