In this episode, I'm joined by Aqila Armstrong, licensed marriage and family therapist and Senior Manager of Counseling at Cortica, for a conversation we've been wanting to have for a long time: mental health in autism. For Mental Health Awareness Month, we go beyond the surface to talk about why mental health is so often overlooked in autism care, and why that needs to change. One 2021 study found that nearly 78% of autistic youth also have a mental health condition, most commonly depression, anxiety, ADHD, or behavioral challenges. And those conditions can affect a person's quality of life sometimes even more profoundly than the features of autism itself. I walk you through, alongside Aqila, why anxiety and depression are so common across the autistic lifespan: the biological factors like sleep and rumination, the mismatch with environment, social isolation, bullying, sensory overload, and the quiet exhaustion of masking. We break down how mental health distress can show up differently in autistic children, why irritability is so often misread as a "bad child," and how what gets labeled as noncompliance or PDA (now increasingly understood as a persistent drive for autonomy) often points to underlying anxiety. We also talk about which therapies work, what to look for in a neuro-affirming practitioner, and how to support the whole family, including siblings carrying a silent burden and the caregivers who are often holding more than anyone realizes. (Research shows parents of autistic youth have higher rates of PTSD than the general public.) This episode is for you if: you've ever wondered whether your child's behavior might be more than autism, you're a parent feeling stretched thin and unsure how to add one more thing to the schedule, you want to understand what neuro-affirming mental health support actually looks like, or you're a clinician, educator, or family member who wants to better support an autistic child or adult.
