Depression in Autistic People

When I first learned about Asperger’s Syndrome and high-functioning autism in 2002, I read an interview with Tony Attwood in a New York disability awareness newsletter. For those who don’t know, Tony Attwood is an Australian psychologist and expert on Asperger’s Syndrome. In the interview, Attwood explained that many people with Asperger’s Syndrome suffer from depression in adolescence because they are aware of their differences but cannot change their behvior on their own. While I have not personally suffered with clinical depression, I can relate to lower-grade depressive symptoms that originated for me at around age twelve when I was first becoming aware of my social differences.

Depression in autistics is often missed, because it overlaps with certain autism symptoms, such as social withdrawal, repetitive/obsessive thoughts, and black-or-white thinking. Also, some autistic people’s depression is mistaken for improvement in behavior. I remember reading in a Dutch book on autism about a young man who had had an obsessive interest that he was constantly talking about. When he stopped talking about his special interest as much, people thought he was improving. In reality, he was severely depressed.

It is often hard to treat depression in autisitcs, especially if the autism is undiagnosed. I mean, people can get their depression in remission throguh cognitive-behavioral therapy, medication or both, but their social differences will not subside. Social skills training may help, but even so, autism cannot be cured, and I’ve found social skills training that was aimed at more general populations particularly frustrating given the lack of practical instruction and the underlying idea that people with depression or other general mental health conditions do essentially possess social skills. One sort of social skills training that I’ve found some use in, is the Liberman module on social relations. Liberman modules were originally developed for people with schizophrenia. They use a lot of repetition, roleplaying etc. rather than just telling the participatns they need to listen, ask questions and reflect on the other person’s feelings. Unfortunately, the training also assumes cognitive deficits, so that for example each of the participants in my group were asked to repeat the goal of the module. I found myself being annoyed by this.

Please realize that insistance on changing socially inappropriate behavior may make an autistic person more depressed. A few days ago I wrote about my diagnostician insisting I unlearn to twirl my hair. When he said this, I was in my first month on the psychiatric ward with significant suicidal ideation. That was not the time to insist on social skills. Therefore, it is my opinion that someone who is still depressed, should not be put into a social skills program. It’s important that depressed autistics (and every autistic for that matter) learn that they are acceptable for who they are.

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16 thoughts on “Depression in Autistic People

  1. It’s so hard when things overlap and it can definitely be harming I think in some ways when things are over looked and the wrong condition blamed.

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  2. I think that should apply as a general rule in life, shouldn’t it? If only we learned to accept people as they are and stop changing their behaviour, the world would be a much better place!

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  3. I never realised that there was a link between the two. I guess it is really hard to diagnose, especially with people who have severe autism and communication difficulties. Wow – another thing to add to the pot perhaps? Thank you for sharing this.

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  4. totally agree everyone needs to be accepted for who they are, and it really does sadden me to think of my child, or any other autistic person, feeling depressed as they grow up because of how hard it is to be accepted and people always judging them for the way that they are. I do know from other parents whos children are slightly older, that they have had a lot of difficulties with this and when the teenagers were suffering depression theres not always enough support for them.
    I’ve never heard of Liberman, so thats interesting to know

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    1. It does sadden me that many autistic children and eteens suffer from depressive symptoms.

      As for Liberman, I am afraid I cannot direct you to any English-language sources on it as all that I googled was in Dutch. I think Liberman is not Dutch though so it may be that I use Google.nl. The way it works is there are various modules which teach for example about psychotic symptoms, antipsychotic medication, leisure, work, social relations as I said, etc. I just remembered there is also Goldstein training which is specifically for individuals with intellectual and developmental disabilities. This is social skills training only but it is very extensive and teaches for example about holding a conversation, arguing and solving conflict, etc.

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