Understanding Autism vs. Mental Illness: Diagnosis, Differences, and Misconceptions

Autism spectrum disorder (ASD) is one of the most misunderstood developmental disabilities today. Many people confuse it with mental illness or believe autism is itself a mental health disorder. However, autism is not a mental illness – it is a neurodevelopmental condition that begins in early childhood and persists throughout life.

With autism awareness and acceptance growing, it’s important for parents, caregivers, educators, and medical professionals to understand the key differences between autism and mental illness. Recognizing autism as a developmental disability rather than a mental disorder can make a huge difference in getting an early and accurate diagnosis. This allows children with autism to benefit from tailored interventions and therapies at the most critical developmental stages.

Understanding Autism vs. Mental Illness Diagnosis, Differences, and Misconceptions
Understanding Autism vs. Mental Illness Diagnosis, Differences, and Misconceptions

What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a complex developmental disability that impacts how a person communicates, interacts socially, behaves, and processes sensory information. ASD begins early in childhood and affects day-to-day functioning across multiple areas of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the leading handbook used by healthcare professionals to diagnose conditions, autism is classified as a neurodevelopmental disorder. This means it stems from differences in how the brain develops, not a mental illness.

Some key characteristics of ASD include:

  • Persistent challenges with social communication and social interaction
  • Restricted, repetitive patterns of behavior, activities, or interests
  • Symptoms present in early childhood, typically before age 3
  • Symptoms cause impairment in everyday functioning
  • Wide variation in symptoms and abilities between individuals

Autism is called a “spectrum” disorder because it encompasses a diverse range of symptoms and severities across different people. No two autistic individuals are exactly alike. A person can be anywhere on the spectrum from low support needs (sometimes called “high functioning”) to very high support needs (“low functioning”).

With early diagnosis and the right interventions, many autistic children can thrive and live full, independent lives.

How Autism Differs from Mental Illness

Mental illness and developmental disabilities like autism are fundamentally different conditions. However, some of the outward symptoms can appear similar at first glance. This unfortunately leads to frequent misdiagnosis of autism as various mental health disorders.

Here’s an overview of how autism and mental illness differ:

Onset

  • Autism: Present from birth or appears during early childhood, typically before age 3.
  • Mental illness: Can develop at any age, including childhood, adolescence, or adulthood. Some mental illnesses also have late onset appearing only in older adults.

Persistence

  • Autism: Lifelong condition. The core symptoms of autism are persistent and consistent day-to-day.
  • Mental illness: Symptoms may come and go, cycling between periods of wellness and illness. Some mental illnesses involve isolated episodes.

Origin

  • Autism: Neurodevelopmental disorder stemming from differences in brain structure and function. Genetic and environmental factors contribute to autism’s onset.
  • Mental illness: Result from a complex mix of biological, environmental, genetic, and psychological factors. Imbalances in neurotransmitters, inflammation, brain structure differences, and childhood trauma may play a role.

Treatment

  • Autism: No medical cure. Early intensive behavioral interventions can improve skills. Supportive therapies target specific symptoms.
  • Mental illness: Often effectively treated with psychiatric medication, psychotherapy, and other interventions with the goal of controlling acute symptoms.

Diagnosis

  • Autism: Diagnosed by specialists such as pediatricians, psychologists, and neurologists. Thorough developmental history required.
  • Mental illness: Diagnosed by mental health professionals such as psychiatrists, clinical psychologists, therapists, and primary care doctors.

Common Misdiagnoses of Autism as Mental Illness

Many autistic traits outwardly resemble behaviors seen in certain mental health conditions. This unfortunately leads to frequent misdiagnosis, especially among verbal children with mild to moderate support needs. Here are some of the most common ways autism may be mistaken for a mental illness:

Autism Misdiagnosed as Anxiety Disorders

Some autistic behaviors like repetitive routines, intense interests, and sensitivities may seem similar to anxiety. However, these are core autism traits related to challenges with flexibility, sensory regulation, and coping with uncertainty. They are not driven by irrational fears or excessive worry like in anxiety disorders.

Autism Misdiagnosed as Obsessive Compulsive Disorder

OCD and autism both involve repetitive behaviors and restricted interests. In OCD these behaviors are unwanted, intrusive, and driven by anxiety-provoking obsessions. In autism, routines and special interests are calming, self-soothing, and even enjoyable.

Autism Misdiagnosed as ADHD

Autistic children often have trouble focusing, sitting still, controlling impulses, and waiting their turn. But these traits in autism result from executive functioning challenges, sensory differences, and communication difficulties rather than ADHD symptoms like inattention and hyperactivity.

Autism Misdiagnosed as Bipolar Disorder

Autistic meltdowns when a child becomes extremely upset and “loses control” may resemble bipolar mood swings. However, autistic meltdowns are reactions to stressors like sensory overload. Bipolar disorder involves distinct manic and depressive episodes not linked to external triggers.

Autism Misdiagnosed as Childhood Schizophrenia

In rare cases, autistic children who talk to themselves or imaginary figures may be misjudged as experiencing psychosis or hallucinations. But autistic children engage in pretend play and muttering as a way of self-soothing. They know their “imaginary friends” are not real.

Autism Misdiagnosed as Oppositional Defiant Disorder

Autistic children’s meltdowns and tendency to avoid demands placed on them could be mistaken for intentional defiance. But autistic kids resist to cope with feeling overwhelmed. ODD involves deliberately arguing with authority figures and refusing reasonable requests.

Getting an Accurate Autism Diagnosis

These examples illustrate the vital importance of an accurate, evidence-based autism diagnosis. Autism is not a mental illness or behavioral disorder. When misdiagnosed, autistic children often receive inappropriate treatment that fails to address their underlying needs. This can lead to worsening of autism symptoms over time.

To get an accurate autism diagnosis, parents and caregivers should:

  • Seek evaluation from autism specialists, such as developmental pediatricians, neuropsychologists, or clinical psychologists with expertise in autism.
  • Provide the doctor with thorough developmental history since early childhood indicating any delays in language, social skills, sensory issues, or restrictive behaviors. Share home videos or photos illustrating these early autism signs if available.
  • Ask about gold-standard autism diagnostic tests like the Autism Diagnostic Observation Schedule (ADOS-2) in addition to clinical interviews.
  • Request referral for multidisciplinary assessment if any uncertainties around diagnosis exist. Occupational therapists, speech therapists, special educators, and other professionals may provide insight.
  • Seek a second opinion if the diagnosis does not seem to fit your child’s difficulties or recommended interventions do not help.

Accessing ABA Therapy for Autism – Call Jade ABA Today!

If your child does receive an autism diagnosis, it’s critical to start tailored interventions as soon as possible while their brain is still rapidly developing. Applied behavior analysis (ABA) is the leading evidence-based behavioral treatment for autism recommended by the American Academy of Pediatrics.

ABA therapy uses positive reinforcement and rewards to motivate autistic children to develop real-life skills – from communication, social abilities, self-care, and school readiness to handling emotions, transitions, and challenges. ABA can benefit autistic children as young as 2 to 3 years old through the teen years and beyond.

Jade ABA Therapy provides top-quality, in-home ABA therapy in Maryland tailored to each child’s unique needs. Our passionate and experienced ABA therapists partner with families to help autistic children thrive in all areas of life.

We offer comprehensive assessments, individualized treatment plans, ongoing progress monitoring, and extensive autism training for parents and caregivers.

Get started with in-home ABA therapy from Jade ABA today! Our outstanding service and proven results have helped countless families. We’re confident we can help you and your child succeed.

Call (410) 616-0901 or email info@jadeaba.org to learn more!

References:

Autism Spectrum Disorder Fact Sheet – National Institute of Neurological Disorders and Stroke

What is Autism Spectrum Disorder? – American Psychiatric Association

Autism Spectrum Disorder – Centers for Disease Control and Prevention

Autism Spectrum Disorder: Diagnosis – American Psychiatric Association

Mental Illness – National Institute of Mental Health

Autism Spectrum Disorder: Misdiagnosis and Dual Diagnoses – Interactive Autism Network

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