About the Author: Dr. Yost Abrams received her PhD from the University of California, Berkeley and is a fellow with ZERO TO THREE. She is a parenting expert and early childhood researcher. Dr. Abrams specializes in parent-child attachment relationships, social-emotional development, and infant mental health.

Depression and Autism: Understanding the Signs in Neurodivergent Children

As we know, depression can affect anybody. However, one study confirms that autistic people are four times more likely to experience depression over the course of their lives. Depression is even more common for children and young adults with autism spectrum disorder (ASD).

In another recent piece, we shared the relationship between autism and anxiety. Those who struggle with anxiety also have an increased likelihood of developing depression—especially younger people with autism. Children and young adults may find it more difficult to be able to recognize and communicate the signs of depression in autism, so as a parent, it’s important to be able to notice and take action on autism and depression symptoms.

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What is Clinical Depression?

According to Mayo Clinic, clinical depression is diagnosed as “a mood disorder that causes a persistent feeling of sadness and loss of interest.” It affects how a person thinks, feels, and behaves, and as such, it may require long-term treatment.

This definition of depression may seem clear, but for children experiencing autism and depression, symptoms aren’t always visible. For example, some autistic children with symptoms that resemble Asperger’s may not always show the emotion that reflects their internal mood and, instead, display an entirely different feeling. They may display a blank or overly enthusiastic expression and express feeling fine when, in reality, they feel extremely sad. Other children with autism spectrum disorder (ASD) may have limited or even no speech capability, so they may not be able to verbally communicate their feelings.

Given the seriousness of what depression entails and the harmful behaviors it could potentially lead to, it is essential to be vigilant in caring for your child with autism. The National Library of Medicine shares that adolescents with ASD are “a population that is now believed to carry a significantly heightened predisposition, not only to depression, but to an array of other comorbid neuropsychiatric conditions.”

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What are the Signs of Depression in Neurodivergent Children?

Though depression impacts everyone differently, there are common symptoms of generalized clinical depression that can affect any individual. Several signs are more commonly noticeable in children with autism, including:

Agitation or irritability that goes beyond how your child typically expresses frustration
Beginning to hurt themselves or self-harming more frequently, such as pulling their hand or biting their hands
Changes in physical appearance, such as significant weight gain or loss
Developing an obsession with death or suicide
Excessive tiredness
Experiencing increased difficulty in doing everyday tasks in different environments
Increased indecisiveness
Increased aggressive behaviors
Lack of energy and motivation
Losing excitement over hobbies or interests they used to enjoy
Low self-esteem
More severe or frequent repetitive and compulsive behaviors
Persistent feelings of guilt, unhappiness, and even hopelessness
Withdrawing from more interactions than they normally would

If you begin to notice these signs of depression, or changes in behavior that last longer than a short period of time, consider reaching out to your child’s physician. Together, you can develop strategies to help your child best manage their unique symptoms.

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Can Autism Cause Depression?

The answer to this is not a direct “yes” or a “no”. In fact, the exact cause of depression in neurotypical adults and children is also unclear. There are a myriad of possibilities for the exact cause of depression, but from what we know about the relationship between autism and neurological mood disorders, autism can certainly be a contributing factor to depression in children.

Possible triggers of depression for autistic children are:

Differentiation – Coming to the realization that the child does not behave the same way as family or friends despite having shared experiences (for instance, academic and/or social stress).
Difficulty coping in unfamiliar situations – When a child with autism enters into certain scenarios for the first time, such as new classes at school or a traumatic event such as a loss of a family member, these new environments may make them feel confused, isolated, and overwhelmed.
Daily challenges – Oftentimes, the hardships and challenges children with autism face in contrast to their peers and loved ones can take a toll. For instance, your child may already experience sleeping issues or tantrums because of autism, but depression may increase the severity in these experiences.
Being misunderstood – Sometimes, children with autism may experience a lack of emotion, and the frustration of not being able to communicate feelings clearly can make a child feel sad or angry.
Lack of support – Unfortunately, not all parents, siblings, teachers, or adult figures in the child’s life know how to cope with the challenges that come with a child’s autism. The child may feel like they don’t have anyone to turn to when appropriate support isn’t provided.
Genetics – Depression does not discriminate. If there is a family history of depression, there is a chance that genetics will play a role in your child developing depression.

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Actions To Take When Parents Have Concerns About Depression and Autism

Thankfully, it is possible to treat depression, and one of the best things a parent can do for their child with autism—whether they experience mild, moderate, or severe symptoms—is to be there for them. Your encouragement and overall presence in your child’s life can go a long way in ensuring they feel seen, understood, and loved. Suicide attempts are prevalent in children with ASD, and early intervention can prevent your child from pursuing suicide ideation.

You can offer tangible support to your child by establishing routines, expressing gratitude, or helping them carve out time for previously-enjoyed activities or discover new hobbies they may enjoy more. Additionally, there are solutions such as ASD-adapted therapy, cognitive behavioral therapy (CBT), support groups for parents with autistic children, and peer-to-peer child support groups. In more severe cases, medications are an option, but a medical professional should always approve and monitor use of these substances.

We hope our insights can assist you in providing the support your child needs, especially as they navigate extremely tough feelings. While everybody can feel sadness periodically—and it is a common human emotion that needs to be experienced—depression requires immediate attention.

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Academic Resources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154372/

https://www.sciencedirect.com/science/article/abs/pii/S1750946712000931

https://pubmed.ncbi.nlm.nih.gov/29497980/

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Resources:

https://www.autistica.org.uk/what-is-autism/signs-and-symptoms/depression-and-autism

https://www.autism.org.uk/advice-and-guidance/topics/mental-health/depression

https://www.autism.org/autism-and-depression/

https://www.autismspeaks.org/expert-opinion/whats-connection-between-autism-and-depression

https://www.autismparentingmagazine.com/child-with-autism-is-depressed/

https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

https://raisingchildren.net.au/autism/health-wellbeing/mental-health/depression-teens-with-asd

https://www.spectrumnews.org/features/deep-dive/the-deep-emotional-ties-between-depression-and-autism/

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