Is There A Connection Between Autism And Paranoia?

The societal perception of autism spectrum disorder (ASD) often focuses on certain sensory or social challenges. However, autism and paranoia are often discussed less, and the connection might be unknown. Paranoia can affect an Autistic person in various ways and may lead to difficulty interacting with others. Below, explore the signs of autism spectrum disorder, the connection between autism and paranoia, and ways people with autism and paranoia can find support. 

What is autism spectrum disorder?

According to the American Psychiatric Association, autism spectrum disorder is a “complex developmental condition involving persistent challenges with social communication, restricted interests, and repetitive behavior.” Parents and caregivers may notice Autistic traits before a child reaches one year old, but the symptoms may be more evident by age two or three.  

Symptoms of autism

Autism can manifest in many ways and to varying degrees for different individuals. However, the symptoms might be categorized into challenges with social interaction and repetitive behaviors. Below are some of these symptoms. 

Social symptoms of autism spectrum disorder 

Autism often causes unique challenges with social skills and communication. The following are possible social symptoms that may be recognized at an early age:

• Lack of facial expression to demonstrate happiness, anger, and other emotions 
• Difficulty making friends
• Avoidance of eye contact
• A tendency to take abstract ideas literally
• Challenges with recognizing others’ emotions

Repetitive behaviors and limited interests in Autistic people 

Repetitive behaviors can also occur in Autistic children and adults. Below are a few of these symptoms: 

• Rocking back and forth or other repetitive movements to self-soothe (“stimming”) 
• A tendency to organize items or ideas in a specific way
• A focus on niche interests
• An expectation that others will be interested in their preferred topics 
• Trouble tolerating changes in routine
• Hypersensitivity to sensory stimuli

Autism and schizophrenia: Mental health implications and paranoia  

Autism research suggests that up to 35% of people with people living with autism experience paranoia. Some might assume paranoia is primarily a symptom of conditions like schizophrenia and not autism. However, researchers believe there is clinical convergence between the two conditions. A systematic review published in 2021 in the journal Autism Research states that children with autism spectrum disorder are three to six times more likely than those without autism to develop schizophrenia. The clinical psychology review also cited research in which a subgroup of people with autism spectrum disorder experienced paranoid ideas and idiosyncratic fears. 

While there may be an increased risk of schizophrenia in people living with autism spectrum disorder, the presence of autism does not guarantee that a person will develop schizophrenia. If a person with autism spectrum disorder experiences paranoid thoughts, they might not have schizophrenia. Only a licensed mental health professional can diagnose this disorder if a person meets enough clinical criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 

Why do some people with autism experience paranoia?

Autistic people may experience paranoid thinking for a number of reasons. For example, they may experience difficulty with social interactions, leading to relationship challenges. Some Autistic people misread non-verbal language cues and assume ill intent in others’ actions. This lack of trust can make developing relationships challenging. In addition, some people may have a heightened instinct to be cautious about what happens around them. They may be highly sensitive to their environment, and paranoia might serve as a defense mechanism. 

Therapy for Autistic people

Therapy may help individuals living with autism and paranoia in several ways. Cognitive-behavioral therapy (CBT) may help them identify and challenge paranoid thoughts. This modality could also guide them to make fewer assumptions about others’ intentions, which may lead to less paranoia and distress. A therapist may also be able to offer instruction in social-emotional learning, including ways to understand other people’s emotions and communication. This technique may improve social interactions, strengthen relationships, and reduce paranoia. 

Accessible mental health support options for autism and paranoia

If paranoid thoughts or other symptoms make it difficult for people with autism to attend traditional in-person therapy, they may benefit from online therapy. Online therapy allows clients to connect with a therapist from the safety of their home environment via audio, video, or live chat. Through a platform like BetterHelp, clients can be matched with a therapist from a list of more than 30,000 mental health professionals, allowing them to potentially find a therapist who has experience supporting clients with autism and developmental disorders. Individuals can also change therapists at any time until they find a professional who suits their needs. 

The family members of a person living with autism also benefit from speaking with a therapist, whether in person or online. Therapy may help them learn more about autism, paranoia, and ways that they might help their loved one experience less fear, whether related to social situations or other factors.

Research shows that online therapy is effective for several mental health conditions, including autism spectrum disorder. One study published in Frontiers in Psychiatry found that online therapy was beneficial for individuals with autism. The participants appreciated the ability to participate in treatment at a time and place that suited their preferences. Other studies have demonstrated the effectiveness of online therapy for various psychiatric disorders, such as anxiety disorders and bipolar disorder, which can cause paranoia in some people.