Autism Co-occurring Conditions: Aphantasia, Anxiety and More

What is aphantasia and autism?

Some people notice signs of both aphantasia and autism in themselves or a family member and want to know whether they are connected.

Research on the overlap is still developing, so the honest answer is that your own clinician is best placed to talk it through. Bring notes on how you think, plan and remember to your next appointment.

Autism comorbidities: types of co-occurring conditions

Clinicians group autism comorbidities (conditions that can occur alongside autism) into a few broad areas.

Mental health conditions that occur alongside autism

• OCD and autism explains how repetitive thoughts and routines differ from autistic interests, and where the two can overlap.
• Autism and anxiety covers how worry shows up for autistic people and which supports are commonly used.
• Autism and depression looks at low mood in autistic people and how it is assessed.
• Bipolar and autism sets out how mood episodes are assessed in autistic people.
• CPTSD vs autism compares trauma responses with autistic traits and where they can overlap.

Neurodevelopmental conditions and look-alike diagnoses

• Down syndrome vs autism explains how the two differ, and how they can occur together.
• Global developmental delay vs autism compares early delays with an autism assessment pathway.
• BPD vs autism explains why borderline personality disorder and autism are sometimes mistaken for each other.
• Autism and narcissism separates a common myth from how autistic people actually relate to others.
• ODD and autism looks at oppositional behaviour and what may sit behind it.
• Autism and tics explains movement and sound tics in autistic children and adults.
• RSD and autism describes intense sensitivity to rejection and how it is talked about in autism.

Physical and neurological conditions

• Autism and seizures covers epilepsy in autistic people and what a seizure management plan includes.
• Hypermobility and autism explains stretchy joints, pain and fatigue alongside autism.
• ARFID and autism explains avoidant eating that is driven by sensory, fear or low-interest factors rather than body image.

Is aphantasia linked to autism?

Whether aphantasia is linked to autism is an open question, and Reframing Autism has a plain-language page on understanding aphantasia and autism.

• Do not assume that having aphantasia means you are autistic, or that being autistic means you have aphantasia, because they are separate experiences.
• Write down how you recall faces, places and instructions, since clinicians can use these examples when they look at your whole profile.
• Ask your GP whether a referral for an autism assessment makes sense if you have other reasons to think you may be autistic.
• Remember that no online test can diagnose autism, and an autism assessment is done by a qualified clinician.

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Co-occurring conditions in autistic children

For children, co-occurring conditions are often noticed first as changes in sleep, eating, mood or behaviour at school.

• Around 40% of autistic children have anxiety, and an estimated 30-60% meet the criteria for an ADHD diagnosis, according to Raising Children Network.
• Depression is diagnosed in 10-20% of autistic children, and around 10% of autistic children are thought to have OCD.
• The Australian ADHD Guideline found children and adolescents with autism have a significantly higher risk of ADHD, as do those with epilepsy, tic disorders or anxiety disorders.
• Keep a short diary of sleep, meals, meltdowns and worries, then bring it and any school reports to your paediatrician.
• Ask about global developmental delay vs autism if your child’s skills are developing at different rates across areas.

Your paediatrician may also discuss genetic or neurological conditions, such as fragile X syndrome or cerebral palsy, where they are relevant to your child.

Co-occurring conditions in autistic adults

Some adults are assessed for autism later in life, often alongside other health conditions. Your GP is a good place to start.

• Ask your GP for a longer appointment and bring a list of the traits, sensory issues and health conditions you have noticed since childhood.
• Read about symptoms of autism and the autism definition before your appointment, as reflection only and not as a self-diagnosis.
• Talk to a clinician about autism and psychosis if you ever experience hearing or seeing things others do not, and call 000 if anyone is in immediate danger.
• Alexithymia (difficulty identifying your own feelings) and autism are sometimes discussed together, so mention any trouble naming emotions to your clinician.
• If you feel overwhelmed or in crisis, Lifeline on 13 11 14 is available, and Autism Connect on 1300 308 699 offers free guidance on autism-specific questions.

Autism and physical health: PMDD, POTS, fibromyalgia and gut health

Physical health concerns are worth raising with your GP, who can check them properly, especially if pain or discomfort is hard to describe.

Autism gut health concerns

Stomach and bowel complaints, sometimes described as autism gut problems, are worth raising with your GP even if they seem unrelated to autism. Please do not start restrictive diets or supplements without advice from your GP, dietitian or paediatrician.

Sensory conditions: misophonia, SPD and autism

Sensory differences are a core part of how many autistic people experience the world, and they are also described as conditions in their own right.

• Misophonia means strong distress at particular sounds such as chewing, tapping or breathing, and an audiologist or psychologist can explore whether it relates to autism for you.
• Sensory processing differences are one feature of autism, but sensory processing disorder and autism are not the same thing.
• Auditory processing disorder and autism can be assessed by an audiologist when understanding speech in noisy places is hard.
• An occupational therapist can assess sensory needs and suggest practical adjustments at home, school and work.
• Synesthesia and autism are sometimes mentioned together, and mixed-sense experiences are worth describing to your clinician instead of dismissing.

Autism vs look-alike conditions: OCPD, dyslexia and catatonia

Some conditions share features with autism, so clinicians compare them carefully before settling on a diagnosis.

For more on related questions, read about dyspraxia and autism, selective mutism and autism and autism and intellectual disability.

What causes autism and co-occurring conditions

Families often ask why autism and its co-occurring conditions happen, and there is no single simple answer.

• Read what causes autism for a plain-language summary of current understanding in Australia.
• Be wary of any website that offers a single cause or a cure for autism, and check health claims with your GP.
• Explore the wider list of medical conditions associated with autism through Raising Children Network, which publishes a guide for parents.
• Ask your specialist how any co-occurring condition was identified, so you can pass the information on to new health providers.

Autism, co-occurring conditions and the NDIS

If you meet the NDIS access requirements, the NDIS can fund supports based on how disability affects your daily life, not on a diagnosis alone.

1. 1Gather your reports. Collect letters from your GP, paediatrician, psychologist, occupational therapist and speech pathologist that describe how each condition affects daily tasks.
2. 2Describe the impact together. Explain how every condition affects daily life, because anxiety, sleep and sensory needs combined may change the support you ask for.
3. 3Read the funding guide. Read our guide to autism funding for how evidence is used in an access request and in planning.
4. 4Ask for free guidance. Ask Autism Connect, the free national helpline delivered by Amaze, for guidance on 1300 308 699 (Amaze).

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Your next step

If you or someone you support is living with aphantasia and autism or another co-occurring condition, start with your GP and gather your reports. TQN Care’s NDIS services include personal care, community access, respite and help around the home, delivered by support workers who listen to what matters to you. Contact us when you are ready and we will call you back.