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Autism. It can be both challenging and interesting. It can present many difficulties. Not each is one in the same. It can be confusing for both us and others. There are those who are sympathetic, those who do not care, those who will exploit or abuse us, those who will show us contempt, and even those who believe the condition is nonsense and does not exist. But there are also many who are helpful and friendly and help us progress.
For myself I’d say contempt is probably one of the most common traits I have come across, basically automatically being sidelined or ignored as if my Autism means I am beneath equal consideration or notice. I can say that many times, especially at school and college, people have spoken to me as if I were a young child, even putting on that kind of light simple voice you would use to speak to young children.
I found this to be extremely annoying and demeaning, although I was too shy to really voice this due to Selective Mutism. When I was at a special needs school I was not met with this kind of contempt, it is something I more got from mainstream institutions.
I think it is important to gauge the person you are speaking to before making assumptions on how to act around them – Autism is a wide spectrum so the actions and mannerisms you should use from one to another are not one in the same. Our intelligence varies like any other person; some have learning disabilities in addition to Autism and others do not; some need extra support in education and to live independently, others do not. So – like I said – not everyone with Autism is one in the same, it varies.
I would say that this is most certainly a problem in employment for many people with Autism as well (meeting contempt and also bullying as well), although I cannot give any examples myself as I have not entered proper employment yet – maybe one day. I’d say that bullying in the workplace is far more malicious than bullying in school because basically by that point you are an adult, you really should know better. Bullying in the workplace is also very different to that which you find in schools, it is harder to spot, often more manipulative and sinister, and pretty much never physical and almost always mental. Worse is that sometimes those in charge, such as supervisors or bosses, will not do anything about it or even perpetuate it or are themselves doing it. Many will also simply not understand.
I have recently started a voluntary job at a charity shop – my first ever voluntary job – and I am finding it quite difficult, more due to having to get used to the routine. I have not yet met any issues with contempt or worse and hopefully it remains that way, everyone seems nice there. But I do think that voluntary jobs are more relaxed and friendly atmospheres anyway because everyone is doing it basically because they want too. I am hoping I get used to it eventually.
Anyway. I just thought today I’d look at the connection between depression and Autism. It is something that can affect people with Autism a lot due to things like societal pressures, not feeling adequate, feeling like you’re not good enough at anything, feeling like you’re too far behind, feeling like you’re never going to get anywhere.
Sure, these kind of thoughts that can cause depression can affect anyone, but they are certainly a very pronounced issue for people with ASD. Sadly, this connection also means the suicide rate for people with ASD is also higher than average. And of course, if these people are facing contempt or bullying in work or elsewhere then this can also be a major source of depression. Plus forming social friendships and relationships for some of us can be difficult due to our brains thinking differently and therefore doing things differently socially, which may be perceived by others as strange, rude and off-putting, when it is not meant to be.
Those who also have issues with handling and containing emotions or who have trouble understanding their emotions may also become depressed due to this or due to finding it hard to communicate how you feel. It should also be considered that some people with Autism may also have been diagnosed with other conditions which may also contribute to depression.
A study in Sweden found that 20% of people with Autism also had a diagnosis of depression compared to just 6% of the general population, and a similar study conducted in the US found that 26% of people with Autism also has a diagnosis of depression compared to 10% of the general population.
Another study that analyzed data from thousands of other studies from around the world found that people with Autism were around 4-times as likely to experience depression at some point in their lifetime. Sadly, suicide is the leading cause of premature death in people with high-functioning Autism, and this grouping has a life expectancy of only 58-years which I find quite appalling and shocking, and it is surprising it is not really talked about.
Another interesting study found that siblings of people with Autism who did not have Autism themselves still had a 40% increased chance of depression relative to the general population, which could suggest a potential genetic role.
I would say that revealing your Autism diagnosis to work colleagues and bosses/supervisors can sometimes work on the social-differences as it may have these people then view you in a new light and be more accepting and understanding of what they would consider to be strange or odd social quirks that we may have. Telling employers and those in-change in general about your Autism diagnosis can often be beneficial as they may be able to make changes to help you fit in more easily.
For myself I would say that although I have had down periods, I have never had full-on depression or at least I do not believe I have. But I do often experience the thoughts listed earlier that could potentially lead to depression – so I try to keep them as contained as possible. But it is not easy.
I think the saddest I have ever been is when my health anxiety flares up and I believe there is genuinely something wrong with my health and that I might die – I think that if I did not seek out therapy for this, which I did, then it could very well have spiraled into full-on depression. I did cognitive behavioral therapy for this, although I know for many with Autism CBT does not help them, so it is important to find out what works for you. It is of note though that according to this article, many CBT programs have been adapted for people with Autism. But also note this is a US-based article so we cannot be sure for other countries.
The article also highlights that Selective Serotonin Reuptake Inhibitors used to treat depression in the general population have not shown to be effective for people with ASD. This is quite unfortunate and displays that people with ASD may not have as many options for treatment when it comes to depression.
I would say that also brings up another issue where there is a lack of research into treatment and medications for depression in people with Autism, not too much is known really on how effective typical therapies, medications and treatments are for people with Autism. We can only hope that more research is conducted over time that eventually leads to the development of more adaptive therapies and treatments and better understanding of the effects of existing depression medication and if something else could be developed that may work better if needed/possible for those with Autism.
I would think there needs to be some degree of adaptation, some of which has already happened, but it is a slow process. Health professionals also need more training on helping, treating and diagnosing of things like depression with those who have Autism, and to also help build confidence and understanding of health professionals in dealing with patients who have Autism.
Another thing that really helped me on health anxiety is thinking realistically on my worries – like for example telling myself that I am young, the chances of me actually having this thing I am scared of is incredibly unlikely, and that I was still alive and not having difficulties and that if anything was wrong there would be more obvious signs or that I would have been dead by that point – maybe that last part is a little be blunt but it worked for me, again you have to find what works best for you. Deep breathing exercises, meditation, and thinking in the moment (thinking about the things I am doing right now, the feel of something, the smells and so on) are other things that helped.
People with Autism are more likely to face things like trauma, long-term stress, low self-esteem, bullying, feeling lonely, lack social support, and feel like they do not belong, due to things like issues with communication and with forming bonds or relationships with others. All of these things are big triggers for depression for anyone, so when you are more predisposed to these things it makes it more likely. Issues with executive functioning and emotional regulation can also make school and employment more difficult and cause depression as it can cause feelings of worthlessness. Anxiety is also something else that is common for people with Autism to suffer with and this as well can increase the chances of depression, I already mentioned my health anxiety which is something that can make me very sad, and I also have Selective Mutism which is a severe form of social anxiety.
There could also be a biological role according to this article. Things like maternal inflammation and infection (as infections can cause inflammation) have been connected with an increased chance of the baby to go on and develop Autism, the same has also been connected with an increased chance of depression later in life – so you have these two things connecting with each other unfortunately. Research conducted on animals have also supported the information on this as well. Things like infections and inflammation during pregnancy can affect neurotransmitters like serotonin during brain development.
Treatment that uses a pro-inflammatory cytokine such as inteferon-alpha, to treat things like cancer, MS, and Hepatitis C, have been shown to cause side-effects in large doses that can mimic some ASD symptoms and also cause depressive symptoms which in severe cases can lead to suicide. Things like pandemics and epidemics have seen increases in depression due to inflammatory consequences of the viruses
But I would say going any further into those things would bring us out of the scope and focus of this blogpost, it is just some interesting connections that tell us depression in those with Autism can be environmental, mental and biological. So, this can mean that not only do people with Autism need better mental health support and awareness in the connection of Autism and depression but also the development and/or introduction of medical treatment for some potential biological factors would perhaps also be beneficial as well.
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If anyone is finding that they are feeling depressed and need help you should reach out. Many countries have their own mental health hotlines and also suicide hotlines as well. It is important to always get help as there is a way out for everyone. You should also make sure to look out for others and if you notice any signs of depression or suicidal behavior – try and encourage them to get help as best as you can. This is also quite important for those with Autism as some of them may not realize or be able to communicate that they are depressed and so will not seek help themselves, or even some of them may want help but just do not know how to get it.
Signs to look out for are them taking less interest in their activities, interests and/or hobbies; sleep changes or disturbances; eating little or too much; they express or seem sad, worthless, or hopeless; they seem to be or are acting more angrily or have a shorter temperament than usual or are more emotional – such as crying more often/more easily; they are finding it hard to focus attention on things; self-harm; being hard on themselves; having less mental or physical energy to do things.
And this is also not just people with Autism, others may also have these signs and need help too. It is just that people with Autism can find it harder to recognise or understand these things. Some traits/symptoms of Autism can actually overlap with depression and vice versa which can further complicate things. For example, a person with Autism may socially withdraw for a time to ‘recharge’ themselves, it does not mean they are depressed. Rumination and low motivation in people with Autism also does not necessarily mean they are depressed, but nonetheless if it is negative, it should still be looked into and they should still be supported, because low motivation and thinking negative still sucks and can still lead to depression.
People with Autism can have repetitive traits, such thinking about things in a repetitive fashion for example, and if this thought process ends up becoming negative, like focusing on negative events over and over again, then this can of course also cause depression. Worse is that when people with Autism are depressed, they tend to fixate on anger and sadness.
There is also something known as the Flat Affect whereby many people with Autism (and also some other conditions) have less of or no obvious expression or visible reaction to things than other people (so it is difficult to tell if they are happy or sad because the typical signs, such as tone of voice or facial expression is not taking place), the flat affect can actually be a symptom of depression, but for people with Autism it can also just be normal and not a symptom of depression, it is just that we react differently to others. So, once again this can bring up some complications when trying to determine if it is depression or just simply a part of having Autism.
As well as that is the appalling way that mental health is sometimes dealt with, especially outside of first world countries, but even in those countries too, such as the heinous ways that people with Autism and learning disabilities in the UK have been dealt with when it has come to depression – cases where they have been kept locked away in hospital units not suited for dealing with mental health for years on end, unable to have contact with others and kept completely isolated. This behavior is completely unacceptable and should be considered abuse of human rights by the state and other authorities involved. Having seen these kind of things come out in the media recently has possibly led to some keeping their depression hidden away and not asking for help in fear of being locked away. Granted things are not as bad when it comes to mental health than they used to be – but that is absolutely no excuse to have these such other things continue on.
Anyway, I just wanted to type up this post to make people more aware of this serious topic.
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Remember if you feel like you need help then get it! Talk to those you trust and love! Call up crisis hotlines! And look out for others who may need help… and try to help them! Also help to spread awareness of the connection between depression and Autism.
Thank you for reading.