The Potential Benefits of Psychedelics for Autistic People
In discussions around the benefits of psychedelics, autistic people are often left out of the conversation. This is despite the fact that autistic people often report experiencing a wide range of benefits from using these compounds.
Before delving into what these benefits are, it is first crucial to mention that autism – unlike conditions such as major depression and generalised anxiety – is not a mental health condition but a neurodevelopmental one. It is more commonly referred to as a form of neurodivergence – not something that needs to be (or can be) ‘cured’.
Autism, as a form of neurodivergence, involves a brain that functions differently from what is considered typical (or neurotypical, or allistic). The neurodiversity approach views autism as a natural variation in people, which affects how people perceive and interact with the world, which can cause distress and problems when faced with a neurotypical world. Neurodivergent traits, like allistic traits, carries both advantages and disadvantages, depending on the context and circumstances.
While legitimate arguments can be made as to why autism is not a ‘disorder’ – but is instead a natural variation in neurodevelopment – this doesn’t mean autism isn’t a source of distress. Individuals with autism are at a greater risk of mental health difficulties such as anxiety, depression, and isolation, due to factors like sensory processing differences, social communication difficulties, and misunderstanding from others.
There is no cure for autism, but emerging research suggests that psychedelics could help with symptom management. In other words, psychedelics could help tackle the co-occurring conditions (e.g. social anxiety and depression) that many autistic people live with.
“Recent clinical and preclinical evidence points towards empathogenic and prosocial effects elicited by psychedelic compounds”
The Emotional and Social Difficulties That Autistic People Face
Autism is a spectrum; it varies in its severity. This is why the diagnosis autism spectrum disorder (ASD) exists: it’s intended to cover the broad range of symptoms that autistic people might have. Autistic people differ in their social and communication behaviours, mental health conditions, and health care and service needs.
Some autistic people might have severe difficulties in social communication, extreme sensory sensitivity, and display restricted, repetitive behaviours, and so need ongoing, intensive care for daily tasks. However, the majority of autistic people don’t need this level of care; their lives look the same as neurotypical people, except there may be unique social and emotional challenges they face. Autism can impact mental health in the following ways:
Stigma: there is a common (stigmatising) belief that autistic people lack empathy or emotions. This can affect self-esteem.
Bullying: people with autism may face bullying due to the ways they differ from neurotypical people, which, again, can impact self-esteem.
Communication difficulties: autistic people might communicate differently from neurotypical people, which can lead to miscommunication and misunderstandings. Autistic people may prefer direct and literal language, a preference for fact-based conversations, and difficulty with non-verbal cues like eye contact and body language. They might find it more challenging to choose a tone, volume, or speed of speech, and struggle with ‘turn-taking’ or being interrupted in conversations. They might also find it difficult to recognise or read body language or facial expressions. Social nuances and norms – such as small talk, sarcasm, and implied meanings – can all be hard to navigate, and autistic people may sometimes ‘info dump’ about their special interests. These differences and difficulties can contribute to social anxiety and social isolation.
Sensory overload: differences in sensory processing can make certain environments overwhelming, stressful, and agitating. People with autism might have sensitivity to sights, sounds, smells, tastes, textures, and touch, which may lead to social difficulties, increased anxiety, and avoidance of certain environments.
Difficulty with change: many autistic people prefer routine and predictability, so change (such as a change of plan or interruption of routine) can be especially challenging and anxiety-inducing.
Emotional exhaustion: many people with autism engage in ‘masking’, which involves unconsciously or consciously suppressing or altering their natural traits to appear neurotypical and fit in with others. Feeling the need to do this can be emotionally and mentally draining.
Psychedelics and Autism
Emerging evidence suggests that classic psychedelics could help ameliorate the distress associated with autism. A 2022 scientific review, published in Frontiers in Pharmacology, notes:
“Recent clinical and preclinical evidence points towards empathogenic and prosocial effects elicited by psychedelic compounds, notably the serotonin 5-HT2A agonists lysergic acid diethylamide (LSD), psilocybin, N,N-Dimethyltryptamine (DMT), and their derivatives. These findings suggest a therapeutic potential of psychedelic compounds for some of the behavioural traits associated with autism spectrum disorder (ASD), a neurodevelopmental condition characterized by atypical social behaviour. In this review, we highlight evidence suggesting that psychedelics may potentially ameliorate some of the behavioural atypicalities of ASD, including reduced social behaviour and highly co-occurring anxiety and depression.”
Traditional treatments for ASD-associated co-occurring conditions – such as depression and anxiety – include antipsychotics, antidepressants, mood stabilisers, and stimulants. However, for many autistic people, these medications may not work, or, if they do provide some benefit, this can be alongside unwelcome side effects.
It is becoming increasingly apparent that psychedelics can enhance pro-sociality and empathogenic effects in both healthy individuals and those with conditions like treatment-resistant depression. Studies have found that they can lead to lasting increases in openness and extraversion, enhance sociability and the desire to be with others, and increase feelings of closeness and empathy. Autism is often accompanied by depression, generalised anxiety, and social anxiety. So, if psychedelics can help address these forms of emotional distress, then autistic people could live with their autistic traits – not free of any social challenges, of course – but be free from severe emotional suffering. It has also been suggested that psychedelics could help prevent youth suicide among autistic people.
A 2023 survey of autistic adults who have used psychedelics found that “The majority of participants attributed reductions in psychological distress (82%) and social anxiety (78%) and increases in social engagement (70%) to their most ‘impactful’ psychedelic experience.” The only substantial predictor of reduced psychological distress among participants was psychological flexibility, which is the capacity to engage with the present moment, be aware of one’s thoughts and emotions, adapt to life’s challenges and stresses, and adjust one’s behaviour to pursue one’s values and goals. Other research has found that psychedelics enhance psychological flexibility and that this mediates decreases in depression and anxiety.
“It is possible that psychedelics may alleviate a few core social-behavioural features in individuals with ASD”
Psychedelics may also help autistic people through their brain-related effects. The authors of the 2022 review draw attention to the dysregulated neurobiological systems that people with autism have, which underlie the symptoms they experience. They add that psychedelics could help improve social behaviour and decrease the burden of co-occurring conditions by targeting synaptic function, serotonin signalling, prefrontal cortex activity, and thalamocortical signalling.
The 2024 survey wasn’t, however, entirely glowing. As the authors state, “A substantial minority (20%) also reported undesirable effects such as increases in anxiety with some describing their psychedelic experience as among the most negatively impactful experiences of their lives.” Early clinical trials (with methodological and ethical shortcomings) from the 1960s and 1970s, which involved administering psychedelics and therapy to children with ASD, resulted in various clinical improvements, but a range of side effects were observed, too. The authors of the 2022 review conclude:
“Early clinical trials in childhood ASD suggest that psychedelics might hold therapeutic potential; however, the side effects encountered represent potential limitations to this treatment. It is possible that psychedelics may alleviate a few core social-behavioural features in individuals with ASD, such as social anxiety, but carefully performing a risk-to-benefit assessment is crucial due to the severity of their potential side effects.
Individuals with ASD represent a highly heterogeneous demographic; therefore, only certain subsets of individuals with ASD may respond well to psychedelic treatment options. Clinical trials must proceed with caution because this population is also comprised of children and some individuals with intellectual disabilities, for which obtaining informed consent is a challenge.”
Conclusion
Around 1 in 36 people in the US qualify for an autism diagnosis. And those who are autistic are at greater risk of mental health conditions such as depression, anxiety, substance use disorders, and obsessive-compulsive disorder. Despite this, the research on the therapeutic application of psychedelics has focused on neurotypical people. Research on the potential benefits of psychedelics for autistic people is lacking – this includes both clinical trials and other kinds of studies, such as survey-based research.
However, autistic people are increasingly raising awareness about how psychedelics have helped them. One such person is Aaron Orsini, the author of Autism on Acid and Autistic Psychedelic, and the creator of the website Autistic Psychedelic. He has written and spoken about how LSD offered him profound relief from his emotional distress. Orsini is bringing attention to the possibility of not just reducing distress and impairment but also encouraging feelings of well-being, connection, and appreciation for one’s autistic traits. This is certainly something that deserves more attention in psychedelic research.
