You’ve noticed your teen seeming down lately. Are they depressed, or is this normal? It’s hard to tell what teenagers are thinking, even more so if they have autism. When they’re depressed, it can be just as hard to tell. Autistic people can get depressed and, in fact, are more likely to. Your concerns are valid and are worth following up on.
Is there a connection between autism and depression?
Yes. One study showed that teens and young adults are nearly three times as likely to develop depression as their neurotypical peers. And about 40% of autistic adults deal with depression at least once in their lives—and are more likely to have suicidal thoughts and/or attempt suicide than non-autistic people.
There is no clear reason as to why autistic people are more likely to develop depression; it’s just clear that that’s the case. Autistic people are more likely to have social challenges and do recognize these challenges, which can lower their self-esteem and increase loneliness. Isolation can lead to depression, but that might just be part of the issue. Some other things, though, make it more.
Symptoms overlap
Some symptoms of depression overlap with concerns that are probably already being monitored by an autistic person’s doctor.
- Flattened affect: Or not readily showing emotions. Autistic people may be less likely to express their emotions in verbal or non-verbal ways, and with depression often are, too. It’s often easier to recognize in neurotypical people who are more likely to express emotion, even nonverbally.
- Self-injury: Autistic people can also have co-occurring self-injurious behavior. They may lack the words they need to get attention, but know they get attention if they’re hurt. But depression also comes with the risk of self-injury.
- Masking: Neurodivergent people, including those with autism, often “mask” their behaviors in order to try and fit in. They may also hide signs or feelings of depression for the same reason. On the other hand, people with depression can feel lots of shame and guilt and want to hide how they feel.
- Aggression: Social norms and emotional regulation are two major issues that autistic people, especially children and teens, have a hard time with. They may act aggressively because they are overwhelmed or don’t read the room correctly. Teens with depression may act similarly to try and not appear weak—or simply because they don’t know what they’re feeling.
Unmet support
Since depression and autism are so hard to tell apart, autistic teens might not be having all of their needs met. When they have appointments with therapists or other professionals, they might not openly talk about their struggles. Parents and doctors might not recognize when the symptoms cross the line from autistic behaviors to depressive signs.
Even support for other things can be lacking, and autistic teens might not know how to ask for what they need. They can get overwhelmed with so much in the neurotypical world, and asking for help often can affect their mental health.
Recognizing depression in autistic teens
So, how can you tell if your autistic teen is struggling with depression? It won’t be easy, but one of the best ways is to look for changes:
- Sleeping more or less than normal
- Eating more or less than normal
- Less energy than normal
- Little to no pleasure in things they like
- Less interest in being social
- Signs of self-harm
- Increased stimming
- More withdrawal from people to hyperfix
If you’re worried about your autistic teen having depression, don’t wait. Talk to them and look for support right away.
What about autistic burnout? Can it cause depression?
Autistic people can get burned out, just like neurotypical people. Constantly masking to try and fit in is exhausting. They might face expectations at home, school, or work that don’t match what they can achieve without support. And, just having to ask for help (as long as people don’t write them off) in a world that’s more geared toward supporting neurotypical people can be draining. Autistic people also often experience more stress during major life events, like moving, starting a new job, or having a depressive episode.
Autistic burnout can cause depression, and the two can overlap. Like autism and depression, it can be hard to tell the two apart. Low motivation, less interest in things, and a low mood can be part of both. It can be easy to feel like giving up when struggling with burnout and depression, but better recognition of when help is needed—and setting better, more appropriate expectations—can help.
How depression in autistic teens is treated
Depression for people with autism is treated largely in the same way it is for neurotypical people. Teens with autism can also respond well to depression treatment, including:
- Cognitive-behavioral therapy (CBT) to identify negative thoughts and how to change them.
- Individual counseling to learn to recognize emotions and how to ask for support.
- Mindfulness to promote emotional regulation and relaxation.
Medication may also be effective. Antidepressants, though, should be used with caution, especially in teens. If your teen is prescribed an antidepressant, work closely with their psychiatric provider to monitor their side effects. Antidepressants can cause an increase in suicidal thoughts, especially if doses are changed or stopped without supervision.
Contact Family First for supportive, affirming care
The Nest at Family First is a neurodiversity-affirming residential program for boys in Palm Beach Gardens, FL. Our staff of highly trained ASD Clinical Specialists engage in over 200 hours of clinical supervision and training every year. While we help your son with emotional regulation and support in other areas of his life, we’ll also work with you to recognize the next time he’s depressed and what you can do to help.
You don’t have to do it alone. Call 888.904.5947 or contact us online now.