Why is it important?

Emotional health is an important part of our wellbeing. Emotional health means your ability to cope with challenges in life. Poor emotional health can lead to problems like anxiety and depression. 

What can I do to improve emotional health? 

“We have a lot of obligations in life, especially as adults. There are a lot of adult responsibilities. Take that time to relax, listen to some music, take a bath, take a hot shower, turn on a movie…whatever feels good to you.”

 – Emily, age 29, autistic self-advocate

 

There are a lot of things you can do to improve your emotional health that are presented in this guide. Sometimes people need the help of a therapist or other professionals during difficult times. At the end of this guide, there is information about how to seek professional help for mental health symptoms or concerns

Reduce Stress

Stress negatively impacts physical and emotional health. Reducing stress is one way to improve your wellbeing. Some tips for reducing stress include: 

• Create routines and schedules to increase predictability and take the stress out of daily activities
• Make time for rest and relaxation in your daily or weekly schedule.
• Even spending just a few minutes resting can make a big difference! 
• One strategy that can be helpful is “energy accounting.” Using energy accounting, you work on balancing activities that drain or recharge you throughout the day and week. 
• Mindfulness can help you feel less stressed. Examples of mindfulness include meditation, breathing exercises, visualizations (picturing your favorite place, imagining a calm setting like a forest or beach), yoga, and progressive muscle relaxation (slowly tensing and relaxing different muscles in your body). There are no right or wrong ways to be mindful and you should find options that work for you.
  

Where can I get more information about stress reduction? 

There are several apps that provide guided meditations and mindfulness exercises. 

• Apps that cost money: Headspace, Calm.  
• Free Apps: UCLA Mindful and Healthy Minds Program. YouTube also has many free guided mindful exercises. 
  

“I know for a bunch of us who are on the spectrum, we’ll get to the end of the day and won’t even have time for these other things and it’s just exhausting. So I try not to schedule so much in one day that I’m exhausted. I’ll try to plan a little more balanced stuff to manage my energy.  Self-care every once in a while is important too.” 
– Leah, age 44,  neurodivergent self-advocate

Connect with nature 

Spending time in nature can improve wellbeing. There are lots of different ways to enjoy the outdoors. Some ideas include: 

• Spend time outside (for example, in a local park, on a hike, in other outdoor spaces) 
  
• Observe wildlife – notice birds, small mammals, butterflies, and other animals when you are outside 
  
• Garden; take care of indoor plants; arrange flowers 
  
• Open your windows; look out the window during the day
  
• Watch nature documentaries 
  
• Notice your environment with your senses: pay attention to what you see, smell flowers, listen to birds, the wind, or wildlife, touch dirt, bark, or plants 
• Collect shells or pebbles; press fallen leaves or flowers in a book; take photos 
  

Manage sensory needs

Everyone has different sensory preferences. Consider your sensory likes and dislikes. Try making changes so that your environment is more comfortable. Common strategies include: 

• Wearing headphones to either cancel noise or listen to music or other input that helps you focus or relax?
• Adjusting lighting; wearing sunglasses
• Go shopping early in the day, or later at night to avoid busy crowds
• Wearing clothes that are comfortable to you 
• Adjusting the temperature of the room, or wearing layers to adjust your own temperature 
• Lighting a candle or using a scent diffuser 
• Using fidgets and/or other sensory tools
• Making time in your day to take sensory breaks in a calm, quiet space or to get needed sensory input 
• Although there may be some changes you can make on your own, you will not always be able to control your surroundings, for example, at work, school, or public settings. If you let someone know about your sensory needs, they may be able to make accommodations for you ahead of time (for example, dimming the lights in their office when they meet with you). Advocating for your sensory differences is one way to get accommodations that help meet your sensory needs. 

Where can I find out more about sensory needs? 

• National Autistic Society - Sensory Differences
• Sensory Preferences Checklist
• Understanding Sensory Overload
  

Self-Compassion

“Try not to worry so much about what other people think about you. Autistic people tend to be people pleasers. I think a lot of times we worry about what other people think of us. Don’t worry so much about that and be yourself…like sharing what you love, or being a friendly person, or whatever it means to you to be yourself.”
 - Emily, age 29, autistic self-advocate

Many autistic adults say that self-compassion has helped their wellbeing. Self-compassion means embracing autistic traits, recognizing strengths, and accepting yourself as you are. Self-compassion takes practice. Some ways to increase self-compassion are: 

• Positive self-talk: practice saying kind things about yourself. Take note of negative thoughts and try responding with a kind response instead (for example, “I am trying my best”). Some people like to use a journal for this.
  
• Identify and celebrate your personal strengths. Make a list of the things you like or appreciate about yourself
  
• Loving-Kindness meditations are mindfulness exercises that focus on building self-compassion
  
• Give yourself gentle touch, such as putting your hand over your heart, giving yourself a squeeze, stroking your arms, or any other form of touch that comforts you 
• Learn about neurodiversity. Neurodiversity means that differences in the way brains work, like autism or ADHD, are part of human diversity. The neurodiversity movement says that autistic people do not need to be fixed, and that we should focus on society accepting autism and other differences. Supports and services for autistic people should focus on an individual’s priorities, preferences, and goals. Learning to see autism as just another kind of difference, not something negative, can help you be more understanding and kind to yourself.

Where can I get more information about self-compassion and autism acceptance? 

• Dr. Kristin Neff - Self-Compassion Practices and Exercises
• https://autismacceptance.com/
• Embrace Autism - Self-Compassion and Self-Criticism
  

Unmasking

Masking, also called camouflaging, means hiding autism in order to fit in. Forcing eye contact, copying body language or facial expressions, stopping stimming behaviors, and putting on an “act” in social situations are some examples of masking. 

Masking can affect your mental health and wellbeing (Bradley et al., 2021; Hull et al., 2019). Many people say that masking makes them feel burned out. Here is an example of what masking could look and feel like:   

On the surface, a college student appears to be doing well. They go to class every day, eat in the dining hall, and meet up with their group of friends. Under the surface, they are working hard to follow the social rules of college life. In the evening, they feel wiped out from being “on” all day. 

It is important to know that society is the reason why people feel the need to mask their true selves. Autism awareness and acceptance is the best solution to masking. These strategies can be helpful for handling masking:

• Recognize when you are masking and how it affects you. You may find it helpful to keep a journal or take notes of when you mask. 
  
• Make time to be your true self. This could be by yourself or with others who accept you for who you are (for example, with close family and friends)
  
• Identify situations where masking is necessary for safety or professional reasons
  
• You may choose to educate others about the challenges of masking and advocate for accepting and inclusive environments 
  
• Self-acceptance and self-compassion can help with the impacts of masking.  The section above talks about these strategies. 
  
• Understanding neurodiversity can help you understand masking and why it happens (see Self-Compassion section for more about neurodiversity).  
  

Where can I get more information about unmasking? 

• Embrace Autism: Masking
  
• Book: Taking Off the Mask by Hannah Louise Belcher, PhD (Autistic researcher and advocate) 
• Book: Unmasking Autism: Discovering the New Faces of Neurodiversity by Devon Price, PhD (Autistic researcher and author)
  

Faith and Spirituality

Being a part of a faith community can be an important part of wellbeing for some people. It is up to each individual person to decide whether religion and faith are a part of their life. For people who have religious beliefs, things like prayer, going to religious services, or talking to a religious leader sometimes help relieve stress and gain support and comfort. 

Spirituality can also be an important part of wellbeing. Spirituality is about discovering meaning and connection in life beyond what we can see and touch. Some people see spirituality as believing in a higher power or divine force. Other people find it through things like meditation, prayer, or nature. If you want to explore your spirituality, a first step is to reflect on your beliefs, values, and experiences. You could also ask yourself questions about what brings meaning and joy to your life, as well as what connects you to something greater than yourself. 

“Spirituality seems to tie it all in. Some people would call it religion or God or grand universe. Others might call it purpose or connection or synergy…something to help address my little fabulous mess that's me and in relation to the existence I perceive.”
 – Brian Be, age 50, autistic self-advocate

Why is it important?  

Physical health refers to the health and wellness of your body. Taking care of your body is one way to support your wellbeing. 

“Having a healthy diet, having a decent routine and consistency, getting out in nature, exercise and movement, sleep…those things are really important for wellbeing.”
 – Leah, age 44, neurodivergent self-advocate

What can I do to improve my physical health?

There are many ways to improve physical health. The sections below focus on sleep, nutrition, exercise, and healthcare. 

Sleep

Get enough sleep:  Adults should try to get 7-9 hours of sleep a night. 

Get better sleep. Some ways to improve your sleep are: 

• Set a predictable bedtime routine that includes activities you find relaxing. Try to go to bed and wake up at the same time every day.
• Avoid caffeine and sugar several hours before bedtime
• Avoid looking at screens for 30 minutes before bedtime, or change the settings on your devices to reduce blue light at night 
• Make your sleeping environment sensory-friendly so that you are comfortable

Where can I get more information about sleep? 

Sleep Tips for Autistic Adults

Eating 

• Eat three meals a day and snacks as needed 
  
• Keep yourself hydrated by drinking water
  
• Try to eat fruits, vegetables, and whole grains 
  
• If you can, eat a variety of different foods. Some autistic people do not like eating a wide variety of foods. Getting the nutrients you need is more important than eating many different foods. You can talk to your healthcare provider about your nutritional needs and what you may need to be including in your diet.  
  

Where can I get more information about nutrition? 

• autismandhealth.org - Nutrition
• NIH Dietary Guidelines for Americans 2020-2025
  

Exercise/staying active 

Physical activity has many health benefits. There are a lot of ways to be active. You should find ways to exercise that work best for you. Some people like to exercise alone, while others like to be with other people. It is especially important to be physically active as you get older because it can help prevent health problems. 

Starting to exercise might seem scary at first, but you can make it easier by taking small steps. For example, you could try walking to the end of your street and then back home or try riding your bike for just five minutes. As you get used to it, you can slowly increase the time you spend exercising. 

• Some ideas for physical activity include: 
  
• Going for a 5-10 minute walk
  
• Jogging, running, or hiking
  
• Swimming or water aerobics
  
• Go to the gym or exercise classes. You can access free workout plans or videos on YouTube or the internet
• Bicycling 
• Yoga; stretching
• Dancing 
• Household tasks: Shoveling snow, mowing the lawn, gardening
• Daily activities: Taking the stairs instead of the elevator; parking your car far from the building to add walking time

Where can I get more information about exercise and physical activity? 

• autismandhealth.org - Exercise
• NIH Physical Activity Tips
  

Healthcare 

Going to the doctor for check-ups can help prevent health problems and is especially important for older adults. You should try to get a check-up once a year. Finding a primary care provider can be difficult. Some considerations include: 

• Insurance: If you have insurance, you can find out what providers are covered by going to a website, calling your insurance provider, or in a booklet sent by the insurance provider. 
  
• If you do not have insurance, you may have to do some research. You can look for free clinics, low cost clinics, self-play clinics, or sliding scale clinics. 
  
• Autism acceptance: You can ask your doctor about their experience with autistic people, if they have experience with your medical conditions, and if they can make accommodations for you (for example, providing a visual, providing written instructions before the appointment). If a provider is not a good fit for you, you can switch to a different provider.  You can also ask for recommendations for providers that have experience working with autistic people from local autism community groups. 
  

Where can I get more information about going to the doctor? 

• autismandhealth.org - Healthcare has tips for finding a provider, making appointments, and deciding if a provider is a good fit for you, and what to do if you do not like your provider. 
  
• ECHO Autism has a directory for finding clinicians trained in best practices for treating autistic people
  

Why is it important? 

Social support and connection are an important part of wellbeing. It is important to remember that there is no right or wrong amount of socialization. Social support is especially important as you get older.   

“That people thing, that ‘gather your tribe’ thing…it’s important.”
– Brian Be, age 50, autistic self-advocate

“I think that belonging is really important. Is this person included and chosen and feels like they belong in whatever it might be – if it’s anime, or D&D group, or swimming, or Scouts or whatever, and how do we help support that.” 
– Lindsey, psychologist and sibling of an autistic adult

What can I do to increase my social support? 

The next section of this guide has suggestions about social support and connection. It may be helpful as a first step to think about how often you like to socialize, the people you like socializing with, and what you like to do when socializing with them.

Connect with the autism community 

Many autistic adults say that being part of an autistic community makes them feel connected and supported. You may have to do research to find a good group for you. 

Where can I get more information about autistic communities? 

• Some places to look for autistic community include your local Autism Society chapter (https://autismsociety.org/); the Association for Autism and Neurodiversity (https://aane.org/services-programs/group-services/support-groups-community-connection/); Autistic Women & Non-Binary Network (https://awnnetwork.org/) searching for social media groups (Discord, Reddit, Facebook); or contacting your local resource center.

Spend time with friends, pets, family, loved ones 

Social support can help improve your wellbeing. There are many ways to be social. Everyone has different preferences about being social. 

• Having a regular plan to spend time with others can help make social times predictable.
  
• Spending time with pets can help you feel less lonely and is another form of support. 
• Joining recreational groups, classes, or clubs is one way to do something fun and spend time with others. There are virtual and in-person options for these types of groups or clubs. There are also apps like Meetup (free) that can help you connect with other people in your area.

Set boundaries

Socializing can help your wellbeing, but it can also be draining. It may be important to set boundaries with others to maintain your wellbeing. If you feel stuck, a therapist can help you with learning and practicing boundaries. Some tips for setting boundaries are: 

• Don’t be afraid to say “no” to social engagements 
• Set limits on how much time you spend in draining social environments (for example, go to a party for the first hour when it is less busy)
• Communicate your boundaries or limits to friends, family members, employers, professionals who support you 
• Use assertive statements like “I want…” “I feel…” or “I need…” when communicating about your boundaries 
  

Where can I get more information about setting boundaries? 

• Everyday Autistic - Setting Boundaries by Samantha Craft, 2019

Why is it important? 

Spending time doing things you like is related to better wellbeing. Hobbies and interests are a source of fun, pleasure, creativity, relaxation, and accomplishment. 

What can I do to improve my recreation and leisure? 

Make time for your passion areas or focused interests. If you have a hard time transitioning from these activities, consider scheduling them at the end of the day when you know you will not have interruptions.   

Join groups that relate to your interests. These could be online or in-person.

Try new hobbies and activities. Consider engaging your creative side or learning about a new topic. Some suggestions include: 

• Cooking
• Art (drawing, painting, digital art, clay, fiber arts) 
• Creative writing; journaling; reading 
• Playing games or sports 
• Learning a new language 
• Gardening 
• Music (dance, playing an instrument, singing) 
  

“Let’s draw something, let’s sing something, come on!”
 – Brian Be, age 50, autistic self-advocate

“Take that time for self-care and do what you love to do. Whether that’s video games, or hanging out with friends, or researching your topic of interest, I think whatever you love is what you should do.”
 – Emily, age 29, autistic self-advocate

Why is it important? 

Participation in meaningful activities is one way that people find a sense of purpose. Sense of purpose is associated with better wellbeing. As you grow older, your role within your family and your community will naturally change. This makes it especially important to have meaningful activities in older adulthood, when there may be more changes. 

What can I do about it? 

Purpose can take many forms. Some people only think about having a job when they think of purpose. Though having a job is one option, there are a lot of ways to be a part of meaningful activities: being a good family, friend, or community member; volunteerism; activism; being a parent; making art; educating others; taking care of pets; caring for the environment; and more. 

“Helping them to find a path that is meaningful for them, even when it’s counterculture, is important.”
 – Kristen, parent of autistic adults 

“As we are getting older and have more physical limitations… because Matt lives with us he can do some things for us that are harder for us to do. Like, ‘can you reach this off the shelf for me?’ ‘ Can you crawl under this thing for me?’ There’s support that goes both ways.”
– Jane-Ann, parent of an adult with autism

Employment

There are different options for employment depending on your goals and support needs. 

If you are not currently employed but want to explore career options, some things to consider include: 

• Job shadowing 
• Supported employment 
• Part-time vs. full-time work 
  

If you are employed but unhappy with your current job, you may consider: 

• Looking into other careers that catch your interest
• Asking about opportunities for growth in your current job (for example, taking on new responsibilities or moving to a position you would like more)
• Identifying your strengths and careers that align with your strengths. A career counselor may be able to help with this if you need support
• Identifying what you do not like about your current job

Unfortunately, stigma toward autism can be a barrier for employment. It is important to know your rights and what accommodations or supports you may be entitled to. For more information on resources that may be helpful, see below. 

Where can I get more information about employment? 

• Colorado Office of Employment First
• Division of Vocational Rehabilitation
• Job Accommodation Network

Volunteerism

Volunteering is a way to contribute to a cause or organization you care about. Before signing up to be a volunteer, consider: 

• The amount of time you have to contribute
• Your goals for volunteering
• Your preferences (working with other people, work that is outside or inside, in-person or remote, short-term or long-term)

Some ideas for volunteering include: 

• Animal shelters or rescues
• Hospitals 
• Tutoring or mentoring 
• Environmental groups 
• Fundraising
• Food banks 
• Tax preparation
• Volunteering expertise/skills (running the social media account for an organization, volunteering to do photography for a charity event)

Advocacy

Advocacy is another way to support causes, policies, and movements that you care about. Some autistic adults say that advocating for the autistic community helps their wellbeing.  Advocacy can involve: 

• learning about local, state, or federal policies 
• sharing your story
• writing to politicians and policy makers
• making phone calls to legislators
• attending meetings or hearings, and more

Some people advocate for changes at a local level, for example, within their town, place of employment, or at a local business. Others advocate for policies set by the state or national government that impact the issue they care about. 

Where can I get more information about advocacy?

• If you are interested in autism and disability advocacy, organizations such as the Autistic Self-Advocacy Network (https://autisticadvocacy.org/); Self-Advocacy Online (http://www.selfadvocacyonline.org/); or your local Arc chapter (https://thearc.org/) are good places to get more information. You can also do research to find advocacy organizations specific to your town or city.  
• There are many causes that people may want advocate for. If you are interested in a cause, you can do research to find advocacy organizations and policies related to that topic. 
  

Why is it important?

“I think it’s important to ask people what they want – what is it that they aspire to, what are some of the things they have goals around, what is it they hope to do…and get a sense of whether they have a good roadmap of how to get there. How can we then as providers, family members, or allies help individuals with supports to get to that point.”
– Lindsey, psychologist and sibling of an autistic adult

Every person deserves the right to set and work toward their own goals, advocate for themselves, and make choices and decisions about their life. This helps quality of life and mental health.

Independence and autonomy as an adult look different from person to person. Some people may need a lot of support in one area but be fully independent in another. It is important to remember that nobody is fully independent. Everyone relies on help and support from others to make choices and be successful.  

What can I do to support independence and autonomy?

• Advocate for what you need and want for your life (self-advocacy) 
• Use accommodations and modifications that support your success. This could include things like sensory accommodations, visual supports, routines, and more. 
• Communicate and build a team including family members, friends, and professionals who support you (for example, therapists, medical professionals, educators, employers)
• Learn about your rights as a person with a disability. This includes your right to vote, your right to accommodations, your right to access services, and more. 

“You have to foster independence…you are trying to work yourself out of a job, by encouraging your son or daughter to be as independent as they can possibly be.”
– Jane-Ann, parent of an adult with autism

“Don’t be afraid to ask for help. And if you make a mistake, then that’s okay.” 
– Matt, age 28, person with autism

Where can I get more information about independence and autonomy? 

• National Resource Center for Supported Decision-Making (all ages including older adults)
• ASAN - The Right to Make Choices  (all ages)
• Vanderbilt Self-Determination Toolkit (young adults)
  

 

How can I support wellbeing as a family member, caregiver, or other support person? 

The suggestions in this guide are for anybody who wants to know about autistic wellbeing. Some additional suggestions are included below for those who are using this guide to help someone else. 

Assess your expectations:

• The “good life” will look different for every person, but it applies to everybody – regardless of support needs. It is easy to get stuck on traditional ideas of a good life, but there are many different paths to a healthy wellbeing. Understanding what a good life looks like for your loved one and your family is an important part of supporting autistic wellbeing. 

Meet a person where they are:

• Bring awareness to the impact of small changes (for example, getting a good night sleep, physical movement, taking a break) 
• Take small steps towards goals 
  

“The thing that we are learning [as parents] is to meet our kids right where they are. And to really pay attention to what expectations you may be projecting. Because without even knowing it, you can be putting on a lot of pressure if your expectations are very different than where your child is currently functioning.”
– Kristen, parent of autistic adults  

Be flexible:

• Understand that interests, passions, and goals change and that is okay. The things that support wellbeing will grow as a person grows.  

“It’s important to partner with the individual to think about what does the good life, or wellbeing look like for our culture, for our family, for this individual…and being open to being creative and adapting and changing and modifying as time goes on.”
– Lindsey, psychologist and sibling of autistic adult

Create an accepting environment: 

• Recognize a person’s strengths and contributions to their family, community, etc.
• Learn about neurodiversity and incorporate these principles in your life
• Encourage and celebrate a person’s hobbies and interests
• Use preferred methods of communication 
• Help put accommodations into place in your setting (home, office, etc.)
  

Support independence and autonomy: 

• Encourage independence by identifying areas where new skills could be learned that are in line with a person’s priorities or goals. For example, if a person loves eating mac and cheese, a step toward independence would be for them to learn how to make mac and cheese. Take small steps when increasing responsibilities or teaching new skills. 
  
• Provide a safe, supportive environment to make mistakes. Learning from mistakes is a part of growth. Know that it is okay and appropriate to need help along the way 
• Respect and honor autistic people’s choices, preferences, and wishes. Center autistic people in making decisions about their life, from daily choices to larger, life-shaping decisions. Supported decision-making is an approach that can be useful for some individuals. See the Independence and Autonomy for resources in this area.  
  

“It’s appropriate to ask for help, it’s appropriate to need our help.”
– Kristen, parent of autistic adults

Take care of your own wellbeing:

• By taking care of yourself, you show others that wellbeing is important.  Many of the suggestions in this guide can be used for yourself!  

“[I have to do] things that feed my soul. It’s the stuff that gives the energy to go do the stuff that’s a little less preferred.” – Jane-Ann, parent of an adult with autism

Doing things to support your wellbeing is good for your mental health, but some people might need the support of a therapist or other professional. Signs that you might need the support of a professional are listed below. It is important to remember that we ALL feel these things from time to time. It can become a problem when these feelings continue over time, interfere with daily life, and do not go away: 

• Nervousness or worries that don’t go away
• Feeling down or depressed for days at a time
• You’re eating or sleeping habits have changed over time (eating much more or much less than usual, sleeping much more or much less than usual)
• You’ve experienced a stressful or traumatic event and are having trouble managing your feelings about it
• Your emotions feel overwhelming most of the time 
• You feel more irritable or angry than usual for days at a time 
• You often feel nauseous, like you can’t breathe, or like your heart is beating too fast with no medical reason 
• You avoid certain situations because of fear, which prevents you from doing things you would like to do 
• You no longer enjoy things you used to 
• You feel unmotivated 

How to seek support: 

• Talk to your primary care provider and ask that they refer you to a mental health provider 
• Reach out to your local mental health center 
• Reach out to your local autism or disability resource center 
  

Crisis or Emergency Support: 

If you need emergency support, contact 911 or call the Colorado Crisis Line at 1-844-493-8255

The 988 Suicide and Crisis Lifeline is available 24 hours, 7 days a week
Call or text 988 or go to https://988lifeline.org/chat/

Colorado Crisis Services has walk-in centers across the state that provide mental health services. This link has a list of the locations in Colorado: https://coloradocrisisservices.org/#map

Mental Health Resources: 

The Department of Psychiatry Outpatient Clinic at the University of Colorado provides therapy and medication management services. To learn more about these services, call 303-724-1000. You can find more information at https://medschool.cuanschutz.edu/psychiatry

Neurodivergent Therapists is a directory of therapists who identify as neurodivergent. You can look for providers in Colorado at: https://ndtherapists.com/colorado/

The following websites provide more information about mental health in autism: 

Adult Autism Health Resources: Anxiety and Depression
AANE: Mental Health and Wellbeing
National Alliance on Mental Illness: Mental Health Conditions

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