Autism Spectrum Disorders - Suicide Risk Factors and Warning Signs

by Lisa Morgan, M.Ed., CAS

(Editor's note: Thank you to the American Association of Suicidology for collaborating with us on this article.)

     Suicide is the second leading cause of premature death for autistic people who do not have a learning disability, yet there is little research as to why. 

     There have been studies showing autistic adults have a higher rate of suicide than the general population. Also, the diagnosis of an autism spectrum disorder (ASD) or autistic traits are independent risk factors of suicidality (Cassidy, Bradley, Shaw, & Baron-Cohen, 2018).  

     ASD is a complex neurodevelopmental condition that includes challenges in areas such as social communication, limited interests, and repetitive behaviors. Although there are many more characteristics of ASD, social communication is what autistic people struggle with most when it comes to issues of suicide.

     There are two aspects of social communication that have been found to be unique risk factors of suicidality: camouflaging and unmet needs (Cassidy et. al., 2018). Camouflaging is a strategy used among autistic people to mask their autism so they look and act like everyone else. The reason autistic people camouflage is to fit in. The cost of camouflaging is exhaustion, lack of support, and feeling as if you have to hide your true self to be accepted. Although camouflaging does help people with an ASD to socialize, it leads to the profound loneliness of not belonging, because no one really gets to know the person. 

     Unmet needs leave autistic adults without support for mental health challenges, employment, housing, education, and relationships. Asking for help is social communication.  Autistic adults struggling with social interactions may have difficulty reaching out for help, knowing who to reach out to, or what to ask. If they do find help, many times they are misunderstood and not helped in the way they need it - mostly because professionals assess them as non-autistic people.

     Knowing the warning signs for suicide in all people is crucial in assessing them in a crisis situation. Although there is a standard set of warning signs for families, friends, and professionals to use, they have been developed for non-autistic people. Autistic people in crisis may not get the help they need using the standard set of warning signs. 

     A few warning signs where autistic adults may present differently are: withdrawing, high anxiety, feeling isolated, and hopelessness. These warning signs can be part of the way an autistic person lives. For example, withdrawing is a coping skill for many people with an ASD.  Indeed, withdrawing can be an essential part of regulating emotions, managing self-care, and reducing the high anxiety many of us live with daily. There are many reasons an autistic adult may feel isolated and hopeless, including the unique risk factors of camouflaging and unmet needs.

     Some important unmet needs affect all of the autism community. They are universal in that we need more research, warning signs developed for autistic people, and being accepted for who we are, so we don’t need to camouflage.

Reference

Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018, July). Risk markers for suicidality in autistic adults. Molecular Autism, Volume 9, Article 42.

Lisa Morgan is an advocate for suicide prevention resources for the autism community. She has a master’s degree in the Art of Teaching, is a Certified Autism Specialist (CAS), and has a graduate certificate in Behavior Analysis. Lisa is chair of the Autism and Suicide committee of the American Association of Suicidology. Lisa, an autistic adult, is a suicide loss survivor due to the suicide of Paul, her husband of 29.8 years, and of her nephew David.