Understanding mental health in autistic teenagers

Navigating the teenage years can be complex and challenging for many adolescents, but autistic teenagers often face distinct challenges that can impact their mental health more profoundly.

Understanding these challenges is crucial for parents, carers, and professionals aiming to provide the proper support and interventions.

The impact of puberty on teen mental health

Puberty marks a period of physical, mental, and emotional transition. For autistic teens, these changes can be particularly intense. The surge in hormones and the physical developments during puberty can significantly affect mood and behaviour, often worsening pre-existing conditions such as anxiety and depression.

It's important to recognise that feeling anxious or depressed at times is a common experience for all teenagers. Research indicates that up to one-third of typically developing teenagers experience a diagnosable anxiety disorder. This rate is even higher in autistic teens, who face increased risks of both anxiety and depression due to the unique challenges posed by autism, including heightened sensitivity to physical and social changes.

Mental health risks for autistic teens

It's important to recognise that feeling anxious or depressed at times is a common experience for all teenagers. Research indicates that autistic teens are at a higher risk of developing mental health disorders compared to their neurotypical peers. These can include anxiety, depression, and behavioural disorders, which can significantly impact their quality of life.

Anxiety disorders

Anxiety is one of the most common mental health issues faced by autistic individuals. The constant effort to cope with an environment that often feels overwhelming can lead to significant anxiety. Social anxiety is particularly prevalent, stemming from persistent struggles with social interaction and communication.

Depression

Depression in autistic teens can often go undetected as symptoms can overlap with some behavioural characteristics associated with autism, such as withdrawn behaviour or reduced expression of emotion. Factors contributing to depression can include chronic anxiety, social isolation, and ongoing struggles with self-esteem.

Behavioural issues

In response to stress, misunderstanding, or frustration, some autistic teens may exhibit behavioural issues. These can range from outbursts and aggression to more withdrawn behaviours. These are often not acts of defiance but expressions of an inability to cope with a particular situation or set of demands.

Accessing support and treatment

Families and carers of autistic teens are often in search of practical support and treatment options to help manage anxiety and depression. Fortunately, many health professionals specialise in addressing these issues within the autistic community. These professionals can offer a range of treatments that can be tailored to each individual's needs.

Psychological support

Talking therapies, or psychological treatments, are commonly used to address anxiety and depression. These therapies can provide teens with strategies to manage their symptoms and cope with stress. Cognitive-behavioural therapy (CBT), in particular, is widely recognised for its effectiveness in treating anxiety and depression among teens, including those who are autistic.

Medication

In some cases, medication may be considered as part of the treatment plan. Antidepressants and anti-anxiety medications can be beneficial, especially when symptoms are severe. Decisions about medications are typically made in collaboration with healthcare providers, considering all possible benefits and side effects.

The importance of early intervention

For all teens experiencing anxiety and depression, early intervention is key to treatment. Parents and carers are encouraged to be vigilant for signs of mental health issues and to seek professional help without delay. Early treatment can prevent worsening conditions and help teens achieve better long-term outcomes.

Signs to watch for

Parents and carers should be attentive to changes in behaviour that might indicate underlying mental health issues, such as:

• Increased self-stimulatory behaviour or stimming.
• Aggression or self-injury.
• Reluctance or refusal to go to school.
• Frequent meltdowns or increased anger.
• Persistent low mood or decreased energy.
• Negative self-talk or putting themselves down.

Co-occurring conditions

During the teenage years, autistic individuals may also experience other mental health conditions or behavioural issues, including:

• Attention Deficit Hyperactivity Disorder (ADHD)
• Obsessive-Compulsive Disorder (OCD)
• Sleep disturbances
• Inappropriate sexualised behaviours
• Psychosis
• Tics

These conditions can co-occur with anxiety and depression, complicating the overall clinical picture and requiring a comprehensive approach to treatment.

Where to find help 

Navigating the journey with autism can be challenging for young individuals and their families. Understanding where to turn for help is crucial in managing not only the primary aspects of autism but also the associated mental health challenges that may arise. Below are some reliable resources and strategies for obtaining support, ensuring young autistic people and their loved ones can find the necessary help.

The role of General Practitioners (GPs)

For most families, a General Practitioner (GP) is typically the first point of contact for health-related concerns, including mental health. GPs are pivotal in the healthcare system, offering initial assessments and guidance. If a young autistic person faces mental health difficulties, a GP can provide a primary evaluation and determine the following steps, which might include referrals to more specialised professionals.

GPs can refer patients to psychologists who specialise in therapeutic interventions. These specialists help individuals develop coping mechanisms and strategies to manage their mental health. GPs may also refer patients to psychiatrists for cases requiring pharmacological intervention. These specialists can assess, diagnose, prescribe necessary medications, and provide a more detailed psychological evaluation.

Immediate help and crisis support

In situations where immediate mental health support is needed, several resources offer crisis intervention around the clock. Here are some key contacts and services available in Australia:

• Mental Health Line - 1800 011 511: Available 24/7 and provides crisis support and guidance, ensuring help is available at any time of the day or week.
• Lifeline - Phone 13 11 14 (or text 0477 131 114): Immediate 24/7 crisis support available throgh phone calls and text messages.
• Kids Helpline (teenagers) - 1800 55 1800: In additionto phone support, Kids Helpline provides 24/7 online resources for teenagers offering emotional support and coping strategies.
• Sane Australia (1800 18 7263): Extensive online resources and phone support, focusing on all Australians dealing with complex mental health issues.

Online resources

In addition to immediate phone support, online resources can be invaluable, providing information, support, and community engagement. The Suicide Response Project, for example, offers resources on detecting and responding to suicide risks in others, including tips and guidelines that can be crucial in urgent situations.

Building a support network

Building a robust support network is essential for young autistic individuals and their families. This network can include healthcare professionals, close friends, family members, and community resources. Regular interaction with a support network can provide emotional relief and practical help in managing day-to-day challenges.

Many non-profits and community organisations offer resources and support groups for autistic individuals and their families. These groups provide a platform to share experiences, seek advice, and connect with others facing similar challenges, fostering a sense of community and mutual support.

Finding the right help for young autistic individuals and their families is essential for managing autism and associated mental health issues effectively. Numerous avenues are available for support and guidance, from utilising the support offered by GPs to tapping into crisis intervention services and building a strong community network. By using these resources, families can navigate the challenges of autism with informed confidence and strong community support, ensuring that young individuals receive the support they need to thrive.

The role of schools in mental health support 

Autistic teenagers experience high school in ways that are very different from their peers. While all young people navigate academic pressures, social relationships, and personal development during these years, autistic students often face additional challenges such as sensory sensitivities, communication difficulties, and social integration. These challenges can increase stress and impact their mental health significantly.

It's important to recognise that autism is a spectrum, meaning each student's experience is unique, and the support must be individualised and flexible to cater to each student's needs. Schools play a crucial role in this by creating an inclusive environment that recognises these students not by their limitations but by their potential.

Schools are places for academic learning and crucial social and emotional development settings. For autistic teenagers, schools that proactively support mental health can make a big difference. Key strategies include:

• ‍Inclusive education practices: Inclusive teaching methods can help autistic students engage better with their curriculum. Techniques such as using clear, direct language, providing written instructions, and allowing alternative demonstrations of learning (like verbal explanations instead of written tests) can be beneficial.‍
• Social skills programs: These programs can help autistic students develop and refine their social skills in a structured way. This training can include understanding social cues, managing interactions, and building relationships.‍
• Sensory-friendly environments: Many autistic individuals are sensitive to sensory inputs such as noise, light, or touch. Schools can accommodate these needs by providing quiet areas, sensory break rooms, or noise-cancelling headphones during noisy periods.‍
• Tailored counselling services: School counsellors should have training in understanding and supporting the mental health needs of autistic students. Counselling that respects the unique perspective of autistic students and offers coping strategies for managing anxiety and stress can be particularly effective.

Collaboration between parents and schools

The partnership between parents and schools is fundamental in supporting the mental health of autistic teenagers. Parents can offer invaluable insights into their child’s needs and preferences, and schools can provide resources and professional support. Effective communication between parents and educational staff ensures that strategies are consistent and reinforce each other.

Peer support and buddy systems

Integrating peer support programs and buddy systems can significantly benefit autistic teenagers. These initiatives encourage other students to interact with their autistic peers in positive ways, promoting understanding and acceptance. Such programs not only support autistic students but also enrich the school community by fostering a culture of inclusivity and empathy.

Professional training for educators

Educators who understand autism can better support their autistic students. Professional development should include training on autism awareness, inclusive teaching strategies, and the latest research on autism and education. This knowledge empowers teachers to adapt their instructional methods and classroom management techniques to effectively meet the needs of autistic students.

Using technology

Technology can be a great equaliser in educational settings for autistic students. Assistive technologies, such as communication apps, organisation tools, and learning software, can help students manage their educational and social demands. Schools should ensure that these technologies are accessible and that students are trained to use them effectively.

Community and external support networks

Schools should also connect with external resources and experts in autism. Mental health professionals, autism advocacy groups, and specialised tutors can provide additional support and resources. These partnerships can enhance the school’s capabilities and offer more comprehensive support to students.

Supporting the mental health of autistic teenagers in high school involves a comprehensive approach that integrates academic, social, and personal development strategies.