Understanding the Relationship Between Autism and Depression

Research suggests that autistic people are more likely to experience depression than those who are not autistic.

A 2019 meta-analysis found that autistic people are four times more likely to experience depression than those who are not autistic. About 40% of autistic adults, and 8% of autistic children and adolescents, have had depression.

It’s possible for autism to be mistaken for depression and vice versa, as they may have some overlapping traits, including:

• difficulties with concentration
• having a neutral or “emotionless” facial expression and voice
• lack of interest in socializing
• sleep problems

However, as a 2019 study points out, the overlapping symptoms alone don’t fully explain why depression is so common among the autistic community. Other factors might be at play.

It’s not entirely clear why autistic people are more likely to have depression. A number of factors may contribute to the co-occurrence of the conditions.

First, discrimination may play a role. Research suggests that autistic children are more likely to be bullied. Bullying can result in lifelong mental health issues, including depression. Likewise, adults may face discrimination due to a lack of societal acceptance of autism.

A 2018 paper found that social stigma causes stress that could contribute to heightened rates of mental illness in autistic people.

Second, it is possible that certain features of ASD can increase the risk of developing depression. A 2020 study compared autistic adults with adults who have depression. Researchers found the groups show similar attentional biases.

An attentional bias is a tendency to ignore certain things while focusing on others. Researchers found that both autistic adults and adults with depression showed attentional bias toward negative emotional material.

Researchers argue that repetitive cognition could explain why autistic people are more likely to have depression. Repetitive cognition is the tendency to repeatedly think about, and ruminate on, certain ideas. Repeatedly thinking negative thoughts is a risk factor for depression.

In other words, repetitive cognition and an attentional bias toward negative material are both common characteristics of ASD and risk factors for depression.

Another common feature of ASD is alexithymia. This is when you have difficulty identifying and describing your emotions.

Some research suggests that alexithymia can increase your risk of developing depression. Research also suggests a significant overlap between autistic people and people with alexithymia.

Common symptoms of depression in autism

Although autistic people may have similar symptoms of depression as the general population, symptoms can differ. For example, a 2020 study found that depression in autistic children often shows up as insomnia and restlessness as opposed to feelings of sadness.

Other than insomnia and restlessness, the symptoms of depression can include:

• changes in weight and appetite
• crying frequently
• decreased energy or fatigue
• difficulty concentrating, remembering, or making decisions
• feeling hopeless, worthless, and pessimistic
• feeling sad, numb, or “empty”
• increased irritability or anger
• lack of interest in usual hobbies and activities
• moving or talking slowly
• physical pain with no clear causes (including cramps, digestive issues, and headaches)
• sleep difficulties (including insomnia and oversleeping)
• social withdrawal
• thoughts of suicide, self-harm, or death

It’s possible to experience the above symptoms without meeting all the criteria for a diagnosis of major depressive disorder. In some cases, another diagnosis might be a better fit.

Regardless of the diagnosis, it’s a good idea to seek professional support if you or a loved one have these symptoms.

There are a number of effective treatments for depression. These treatments can include psychotherapy (talk therapy) and antidepressant medication.

If you think you have depression, finding a therapist is a good place to start. When choosing a therapist, consider looking for one who has experience treating autistic clients.

You can also try the following lifestyle strategies:

• Maintain a regular sleep schedule.
• Ensure you get enough food and hydration.
• Exercise on a regular basis.
• Do things you enjoy, whether that’s hobbies, volunteering, or something else.
• Learn techniques for regulating your emotions, such as mindfulness or journaling.
• Cultivate healthy relationships with loved ones.
• Join support groups and forums for autistic people.

Certain supplements might help improve mood. Talk with your doctor before using any health products, including supplements and over-the-counter medication.

Autistic people may be more likely to develop depression, possibly because certain characteristics of ASD are risk factors for depression. Discrimination and social stigma can also play a role in increasing the risk of depression.

Depression is treatable. If you think you’re experiencing symptoms of depression, consider speaking with a doctor or finding a therapist who’s experienced in treating depression in autistic people.