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
- 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:
- experiencing stress or trauma (such as bullying)
- a family history of depression
- drugs, alcohol or medication
- other mental or physical conditions
- a lack of resources to provide adequate support
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.
Further Reading and Resources:
The deep emotional ties between depression and autism
In autism, depression takes on unusual forms
How to Recognise When an Autistic Adult is Depressed?
6 Tips to get you Through an Autistic Depression
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With the rate of autism-diagnoses increasing, maybe school teachers should receive mandatory ASD training. There could also be an inclusion in standard high school curriculum of child-development science that would also teach students about the often-debilitating condition (without being overly complicated).
If nothing else, the curriculum would offer students an idea/clue as to whether they themselves are emotionally/mentally compatible with the immense responsibility and strains of regular, non-ASD-child parenthood.
It would explain to students how, among other aspects of the condition, people with ASD (including those with higher functioning autism) are often deemed willfully ‘difficult’ and socially incongruent, when in fact such behavior is really not a choice. And how “camouflaging” or “masking,” terms used to describe ASD people pretending to naturally fit into a socially ‘normal’ environment, causes their already high anxiety and depression levels to further increase.
Of course, this exacerbation is reflected in the disproportionately high rate of suicide among ASD people. … There could also be childrearing/parenting instruction in regards to children born with ASD.
[As for my own autism-spectrum disordered brain, I’m sometimes told, “But you’re so smart!” To this I immediately agitatedly reply: “But for every ‘gift’ I have, there are a corresponding three or four deficits.” It’s crippling, and on multiple levels!]
Low-functioning autism is already readily recognized and treated, but higher-functioning ASD cases are basically left to fend for themselves. … As a moral rule, a physically and mentally sound future should be EVERY child’s fundamental right, especially considering the very troubled world into which they never asked to enter.
The pharmaceutical industry greatly financially gains from the continual sedation and/or concealment, via tranquilizers and/or antidepressants, of autism-spectrum-disorder-related anxiety symptoms as well as those from adverse childhood experience trauma.
I wouldn’t be surprised if industry representatives had a significant-enough say in the Diagnostic and Statistical Manual’s original composition and continue to influence its revisions/updates.
From my understanding, only a small percentage of Canadian physicians currently are integrating ACE-trauma science into the diagnoses and (usually chemical) treatments of patients.
I don’t believe it is just coincidental that the only two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general practitioner health professions.
Such non-Big-Pharma-profiting health specialists as counsellors, therapists and naturopaths (etcetera) are not covered at all. … For me, the $150-$200+ per hour psychotherapy fee is for a transaction for which there’s only one party that is always a winner — the therapist’s bank account.