Depression - a guide for parents and carers
Depression is a mental health condition that results in persistent feelings of sadness and/or hopelessness. Anyone can be diagnosed with depression. The symptoms are the same for anyone regardless of whether they are autistic or not. Research however suggests that autistic people may be more likely to experience depression than the general population.
This guide focuses on the ways that depression can affect autistic people and how to get support for your child or a member of your family.
What is depression?
Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days. Depression affects people in different ways and the symptoms can range from mild to severe.
With the right treatment and support, most people with depression can make a full recovery.
What are the symptoms of depression?
Some symptoms for depression are the same for anyone, whether you are autistic or not. As well as persistent low mood, your child may also:
- feel helpless
- have low self-esteem
- lose motivation or interest in things
- feel anxious or worried.
They may also experience physical symptoms such as:
- moving or speaking more slowly than usual
- changes in appetite or weight (usually decreased, but sometimes increased)
- lack of energy
- disturbed sleep – for example, finding it difficult to fall asleep at night or waking up very early in the morning.
There could be other symptoms such as not wanting to see friends as much, or neglecting hobbies or interests that they previously enjoyed.
There is some evidence to suggest some specific signs of depression in autistic people. These may include:
- an increase in repetitive and obsessional behaviours
- self-harm
- withdrawing socially or changes to their normal engagement with other people.
How common is depression in autistic people?
Depression is common among autistic people, but research varies as to exactly how many autistic people have depression. Age may be a factor, with some research suggesting higher depression rates for autistic teenagers and young adults.
Causes of depression in autistic people
Autistic people may be more likely to experience depression for a range of reasons. These include:
- having a family history of depression
- IQ – those without a learning disability are more likely to have depression
- being aware of your differences with peers
- experiencing stressful life events (bereavement, trauma, bullying)
- difficulties with social relationships and in social situations
- alexithymia - a person's inability to identify or describe their feelings
- having other mental health conditions such as anxiety
- rumination – repeatedly thinking about negative events or emotions.
There is evidence to suggest a link between depression and anxiety and personal accounts from autistic people experiencing depression talk about overwhelming anxiety. Feeling anxious in social situations and worrying about their performance at school or work may make your child or family member more likely to develop depression.
The impact of depression
Depression can be an overwhelming experience and can result in your child wanting to withdraw from social activities and school or work. This can in turn make them feel more lonely and isolated. When your child feels depressed, you may notice they have more meltdowns and that repetitive behaviours (such as stimming) increase.
If you think your child or family member could be depressed, it is important to access support as early as possible.
How to get help with depression
Your GP will be able to offer some advice and may refer your child for further help and support. You might find our information on seeking support with mental health page useful.
Challenges with seeking treatment
As a parent/carer, you may experience some challenges getting the right support for your child. Some symptoms of depression may be misinterpreted as autistic traits and therefore be overlooked and untreated, for example:
- difficulties with sleep
- self-injurious behaviour
- meltdowns.
Your child may find it difficult to communicate how they are feeling. Some autistic people experience alexithymia (difficulties identifying emotions) which might further hide any signs of depression. If they express an emotion differently from how they actually feel, it can make diagnosing clinical depression more difficult. It is essential to tell your medical professional what your child’s general emotional health is like and the way they express themselves, to help them identify when things are not as they should be.
Treatments for depression
This will depend on whether your child has mild, moderate or severe depression.
If they have mild depression, your doctor may suggest waiting to see whether it improves on its own, while monitoring their progress. They may also suggest changes they can make to their lifestyle such as exercise.
If the depression doesn’t improve or is more severe, your doctor may suggest talking to a therapist. Talking therapies, such as cognitive behavioural therapy (CBT), are often used to treat depression. Your doctor may also prescribe antidepressants.
Therapy
If your child is referred for therapy, check that the therapist has experience of adapting their approach to autistic people.
Antidepressants
There is little research into autistic people’s use of antidepressants. What does exist suggests autistic people may be more likely to experience side effects such as drowsiness, irritability and reduced activity. If you are worried about side effects, you should talk to your doctor.
Advice from other autistic people
Autistic people who have experienced depression suggest that the following might help:
- asking for support
- keeping routines
- structuring time and days
- time with friends/family to socialise
- exercise
- using sensory toys and distractions such fidget toys
- allowing yourself extra time to get things done
- doing things you find calming and relaxing; listening to music, watching tv, gardening, walking, socialising with friends.
You can try some of these measures to help the person you care for.
Useful links
The following accounts may share information and experiences that you may find distressing.
