Autism and Depression Connection, Diagnosis & Treatment

By We Level Up FL Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: January 16, 2023

Autism and Depression Statistics

Individuals with autism are four times as likely to experience depression. Rates of depression increase with intelligence and with age. This results in over 70% of adults with autism having mental health conditions, including anxiety and depression. Sadly, these conditions often persist or worsen into adulthood.

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Emotions and Mood

• Increased moodiness may include increased anger, irritability, sadness, and tearfulness.
• Feelings of worthlessness or fixation on mistakes
• Need for excessive reassurance
• Loss of interest or pleasure in previously favorite activities

Behaviors and Skills

• Aggression
• Indecisiveness
• Noticeable decrease in self-care
• Regression of previously learned skill
• Changes in autistic symptoms, which may include increased stereotypic behavior or decreased interest in restricted interests

Health and Wellness

• Hyperactivity
• Agitation or restlessness (e.g., handwringing, pacing, inability to sit still)
• Fatigue or loss of energy
• Sleeping too much or too little
• Changes in appetite leading to weight loss or gain
• Complaints of unexplained body aches and headaches increased visits to the school nurse

Autism vs Depression Disorders

Recognizing depression in individuals with autism can be challenging as some of the characteristics of autism can resemble some signs of depression. For example, some individuals with autism may not interact much with peers or identify many friends, which may also be signs of depression in adolescents. Another challenge is that some of the characteristics of autism may mask signs of depression. Some young adults with autism may not show much emotion, so depression may not be as observable as a look of sadness on their faces. Additionally, the communication difficulties of individuals with autism may impact one’s ability to recognize depression in this population. Even students with autism who communicate in complete sentences may have difficulty communicating their feelings.

Depression in Autism Diagnosis

The symptoms of depression may be harder to recognize in people with autism. Sometimes that’s because “high-profile problems,” such as aggression and self-injury, draw doctors’ attention away from depression and anxiety, according to some researchers. [2] Many advocates and doctors say it is vital to look beyond a person’s autism and consider depression a possible diagnosis.

Unfortunately, there are no lab tests or scans for depression. Doctors typically rely on a patient’s ability to describe his feelings. That’s a heavy burden for people whose autism impairs their communication ability through words, facial expressions, and body language.

Other times, the signs of depression may be mistaken for autism itself. Although depression and autism are very different, some symptoms may be found in both conditions. These overlapping traits include a lack of interest in socializing, sleep problems, trouble concentrating, and having an emotionless facial expression and monotone voice. And sometimes, symptoms of depression may differ from textbook examples. Rather than looking tired and sad, a depressed person who has autism may be irritable or agitated or have emotional outbursts, according to research. [3]

Children may be unable to label their feelings as guilt or worthlessness, which are some of the words doctors look for when considering depression. Adults who speak fluently may struggle to identify their moods or emotions, a condition called alexithymia.

Autism Anxiety: Autism And Anxiety

If you’ve met one autistic person, you’ve met them all, according to a proverb. The reality is that no two individuals on the autism spectrum are alike. However, research points to a possible increased risk of anxiety in the autistic population as a whole.

It may be challenging to tell the difference between anxiety and autism spectrum disorder (ASD) to the untrained eye. According to experts, a deeper comprehension of the connection between anxiety and autism can help autistic persons lead healthier lives.

How Does Anxiety Shows Up in Autism Spectrum Disorder? Social Anxiety Vs Autism

According to research, autistic individuals experience anxiety more frequently. Anxiety was reported by roughly 20% of autistic individuals, compared to about 9% of the population controls, according to a 2019 research on sibling pairs.

According to Dr. Jephtha Tausig, a clinical psychologist in New York City, “many [autistic] persons are well aware they’re struggling in ways their peers may not be, and that they have some sensitivities and concerns that their peers may not.”

Anxiety And Autism (Autism And Anxiety Adults): Unique Characteristics

No two persons with anxiety are the same, just as no two people on the autism spectrum are the same. Understanding some of the typical and distinctive traits of autistic people can help with diagnosis and care.

Whether or not they are on the autism spectrum, people with anxiety may share several characteristics, according to board-certified pediatric neurologist Dr. Dilip Karnik, including:

• Separation anxiety autism (autism and separation anxiety): Separation anxiety, or distress when separated from a loved one or caregiver
• Difficulty transitioning to new environments
• Nervousness or fear over meeting new people

According to her, it could be more unpleasant if the distress is brought on by a shift in habit, which is something autistic people frequently go through.

In addition to the worry itself, she adds, “when they feel a surge in anxiety, it can seem unsettling and discombobulating.”

Anxiety Vs Autism: Behavioral symptoms

In autistic people, anxiety can manifest as behavioral symptoms, some of which may overlap with autism itself.

According to the Anxiety and Depression Association of America, typical behaviors in both anxious and autistic individuals include:

In autistic people, anxiety can manifest as behavioral symptoms, some of which may overlap with autism itself.

• A severe, specific, and irrational phobia
• Obsessive-compulsive disorder (OCD)
• intense fear of being judged in social situations, or social anxiety
• Separation anxiety
• Severe distress about changes to a routine or environment

Autism Vs Social Anxiety (Social Anxiety And Autism) – Autism Social Anxiety (Social Anxiety Autism)

Autism and social anxiety (social anxiety or autism): Social anxiety and autism are two distinct conditions. While social anxiety disorder is a mental health illness that can appear in infancy or maturity, autism is a neurodevelopmental condition that first manifests in early childhood. One or both may exist in a person.

Autism Vs Anxiety: High-Functioning Autism And Anxiety Causes

High functioning autism and anxiety: Autism is neurodevelopmental, whereas anxiety is mental-emotional. However, a 2020 study suggests that the amygdala, a region of the brain involved in the expression of fear, may contribute to the co-occurrence of anxiety and ASD. According to Dr. Karnik, development might also be important.

The amygdala “continues to expand into maturity in [neurotypical] youngsters,” claims Karnik. But among kids [on the spectrum], it grows more quickly in the beginning, up until about age 12, and then it slows down. It may even shrink on occasion. The behaviors of youngsters [on the spectrum] are significantly influenced by these areas, particularly anxiety.

Anxiety may be influenced by social and emotional variables as well. People with autism might require assistance to learn how to interpret body language and other social cues. They may occasionally experience anxiety and overwhelmed in certain situations.

Anxiety Or Autism? Symptoms of Anxiety Autism

Knowing the signs may give you the confidence to ask for an assessment for yourself or a loved one. Here are some typical signs to be on the lookout for, though they will vary.

People with autism frequently experience anxiety, and a qualified healthcare expert can differentiate between the two conditions.

Autism or social anxiety? Social anxiety, generalized anxiety, and any specific phobias should be covered in a child with ASD’s evaluation and medical history, according to Karnik. “Symptoms of anxiety and ASD [often] overlap, therefore in these circumstances rigorous screening is needed.”

Stranger Anxiety Autism

Children are frequently taught that strangers are “hazardous,” despite the fact that children with ASD frequently struggle with imitation. Additionally, if caregivers educate autistic children that approaching strangers is dangerous, they will exhibit stranger anxiety and struggle to comprehend other concepts as they get older.

Autism Or Anxiety? Autism Anxiety Medication

Medication won’t cure anxiety, but it may help manage symptoms, according to Dr. Karnik.

“SSRI medications have been seen to be effective in anxiety,” he says.

Examples include:

• Sertraline (Zoloft)
• Fluoxetine (Prozac)
• Escitalopram (Lexapro)

Other medications that may be prescribed to treat anxiety include:

• Buspirone (Buspar)
• Propranolol
• Clonazepam

Autism Parents Depression: Signs Of Depression In Parents Of Autistic Children

Several factors have been shown to work in concert to increase stress in parents of children with ASD. First and foremost, realizing there is no cure for the disorder may increase parenting stress. Aspects of the child’s behavior, specifically socially inappropriate and aggressive behaviors typically associated with ASD, are associated with increased parenting stress and being confronted by antipathy for their child’s behaviors due to a lack of understanding of ASD. Raising a child with ASD typically involves allocating extra time to meet the child’s needs. These findings suggest that multiple changes occur in the parental role to accommodate the challenges of raising a child with ASD. [4]

Sometimes you will hear a desperate parent say, “Forget about me. It doesn’t matter how I feel. Just take care of my child.” This sentiment is understandable, but it ignores that the family is a system and that each person has an impact on the others. Decreasing the stress and depression faced by parents of children with ASDs, and doing everything possible to improve their mental health and ability to cope, is a worthwhile goal. Helping parents help children, too. 

Depression Autism Mental Health Treatment

It is very common to have times when we feel sad or low. However, when these feelings last for more than a few weeks and affect your daily life, it may be a sign of depression. Research suggests autistic people may be more likely to experience depression than non-autistic people and estimates that it affects up to half of all autistic people at some point in their life. Depression is treatable, and with the proper support, you can feel better. If someone is experiencing depression, it is essential to seek help. 

The treatments used to treat autism and depression are similar to those used in the general population. Some slight modifications may be needed to account for differences in thinking, communication, or behavior.

• Psychotherapy – Specifically, modified cognitive behavioral therapy has been shown effective to treat depression in people who also have autism spectrum disorder. Cognitive behavioral therapy and other psychotherapies can help address rumination and other thought processes related to depression.
• Medication – Antidepressant medications are most useful when combined with some form of therapy. Research shows that medication alone may be less effective than other treatments. More research is needed into the possible effects and side effects of depression medication in individuals with autism. 
• Combination of Psychotherapy and Medication – Research has shown that a combination of medication and psychotherapy is among the more effective treatments for depression.

Connection Between Autism and Depression FAQs