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Autism and Depression Connection, Diagnosis & Treatment

Read more about the connection between Austim and Depression and how these two mental health illnesses affect each other. Discover the treatment options available to you or your loved ones struggling with autism and depression.


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 in Adults

Individuals with autism spectrum disorder (ASD) have increased rates of depression compared to the general population. Repetitive cognition is a core feature of ASD. In developing young adults, repetitive cognition has been associated with attentional biases to harmful emotional material and increased prospective depression risk. [1]

Depression can co-occur with autism. It presents some unique challenges for individuals, clinicians, and care providers. Signs and symptoms of depression may be more challenging to observe in individuals who also have symptoms of autism. Although depression treatment options are similar in people with or without autism, there is little research on how the combination of autism and depression may affect treatment outcomes. 

Can Autism Cause Depression?

There are reasons why depression is common for autistic people. Daily life can be more challenging for autistic people. Differences in understanding social situations and relationships. Moreover, being misunderstood or not accepted by non-autistic people can increase anxiety and stress. This can lead to low self-esteem, social isolation, and loneliness. These can all contribute to depression.  

Other reasons include the following:

  • Alexithymia (difficulty identifying, understanding, and managing feelings)
  • A lack of adequate support

General causes of depression that can affect anyone include the following:

  • Experiencing stressful events or trauma
  • A family history of depression
  • Other mental or physical health conditions
  • Drugs, alcohol, or medication

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.

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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.


37%

Rates of major depressive disorder have been reported as
high as 37% in young adults with autism.

Source: NCBI

1 in 5 Americans

1 in 5 Americans will experience a mental illness in a given year. 

Source: CDC

1 in 68

CDC estimates that 1 in 68 developing young population has autism spectrum disorder.

Source: CDC


Depression and Autism Facts Sheet

Depression is a serious medical condition associated with symptoms such as melancholy, loss of pleasure, loss of energy, difficulty concentrating, and suicidal thoughts.

Depression symptoms can include the following:

  • Trouble concentrating, remembering details, and making decisions
  • Feelings of guilt, worthlessness, and helplessness
  • Pessimism and hopelessness
  • Insomnia, early-morning wakefulness, or sleeping too much
  • Crankiness or irritability
  • Restlessness
  • Loss of interest in things once pleasurable, including sex
  • Overeating or appetite loss
  • Aches, pains, headaches, or cramps that won’t go away
  • Digestive problems that don’t get better, even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Suicidal thoughts or suicide attempt
  • Lose pleasure in life

Depression Causes

Doctors haven’t pinpointed the exact causes of depression. They think it may be a combination of things, including:

  • Brain Structure – People with depression seem to have physical differences in their brains from people who don’t have depression.
  • Brain Chemistry – Chemicals in your brain, called neurotransmitters, are a huge part of your mood. When you have depression, it could be because these chemicals aren’t working the way they should.
  • Hormones – Your hormone levels change because of pregnancy, postpartum issues, thyroid problems, menopause, or other reasons. That can set off depression symptoms.
  • Genetics – Researchers haven’t yet found the genes responsible for depression, but you’re more likely to have depression if someone you’re related to has it.

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. 

The following may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, ask your pediatrician or family doctor for an evaluation right away:

By 6 months

  • Few or no big smiles or other warm, joyful, and engaging expressions
  • Limited or no eye contact

By 9 months

  • Little or no back-and-forth sharing of sounds, smiles, or other facial expressions

By 12 months

  • Little or no babbling
  • Little or no back-and-forth gestures, such as pointing, showing, reaching, or waving
  • Little or no response to their name

By 16 months

  • Very few or no words

By 24 months

  • Very few or no meaningful, two-word phrases (not including imitating or repeating)

At any age

  • Loss of previously acquired speech, babbling, or social skills
  • Avoidance of eye contact
  • Persistent preference for solitude
  • Difficulty understanding other people’s feelings
  • Delayed language development
  • Persistent repetition of words or phrases (echolalia)
  • Resistance to minor changes in routine or surroundings
  • Restricted interests
  • Repetitive behaviors (flapping, rocking, spinning, etc.)
  • Unusual and intense reactions to sounds, smells, tastes, textures, lights, and colors
Ryan Zofay forming a circle and hugging friends.

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The symptoms of depression may be harder to recognize in people on the spectrum. Consider keeping a journal to track moods and behaviors. Written records tend to be more reliable than memory or casual observation – record changes in sleep patterns, appetite, weight, interest, and overall mood. 
The symptoms of depression may be harder to recognize in people on the spectrum. Consider keeping a journal to track moods and behaviors. Written records tend to be more reliable than memory or casual observation – record changes in sleep patterns, appetite, weight, interest, and overall mood. 

Autism Depression Symptoms

If you are concerned about the possible depression of your loved one with ASD, talk to a mental health professional. Parents can talk to a healthcare professional (who should be knowledgeable of ASD) and determine if a referral to a mental health professional is needed. For school staff, schools or school districts typically have counselors and psychologists who are trained in recognizing depression and may be able to support the student.

If you are meeting with a health professional, make a list of the following:

  • Any significant stresses or recent life changes
  • Anything different observed lately, even if it does not seem related to depression
  • Information from discussions with other people in the person’s life, such as school personnel
  • All medications, vitamins, herbal remedies, and supplements the person is taking
  • Any additional questions

See the list below for some of the signs of depression that have been observed in individuals with ASD.

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

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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.

Although some individuals with autism may struggle to communicate emotions and feelings, it is essential to check in with them and see how
they are feeling. You can incorporate some visual representation of emotions, like an emotion meter or a 5-point scale for a regular check-in.

Since individuals with autism often have characteristics that can mimic or mask depression, it is crucial to look for changes in behavior. For parents, it might mean paying attention to eating and sleep habits and looking for changes in mood and behavior around the home and community. For teachers, it might be looking for changes in mood or behaviors during class or paying particular attention during other times such as transitions, lunch, or clubs.

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.
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.

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

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

Some individuals with autism and depression may struggle to recognize or express their feelings.
Some individuals with autism and depression may struggle to recognize or express their feelings.

About 50% of all mothers of children with autism spectrum disorder (ASD) had elevated levels of depressive symptoms over 18 months. Parents of children with autism spectrum disorders (ASDs) have been shown to experience increases in stress, depression, and anxiety, which are also associated with child behavior problems related to ASDs.

Autism spectrum disorders (ASDs) are lifelong neurodevelopmental disabilities that begin in infancy and impair communication and social behaviors. Recent estimates of the prevalence of autism suggest that the disorder is increasing, with as many as 1 in 110 children diagnosed with ASD in the United States. With the incidence of ASD rising, it becomes crucial to understand how these disorders affect the parent-child relationship, including reciprocal associations between parent emotions and child behavior.

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. 

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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.

A range of autism and depression treatments includes psychotherapy, medications, and exercise. Treatments/interventions for depression should be comprehensive and implemented under the guidance of a qualified professional (psychiatrist, psychologist, or mental health practitioner). If staff or parents think the patient is in immediate danger of self-harm or attempting suicide, they should immediately call 911 or the local emergency number. Or, if parents think they can do it safely, they can drive their child to the nearest hospital emergency department. They have trained crisis management staff prepared to help in this situation.

Having a relative or loved one with depression and autism can be stressful, and family members or caregivers may unintentionally act in ways that can worsen their loved one’s symptoms. Call us now for a free mental health assessment! In addition, for the substance abuse or dual diagnosis approach, our inpatient treatmentinpatient medical detox, and residential primary addiction treatment may be available at our affiliated facility. For more treatment resources for autism and depression, call us about your symptoms, and we can help you determine the cause and develop a treatment plan.

What treatments are being used for autism and depression? Contact us today for options and assessment to find options that could work best for you!
What treatments are being used for autism and depression? Contact us today for options and assessment to find options that work best for you!

Connection Between Autism and Depression FAQs

  1. Does autism cause depression?

    Yes, depression may show up in individuals with autism in an unusual way — most commonly as insomnia and restlessness. 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. 

  2. Is depression on the autism spectrum?

    Yes. People who have autism spectrum disorder (ASD) have a lifetime rate of depression that is nearly 4 times greater than that of the general population. Depression in ASD is shown to greatly impact quality of life.

  3. What’s the connection between autism and depression?

    Compared to typically developing individuals, individuals with ASD are 4-times more likely to experience depression in their lifetime. These results suggest that individuals with ASD should be regularly screened and offered treatment for depression.

  4. Do I Have Autism Or Social Anxiety?

    People who struggle with social anxiety are more likely to speak softly and keep their distance when speaking. Without disguising, autistic individuals may be less conscious of normative neurotypical social expectations and may approach others too closely. Be aware that autistic people frequently stand too near to others or.

Search Autism and Depression Topics & Resources
Sources

[1] Unruh KE, Bodfish JW, Gotham KO. Adults with Autism and Adults with Depression Show Similar Attentional Biases to Social-Affective Images. J Autism Dev Disord. 2020 Jul;50(7):2336-2347. DOI: 10.1007/s10803-018-3627-5. PMID: 29882107; PMCID: PMC6286233.

[2] Charlot L, Deutsch CK, Albert A, Hunt A, Connor DF, McIlvane WJ Jr. Mood and Anxiety Symptoms in Psychiatric Inpatients with Autism Spectrum Disorder and Depression. J Ment Health Res Intellect Disabil. 2008;1(4):238-253. DOI: 10.1080/19315860802313947. PMID: 24009649; PMCID: PMC3760522.

[3] Leyfer OT, Folstein SE, Bacalman S, Davis NO, Dinh E, Morgan J, Tager-Flusberg H, Lainhart JE. Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord. 2006 Oct;36(7):849-61. DOI: 10.1007/s10803-006-0123-0. PMID: 16845581.

[4] Rezendes DL, Scarpa A. Associations between Parental Anxiety/Depression and Child Behavior Problems Related to Autism Spectrum Disorders: The Roles of Parenting Stress and Parenting Self-Efficacy. Autism Res Treat. 2011;2011:395190. DOI: 10.1155/2011/395190. Epub 2011 Dec 13. PMID: 22937246; PMCID: PMC3420762.