Comorbidities That Exist with Autism Spectrum Disorder
Comorbidity refers to the simultaneous occurrence of two or more health conditions in an individual, which can have a significant impact on their day-to-day life.
While each case of ASD is unique, there are several comorbidities that often exist with the disorder. In this blog post, we will explore some of the most common comorbidities associated with Autism Spectrum Disorder and discuss the ways in which they can affect individuals living with ASD.
Anxiety disorders
Anxiety disorders are one of the most common comorbidities with Autism Spectrum Disorder (ASD). Anxiety is a condition characterised by excessive worry or fear. Symptoms can include feelings of restlessness, difficulty concentrating, muscle tension, fatigue, and sleep disturbances. Some studies have suggested that around 40-60% of individuals on the autism spectrum have an anxiety disorder.
It is not yet clear why anxiety is so common among those on the autism spectrum, but some factors may be genetic, arise from communication difficulties, heightened sensitivity to stimuli, and the experience of bullying or rejection due to differences in social interaction.
Medication can also be used to help reduce the symptoms of anxiety. These medications are often used in combination with psychological interventions such as CBT or exposure therapy. It is important to work closely with a doctor or psychiatrist to make sure the medication is safe and effective.
Anxiety disorders are common in individuals with ASD, but with appropriate treatment and support, these symptoms can be managed and quality of life can be improved. If you or your loved one is struggling with anxiety associated with ASD, it’s important to speak to your doctor about available treatment options.
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is a commonly seen comorbidity with Autism Spectrum Disorder (ASD). It is estimated that about 30% to 50% of individuals with ASD may have ADHD. In some cases, the symptoms of ADHD can be so severe that it has a major impact on the individual’s daily life.
Symptoms of ADHD include difficulty staying focused, being easily distracted, fidgeting, impulsivity, restlessness and hyperactivity. People with ADHD also tend to have problems with organising their time, finishing tasks, and paying attention to details. These symptoms often cause individuals to struggle with their academics, work, and social relationships. Researchers believe that there are several factors that may contribute to a person having both ASD and ADHD. It could be genetic, biological, or environmental. It could also be due to an overlap between the brain regions responsible for executive functioning, language and communication.
The diagnosis of ADHD in someone who already has a diagnosis of ASD can be tricky. However, it is important to note that both conditions require different treatments. Dr Steven Joseph, at English Doctor Barcelona, states that “it is crucial to diagnose any additional disorders in individuals with ASD, such as ADHD, since they require different treatments and interventions”.
One of the most effective treatments for both ADHD and ASD is behaviour therapy. This type of therapy teaches individuals how to manage their behaviour and increase their focus and attention span. It also teaches them strategies for managing their emotions and improving their social interactions. Additionally, cognitive behavioural therapy (CBT) can be used to help individuals regulate their emotions, increase their self-control, and develop better problem-solving skills.
Medication can also be used to treat some of the symptoms associated with ADHD and ASD. Stimulant medications such as Adderall and Ritalin are commonly used to reduce hyperactivity and improve attention. However, it is important to note that these medications can have side effects and should only be taken under the supervision of a doctor.
It is important to note that having both ASD and ADHD does not necessarily mean that an individual will have more severe developmental delays than those with only one disorder. With the right combination of treatment and support, people with both ASD and ADHD can live full and productive lives.
Obsessive Compulsive Disorder (OCD)
Oftentimes, those who suffer from Autism Spectrum Disorder (ASD) also suffer from Obsessive Compulsive Disorder (OCD). OCD is a type of anxiety disorder that involves unwanted and intrusive thoughts, feelings, or images that cause distress and anxiety. People who suffer from OCD may feel compelled to perform certain behaviours or rituals to reduce the anxiety or worry that comes from these intrusive thoughts.
Examples of such behaviours may include handwashing, counting, checking, arranging, touching, and mental rituals like repeating certain words or phrases or mentally reviewing past events.
Those with ASD who experience OCD symptoms often report having an increased sense of responsibility to protect their loved ones from harm. This can lead to rituals and behaviours related to safety and cleanliness. For example, they may repeat steps to ensure that something is done safely or cleanliness is maintained. They may also feel a need to check to make sure that something is done correctly. Additionally, those with ASD who experience OCD symptoms may become preoccupied with details such as needing to make sure all items are symmetrically arranged or having to organise items according to a certain colour or pattern.
Obsessive Compulsive Disorder can co-occur with other disorders such as ADHD, Oppositional Defiance Disorder (ODD), depression, Bipolar disorder, Schizophrenia, Tourette Syndrome, Sensory Processing Disorder, and specific learning difficulties. It is important for those who suspect they may have OCD to seek professional help to properly assess and treat their condition. Treatment typically involves cognitive behavioural therapy (CBT) and/or medication.
Depression
Depression is a common comorbidity of Autism Spectrum Disorder (ASD) and can have a profound effect on an individual's quality of life. It is estimated that around 50-70% of those with ASD experience depression at some point in their lives. The cause of depression in ASD is still not fully understood, although it is thought to be the result of a combination of genetic, biological and environmental factors.
The symptoms of depression in those with ASD can include feeling sadness and low mood, lack of interest in once enjoyable things, changes in appetite and sleep, difficulty concentrating, social withdrawal, lack of energy and feeling hopeless. It is important to remember that depression looks different in those with ASD, so these symptoms may be expressed in different ways such as increased aggression or irritability, or increased self-injurious behaviour.
To assess depression in those with ASD, several assessments may be used including the Diagnostic Interview for ADHD and Related Disorders (DIAD) and the Autism Obsessive Compulsive Scale (AOCS). It is important to diagnose and treat depression in those with ASD as early as possible. Treatment may include medications such as antidepressants and cognitive behavioural therapy (CBT). Although there is no specific ‘cure’ for depression in those with ASD, making sure that any underlying issues such as difficulty communicating or interacting with others are addressed can help to reduce symptoms of depression.
Bipolar Disorder
Bipolar Disorder is a mental health condition that can co-occur with Autism Spectrum Disorder (ASD). This mental health condition is characterised by extreme highs and lows in mood, energy, and behaviour. People who experience bipolar disorder may have periods of mania and depression, often cycling between these two states.
Individuals with ASD are more likely to experience comorbid Bipolar Disorder, as some researchers suggest that as many as 30% of those with ASD have experienced symptoms of Bipolar Disorder. ADHD, OCD, and other mood and behaviour disorders can be present at the same time as Bipolar Disorder in individuals with ASD.
Those with both ASD and Bipolar Disorder may have difficulty recognizing the signs and symptoms of both conditions. As a result, family members or caregivers of an individual with ASD need to be aware of the signs and symptoms of Bipolar Disorder. These include increased activity levels, difficulty sleeping, impulsivity, irritability, poor judgement, talkativeness, delusions, hallucinations, and euphoria.
It is also important to note that it can be difficult to diagnose Bipolar Disorder in individuals with ASD because the symptoms can overlap with the traits of ASD itself. For example, some individuals with ASD may exhibit mood swings, restlessness, hyperactivity, or easily-triggered behaviours due to their autism without having actual bipolar disorder. It is best to speak to a qualified medical professional if you suspect that someone may be struggling with both ASD and Bipolar Disorder.
In some cases, medications such as antidepressants or mood stabilisers may be prescribed to manage the symptoms of Bipolar Disorder in those with ASD. However, it is important to understand that medications alone may not be enough to manage the symptoms of this condition.
The English Doctor Barcelona clinic has a highly trained specialist available to provide assessments and treatment for individuals with both ASD and comorbid bipolar disorder. If you or someone you know is experiencing symptoms of both ASD and bipolar disorder, contact English Doctor Barcelona Clinic for an appointment today.
Schizophrenia
Schizophrenia is a mental disorder that is estimated to affect around 1% of the population. It is considered one of the most severe mental illnesses and involves a range of symptoms, such as hallucinations and delusions. Research has found that Autism Spectrum Disorder (ASD) and Schizophrenia are often comorbid, meaning they co-occur in individuals. This means that individuals with ASD have an increased risk of developing Schizophrenia. Studies have shown that people with both ASD and Schizophrenia tend to exhibit more intense symptoms than those with only one of the disorders. Additionally, those with both conditions tend to have worse outcomes than those with only one condition. Individuals with comorbid ASD and Schizophrenia may experience challenges with communication, social interactions, and behaviour, as well as cognitive deficits. They may also experience more extreme symptoms related to psychosis, such as hallucinations or delusions.
Research has suggested that individuals with ASD and comorbid ADHD, OCD, or other mental health conditions may have an increased risk of developing schizophrenia later in life. It is important for clinicians to be aware of this risk so they can monitor individuals with ASD who have comorbid mental health conditions and intervene early if necessary.
Overall, it is clear that individuals with ASD who have comorbid Schizophrenia may require extra attention and care to manage their symptoms effectively. Clinicians need to be aware of the potential for comorbidity so that they can provide appropriate interventions. With early diagnosis and intervention, individuals with both ASD and Schizophrenia can receive the support they need to live full and meaningful lives.
Tourette Syndrome
Tourette Syndrome (TS) is a neurological condition that is often comorbid with Autism Spectrum Disorder (ASD). Characterised by multiple motor and vocal tics, TS can make communication difficult. TS is caused by a genetic disorder, but the exact cause is not known. Those with TS experience repeated, uncontrollable movements and sounds, called tics, which can range from mild to severe. Common tics associated with Tourette's are blinking, shoulder shrugging, sniffing, and vocalisations such as grunting or clearing of the throat.
Though it is unknown exactly why, children and adolescents with ASD are more likely to also be diagnosed with TS than those without ASD. As comorbidity, the presence of both disorders can often make treatment and management more complicated. Additionally, co-occurring ADHD and OCD are common with TS, which can further complicate symptoms and increase the likelihood of social impairment in those with ASD.
The primary treatment for TS includes medications such as antipsychotics and alpha-2 agonists which can reduce tics. However, psychotherapy may be necessary to address the social aspects of the disorder as well as any anxiety and depression which may result from coping with comorbidities.
Sensory Processing Disorders
Sensory Processing Disorder (SPD) is a condition that affects how a person responds to the sensory stimuli they encounter in everyday life. It can affect people with Autism Spectrum Disorder significantly, and it is estimated that 80-90% of patients on the spectrum will also experience Sensory Processing Disorder. Symptoms of SPD vary but often include hypersensitivity or hyposensitivity to sound, touch, sight, taste and smell. People with SPD may also have difficulty regulating their emotions, as well as controlling their impulses and movements.
Hypersensitivity refers to an overreaction to certain stimuli, while hyposensitivity involves an under-reaction. Hypersensitivity can be experienced when a person is exposed to certain types of sound, light, taste, smell, texture or movement.
An individual with hypersensitivity might become easily overwhelmed when in a crowded environment, or be overly sensitive to strong smells or certain textures. Hyposensitivity can cause an individual to require more stimulation than usual, such as having to engage in rough play to feel sensations. They may also struggle to interpret and respond appropriately to social cues.
SPD can have significant implications on a person’s ability to learn and interact socially. It can also increase the likelihood of developing other comorbid conditions, such as ADHD or OCD. Many children with ASD and SPD also experience difficulties regulating their emotions, resulting in difficulty controlling their behaviour. With appropriate intervention and support, however, these issues can be successfully managed.
The key to managing SPD is to identify the triggers that cause distress and then develop strategies to help the individual manage these reactions. Occupational therapy is an effective treatment option for managing SPD; occupational therapists will work with individuals to develop coping mechanisms and support them in adapting their environments to reduce sensory overload. Other interventions include sensory integration therapy, which helps individuals regulate their reactions to sensory stimuli, and behavioural therapy, which can assist in managing disruptive behaviours.
Individuals with Autism Spectrum Disorder often require support from multiple professionals to effectively manage the range of challenges associated with the condition. While sensory processing disorders are just one of the many comorbidities associated with ASD, understanding and addressing SPD can go a long way in helping a person reach their potential and lead a fulfilling life.
Specific Learning Difficulties
Individuals with Autism Spectrum Disorder are at an increased risk for developing comorbidities or related conditions. One such condition is specific learning difficulties. This includes dyslexia, dyscalculia, and dysgraphia, which are characterised by difficulties with reading, mathematics, and writing, respectively. Dyspraxia, which is a difficulty with coordination and motor planning, can also be experienced.
Individuals with ASD can also experience difficulties in working memory, executive functioning, and visual-spatial processing. Working memory is the ability to hold information in your mind while using it, while executive functioning involves planning and organisation. Visual-spatial processing involves the integration of visual information while understanding spatial relationships and directions.
While individuals with ASD may not necessarily have an intellectual disability, they may experience academic difficulties due to these areas of learning impairment. These impairments are not only linked to specific learning difficulties but can also occur alongside other comorbidities such as ADHD and OCD. For example, children with ADHD often struggle with executive functioning skills and difficulty paying attention; whereas, individuals with OCD may find themselves struggling with organisation and planning tasks. Having a thorough evaluation and assessment by a qualified professional can help to identify whether a patient has one of these specific learning difficulties or another comorbidity associated with ASD. Early intervention can then be used to reduce symptoms and help improve the individual’s functioning to increase independence and lead to better outcomes.
If you would like to book an appointment to have an Autism Assessment, or if you have already been diagnosed with Autism Spectrum Disorder and need help managing the comorbidities, give us a call at English Doctor Barcelona, our in-house specialist will attend to your needs.
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