Tharon’s Thoughts : Autism and the Hidden Impact of Co-Occurring Conditions

September 22, 2026




By Tharon

Neurodivergent Consultant at helpz


When people think about autism, they often think about communication differences, sensory sensitivities, routines, or social interaction. What is discussed far less often is the significant number of co-occurring conditions that many autistic people experience alongside autism.


In fact, research suggests that autistic people are substantially more likely than the general population to experience a range of physical and mental health conditions, including ADHD, sleep disorders, anxiety, depression, autonomic nervous system disorders, central sensitivity disorder and connective tissue conditions such as hypermobility. 


For many autistic people, these co-occurring conditions can have as much impact on daily life as autism itself.


When the Brain Is Different in One Way, Other Systems are More Likely to be Different Too


There is a growing understanding that autism is not simply a difference in social communication or behaviour. The nervous system influences every part of the body, including sleep, digestion, heart rate, pain and other sensory perceptions, and emotional regulation.


When one aspect of your brain is different, there is, statistically, a greater likelihood of multiple things different in the brain as well. This does not mean something is "wrong" with autistic people. Rather, it reflects the complexity of human development and the interconnected nature of the brain and body.


One area gaining increasing attention is the relationship between autism and disorders of the autonomic nervous system.


Understanding POTS


Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the autonomic nervous system, the system responsible for regulating many automatic functions in the body, including heart rate and blood pressure.


A simple way to understand POTS is that the body is not always sending the appropriate signals to blood vessels when a person changes position, particularly when sitting or standing. As a result, blood may not circulate as efficiently as it should, leading to symptoms such as:


  • Dizziness
  • Light-headedness
  • Rapid heart rate (+30bpm)
  • Fatigue
  • Fainting or near-fainting
  • Brain fog
  • Exercise intolerance


Research has found autonomic dysfunction to be overrepresented in autistic populations (AKA high co-morbidities), with POTS being one of the most commonly identified autonomic conditions. 


Unfortunately, many of these symptoms can be mistaken for anxiety, stress, behavioural issues, or simply "part of being autistic." This can lead to significant delays in diagnosis and treatment. I am of the personal opinion that when an ADHD or ASD diagnosis is confirmed, an assessment for central sensitivity disorders / autonomic nervous system disorders should immediately follow.


The Link Between Autism, Hypermobility and Sensory Sensitivity


Many autistic people also report experiences of hypermobility, joints that move beyond the typical range of motion.

While flexibility is often viewed positively, hypermobility can be associated with chronic pain, fatigue, injury, proprioceptive difficulties, and autonomic dysfunction. Studies investigating autistic adults with autonomic disorders have found a strong association between autism, POTS and hypermobile Ehlers-Danlos Syndrome (hEDS). 


These conditions often coexist alongside heightened sensory sensitivity.


For some autistic people, everyday sensations such as sounds, lights, textures or movement can be experienced with extraordinary intensity. Others may struggle with proprioception (recognising where your body is in space, having issues with this can lead to clumsiness) or interoception, the ability to recognise internal bodily signals such as hunger, thirst, pain or fatigue.


When sensory differences, hypermobility and autonomic dysfunction occur together, they can create a level of physical and cognitive exhaustion that is often invisible to others and can cause or manifest as chronic fatigue syndrome.


The Importance of Sleep


Sleep issues are among the most common co-occurring conditions in autism and can present from early childhood and often kick into high gear during the teenage years. Studies estimate that between 50% and 80% of autistic people experience significant sleep difficulties. 


One frequently reported issue is Delayed Sleep-Wake Phase Disorder, where a person's natural sleep cycle is shifted later than conventional societal expectations. This is exacerbated by a genetic disposition towards being a night owl.


The problem is often framed as laziness, a lack of motivation or poor sleep habits. Yet for many autistic people, the challenge is neurological rather than behavioural. Their bodies simply do not become sleepy at the times society expects them to.


The impacts can be significant:


  • Increased anxiety
  • Reduced concentration
  • Poor emotional regulation
  • Greater fatigue
  • Lower overall wellbeing
  • =

When sleep is consistently disrupted, every other challenge becomes exponentially harder to manage.


Mental Health and the Cost of Living in a Misunderstanding World


Autistic people experience higher rates of depression and Post-Traumatic Stress Disorder/ complex Post-Traumatic Stress Disorder (c-PTSD), than the general population. Research consistently finds elevated rates of anxiety and depression among autistic children, adolescents and adults. 


A crucial question is why.


Part of the answer lies in the way many autistic people experience the world.


From an early age, autistic children receive 14,000 – 20,000 more negative messages than their neurotypical peers. The messages are always about the way we communicate, move, think or interact is somehow inappropriate or otherwise wrong:


  • "Stop doing that."
  • "That's too much"
  • "Tone it down."
  • "Not enough"
  • "I can only take you in small doses, because you are too annoying."
  • "You're being antisocial."
  • "Why can't you just fit in?"


These messages are rarely intended to cause harm. In most cases they come from parents, teachers and professionals who genuinely want to help.

However, intent and impact are not always the same thing.


Repeatedly being told that your natural way of existing is incorrect can have a profound effect on identity and self-worth. Many autistic adults describe growing up with the feeling that they were constantly failing expectations they did not fully understand.


Over time, these experiences can contribute to c-PTSD/PTSD, anxiety, depression, chronic stress and trauma responses.


Looking Beyond Autism


One of the greatest challenges facing autistic people today is that many co-occurring conditions remain under-recognised.

Fatigue may be attributed to autism when it is actually related to sleep disorders or POTS, chronic fatigue or an iron deficiency related to fussy eating.


Emotional distress may be interpreted as behavioural difficulty when it is connected to chronic pain, sensory overload, anxiety, trauma or executive dysfunction, among other things.


Many autistic people and people with ADHD experience chronic exposure to negative social experiences, including bullying, exclusion, victimisation and repeated messages that their natural way of thinking, communicating or behaving is wrong. Researchers have increasingly recognised these experiences as potentially traumatic and as contributors to the elevated rates of PTSD and complex PTSD observed in neurodivergent populations.


Difficulty concentrating may be seen as an autism-related issue when ADHD is also present.


The result is that people often receive support for only part of their experience.


Good support begins with curiosity. It requires us to look beyond autism as a standalone diagnosis and consider the whole person - their physical health, sleep, nervous system, mental health, sensory profile and life experiences.


When we do this, we gain a better understanding of not only the challenges autistic people face, but also the support they need to thrive.

 

References

Owens, A. P., Mathias, C. J., & Iodice, V. (2021). Autonomic Dysfunction in Autism Spectrum Disorder. Frontiers in Integrative Neuroscience, 15, 787037. 

Prosper Health. (2025). Understanding the Link Between POTS and Autism in Adults. 

NeuroLaunch. (2024). Autism and POTS: Understanding Their Connection. 

NeuroLaunch. (2024). POTS and Autism: The Intricate Connection and Overlap of Autonomic Disorders.

Rumball, Happé & Grey (2020), who found more than 60% of autistic adults reported probable lifetime PTSD. [pubmed.ncb...lm.nih.gov] 

 Webb et al. (2024), who concluded that exposure to adversity is elevated in autistic populations compared with neurotypical peers.



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