Depression is a clinically diagnosed psychological condition and often co-occurs with autism spectrum disorder. In fact, according to the CDC, people with autism are more likely to be diagnosed with depression than those without it, but diagnosing depression in autistic individuals is challenging due to the overlap of the symptoms of both of these conditions. However, treatment may be similar.
What is Depression?
Depression is more than a fleeting period of sadness. It is a psychological condition that persists for more than two weeks at a time and can be very debilitating for those going through it. The actual cause of depression is unknown but may stem from a combination of factors such as trauma, genetics, limited physical activity, major life changes, or substance use.
People diagnosed with depression have similar but unique experiences. Having autism with depression may compound the symptoms. . Some of the symptoms characteristic to depression are:
- Loss of interest in previously enjoyable activities
- Weight gain or weight loss
- Sadness
- Inconsistent or disturbed sleep patterns
- Excessive guilt or feeling of unworthiness
- Failing to be physically active or dwell in stimulating activities
- Having suicidal thoughts
- Restlessness
- Persistent fatigue
Causes of Depression for People with Autism
Depression is not the result of any singular trigger or cause. Rather it is a combination of various factors and their impact over time.
Autistic individuals face many developmental, cognitive, and social challenges because of their neurodevelopmental disorder. These challenges can lead to other conditions such as high stress, low self-esteem, or anxiety and the compound impact of all of these factors can over time cause depression. Let’s take a look at some of the challenges autistic people may encounter:
Alexithymia
This is known as the inability to describe or identify one’s own emotions and is strongly linked to depression in autistic individuals. Autistic individuals may struggle with understanding and regulating their feelings, often leading them to be frustrated and misunderstood.
Social Challenges
Autistic people may face discrimination or lack of acceptance by the non-autistic community as they struggle with communication, understanding social nuances, and navigating relationships.
They may constantly worry or stress over not knowing what to say or do or making a mistake in front of others. Such thoughts can cause low confidence, isolation, and loneliness.
Lack of Support
Autistic individuals may experience isolation as people around them struggle to accommodate their special needs or show patience in dealing with them as they undergo therapy for managing autism symptoms.
Learning Disabilities
Autistic individuals may learn new skills at a slower pace than their peers, or struggle to comprehend a seemingly simple task.
Sensory Overload
People on the autism spectrum can become easily overwhelmed by different sounds, textures, and lighting conditions, which may quickly lead to intensely disturbing or painful experiences for them. If they have not developed coping skills to manage sensory experiences, they can feel hopeless and depressed.
Attention to Detail
Autistic individuals often have unusually high attention to detail, causing them to overanalyze any minor change in their environment or someone’s behavior. This overthinking can prevent them from easily getting over minor inconveniences or letting go of things that upset them.
Genetic Factors
Autism and depression both can be hereditary conditions.
People with autism may experience some or all of these conditions, and without developing skills to navigate these challenges, their lives can become isolated, dependent on others and fuel hopelessness, loneliness, and depression.
Challenges in Diagnosing Depression in Autistic Individuals
Symptoms of autism and depression have some similarities, including sleep disturbances, social isolation, lack of interest in interacting with others, or showing limited or no facial expressions. This makes it challenging to diagnose depression in autistic individuals, even for professional therapists. It takes a lot of observation and trend analysis to make an accurate diagnosis.
Additionally, many autistic individuals struggle with communication, and speech, or may be non-verbal. This adds to the challenge of diagnosing them with depression as they cannot validate any diagnosis, or communicate their feelings or preferences or why they feel inclined or not inclined towards something.
Treatment Options for Depression in Autism
The treatment of depression includes medications, psychotherapy, or both, regardless of a co-occurring autism diagnosis.
Psychotherapy
Therapies such as Cognitive Behavioral Therapy (CBT), behavioral activation (a low-intensity CBT model), and mindfulness-based therapy are examples of psychotherapies used for depression in autism. These focus on rumination, changing perspectives, and thought patterns to work through a problem or a difficult phase.
Medication
A clinical prescription of antidepressants can help manage depression in autism, but these are considered effective when taken in combination with psychotherapies rather than independently. Medication for depression should only be taken when prescribed by a professional therapist.
Conclusion
Depression and autism are disorders that can co-occur in people. Depression is not the result of a singular cause but a combination of various internal and external factors and their impact over time. The symptoms of depression are similar to those of autism, which makes it difficult to diagnose; however, the treatment options for depression can be used whether or not autism is in the mix.
Disclaimer: This article does not contain behavior-analytic content.
