How can we recognize depression in autistic individuals and find the support they need?

While depression is a mental health condition that can affect anyone, autistic individuals are 4 times more likely than the general population to experience depression. Research suggests that up to half of all autistic people will be depressed at some point in their lives. Depression should not be ignored and is treatable with the right support. If you or someone you know is experiencing depression, it is important to seek help.

Most people will go through periods of feeling down at different times in their lives, but depression is feelings consistently sad and low for weeks or months rather than for just a few days.

Depression affects people differently and can range from mild to severe. Mild depression can make a person feel persistently low in mood; severe depression can make a person feel that life is no longer worth living. The Autistica website says that autistic people without an intellectual disability are 9 times more likely to consider suicide that the general population.

Depression in autistic people is more more common during adolescence and young adulthood and can often co-occur with anxiety. It can difficult for autistic people to know if they are not feeling completely right because of struggles with alexithymia. Alexithymia is a term that is used to describe when someone has difficulty identifying their feelings, or more specifically identifying and describing their emotions. Researchers have found that one in 10 people can experience this alexithymia and these rates are even higher in people that are neurodivergent, have experienced trauma and/or have a mental health diagnosis.

In 2017 in the UK, the Know Your Normal campaign was launched and a toolkit designed to help young people outline what their ‘normal’ is so they can explain to those who support them when they aren’t feeling themselves. You can read the Ambitious About Autism’s research report about young people’s experience of mental health issues. You’ll learn things such as 90% of autistic youth experience a lack of comfort disclosing mental health issues to educational professionals. Two thirds said said that if they did ask for help they had little or no confidence they would get what they need.

What are the signs of depression?

The National Autistic Society lists the following symptoms on their website:

Changes in mood

Continuous low mood or sadness
Feeling hopeless
Having suicidal thoughts or thoughts of self-harm

Physical changes

Changes in appetite or weight
Disturbed sleep
Lack of energy

Changes in how you connect with others

Avoiding contact with people
Difficulties at home, work or with family
Neglecting hobbies or interests.

Other symptoms experienced more often by autistic people can include:

social withdrawal
an increase in repetitive behaviors
a change in interests
more frequent meltdowns
an increased risk of self-harming or suicidal thoughts

What are some of the causes of depression?

Depression can be experienced by autistic people due to:

masking
burnout
alexithymia
experiencing stress or trauma (such as bullying)
isolation/loneliness
a family history of depression
drugs, alcohol or medication
other mental or physical conditions
a lack of resources to provide adequate support
rumination

Where do you find support?

If it doesn’t help to talk with a trusted person in one’s life and more support is needed, start by speaking with a family doctor (GP). A GP may be able to suggest some self-help strategies such as regular exercise or getting outdoors. They may also be able to make a referral to a counsellor, therapist or prescribe medication.

There are different types of therapies to help with depression such as:

Cognitive Behavioral Therapy (CBT)
Augmented Depression Therapy (ADepT)
mindfulness training
emotional awareness training (developing interoceptive awareness)
psychodynamic therapy (analytical talking therapy)

Any treatment or therapy should be delivered by someone who has an understanding of autism and experience in treating autistic individuals.

What are some mental health coping strategies?

Different strategies will help different people when they are experiencing depression. These strategies, listed in the CAMH booklet Depression and Autism, were created by youth to support youth.

Make sure you are eating and drinking enough. Keep “safe” food close at hand.
Take time to recharge your social batteries. Know what activities drain or give energy.
Spend time in a safe and comfortable environment. (A space that is quiet and predictable.)
Find creative ways to communicate other than having to use words such as through drawing, music, dance, photography, or writing.
Have a simple goal to accomplish or routine to follow every day.
Have a safe person that you can trust and confide in.

For more information on the topic of depression and autism, I highly recommend reading the booklet Depression and Autism created by the CAMH – Cundhill Centre for Child and Youth Depression. It is an outstanding resource aimed at young people aged 14 – 25.