This session will share findings from a mixed-methods dissertation exploring the mental health implications of twice-exceptional (2e) students identified as gifted and diagnosed with Autism Spectrum Disorder. Drawing from both teacher survey data and parent interviews, the study highlights the prevalence of anxiety, depression, and social struggles among 2e learners, as well as the impact of rigid school structures and inadequate accommodations. Themes such as masking, identity formation, and the critical role of interest-based learning and flexibility will be discussed. Educators will leave with research-based insights into how mental health challenges intersect with giftedness and disability, along with practical implications for supporting 2e students in the classroom.