Autism and Co-occurring Conditions: Depression

Are people with autism at a higher risk for depression? It would seem likely, given the myriad of challenges they face on a daily basis, but diagnosing depression in a patient with autism can be challenging.

Dr. Christopher McDougle, director of Massachusetts General Hospital’s Lurie Center for Autism, explains,

“Many individuals with autism show little facial emotion. This does not necessarily mean they’re depressed! In other words, their affect doesn’t necessarily match how they feel. However, it does make it more difficult to recognize depression in someone with autism. In addition, many individuals with ASD have limited or no speech. So they may not be able to tell us how they feel.”

Many of the behaviors that are considered diagnostic criteria for depression are often displayed by individuals with autism, even if they are not clinically depressed. Lack of affect and social withdrawal may signal depression in neurotypical people, but for someone with autism, they can be normal behavior.

However, this does not mean that individuals with autism do not suffer from depression. Actually, there are many reasons why people with ASD may be more prone to depression than neurotypical individuals. Difficulty with communication and social interaction can cause people with ASD to feel alone and isolated. Even when there are people close by, it can be difficult for them to express their feelings, or to feel understood by others. Add in sensory issues, which can make it extremely challenging to function in the world, along with years of social rejection, and it’s easy to see how people with autism could become depressed.

A study from Penn State found that children with ASD were 28 times more likely to have suicidal thoughts than their peers without ASD. The study followed over 1,000 children, ages 1 to 16.

Scientists have even found a genetic link between depression and autism. A Harvard Medical School study found a genetic link between autism and several other psychological disorders, including depression, bipolar disorder, obsessive-compulsive disorder, and schizophrenia.

Online forums for people with autism are full of posts regarding depression. JacobV on Wrongplanet.net says,

“It seems to me that having a genuine friend or confidant reduces the chance of depression. I am assuming this is why practically EVERY NT works so hard to keep at least 1 or 2 friends in their lives. . . I haven’t had a genuine friend since high school over 10 years ago. I have stopped trying to befriend NTs because I feel like I can’t be myself around them. . . wish I had an aspie friend in real life, but aspies are few and far between.”

Zincubus, another member of Wrongplanet.net, says,

“I’ve battled mood swings and/or depression for decades. . . I can’t actually recall ever actually being happy for long.”

Treatment for depression includes SSRI medications, which are not always effective in patients with autism, and therapy. Other recommendations include regular exercise, spending time outdoors, and eating healthy foods.

If you are depressed, or are worried about a loved one, seek help from a qualified medical professional.

To read other articles in this series on autism and co-morbidity click here