Depression - a guide for professionals
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 provide support.
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 they are autistic or not. As well as persistent low mood, they 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 your 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 their 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
- presence of 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 your performance at school or work may make you more likely to develop depression.
The impact of depression
Depression can be an overwhelming experience and can result in people feeling like they want to withdraw from social activities and work. This can in turn make them feel more lonely and isolated. When an autistic person feels depressed, you may notice they have more meltdowns and that repetitive behaviours (such as stimming) increase.
If a person you support is feeling depressed, it is important to access support as early as possible.
How to get help with depression
If you feel that the person you care for might have depression and recognise some of the signs described here, you should encourage them to visit their GP. Their GP will be able to offer some advice and may refer them for further help and support. You might find our information on seeking support with mental health useful.
Treatments for depression
This will depend on whether the person has mild, moderate or severe depression.
If they have mild depression, their 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 their depression doesn’t improve or is more severe, the doctor may suggest talking to a therapist. Talking therapies, such as cognitive behavioural therapy (CBT), are often used to treat depression. Their doctor may also prescribe antidepressants.
Therapy
If the person you support 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 the person you support is worried about side effects, they should talk to their 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 extra time to get things done
- doing things you find calming and relaxing; listening to music, watching tv, gardening, walking, socialising with friends.
Useful links
Personal accounts
The following accounts may share information and experiences that you may find distressing.
