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Be Well, Think Well: Overview of Depression

Overview

This resource, part of the Be Well, Think Well resource collection, provides information about recognizing depression, signs and symptoms of depression in individuals with autism, diagnosing anxiety and depression in individuals with autism, and behaviors to look for to identify whether what you’re seeing is a symptom of autism or something else.

Recognizing Depression

Everyone feels sad or down sometimes, usually when something bad or sad happens. Depression is when people feel really sad for a few months or longer.

BRAIN

  • Feeling tired and having little energy
  • Changes in how much you you sleep: a lot less or a lot more
  • Changes in how much you eat: a lot less or a lot more

THOUGHTS/EMOTIONS

  • Not interested in favorite subjects or activities
  • Thoughts about death or not wanting to be alive
  • Don’t want to spend time with friends or loved ones
  • Easily frustrated, irritable, easily upset about things that don’t normally bother you

BODY

  • Not caring about taking care of your body like brushing teeth or showering
  • Feeling achy or having pain you can’t explain
  • Having an upset stomach

Signs and Symptoms of Depression in Individuals with Autism

Depression is a serious mental health disorder that consists of long periods of low mood, a loss of interest or pleasure in activities, and physical changes that get in the way of everyday tasks. Depression is more than a bad day.

Changes in mood

These feelings might include feelings like sadness, hopelessness, or irritability that last two weeks or more. It may be difficult to notice changes in mood in individuals with autism since they sometimes have trouble identifying and talking about emotions.

Physical changes

People with depression might have a loss of energy, changes in sleep, changes in appetite, or changes in their weight. Some people might have an increase in compulsive behaviors or stereotypic behaviors when they are depressed.

Changes in activity

Motivation to participate in activities goes down when people have depression. They may miss work or school, spend less time on hobbies, isolate themselves from family or friends, or not take care of their personal hygiene. For individuals with autism, there may be an increase of self-injurious behaviors.

Changes in thoughts

Depression can change the way people think about the world, themselves, and the future. A person with depression may be more negative and easily frustrated than usual. They may think about negative events and emotions over and over again.

There are several risk factors that might increase the chances of depression. These things include:

  • genetics
  • stressful life events
  • medications
  • medical problems
  • a history of depression

There are a few ways to treat and manage depression. Therapists can help recognize the signs of depression and teach people coping strategies. Doctors may prescribe medications when depression is impacting an individual’s everyday life.

Diagnosing Anxiety & Depression in Autism Spectrum Disorder

Clinical Interview

Mental health professionals can diagnose anxiety and depression by asking questions. These questions include details about the individual’s history, mood symptoms, appetite, sleep patterns, and other signs of anxiety or depression. They will use that information to determine if the individual meets the criteria for anxiety or depression and make a plan to treat the anxiety or depression.

Screening Tools

Screening tools ask about specific symptoms an individual might have. Screening tools can be completed by the individual, a family member or support staff who knows them well. A mental health professional will interpret the screening tools and discuss the results. Screening tools can also be used to help track anxiety and depression over time to see if symptoms improve.

Input From Family and Friends

Sometimes it’s hard for individuals with autism to describe their thoughts or feelings to others. Some people might not notice concerns with their mood or behavior. It is important for mental health professionals to get input from people close to the individual to make a correct diagnosis.

Who Can Diagnose

There are many health professionals who can diagnose anxiety or depression. Some examples are: a psychologist, a psychiatrist, a primary care physician, a physician’s assistant, or a nurse practitioner.

Symptoms of Autism that Could Be Misinterpreted

Autism can have symptoms that seem similar to other mental health issues, especially when the person is stressed or in crisis.

Non-Responsiveness

A person with autism who is in crisis may get overwhelmed and shut down. For people with autism, they may behave in a certain way as a result of anxiety, sensory overload or over-stimulation.They may have their head down, be completely silent, or not respond to attempts to gain their attention. These behaviors could be mistaken for someone under the influence of drugs or alcohol, or someone with schizophrenia who is in a catatonic state.

Self-Stimulatory Behavior

A person with autism may engage in self-stimulatory behavior because of their sensory needs. This may look like: making unusual noises, rocking, spinning, or flapping hands. They may even engage in self-injurious behavior (e.g., slapping their head, biting themselves). These behaviors could be mistaken for being under the influence of drugs or alcohol, schizophrenia, or hallucinations. For people with autism, they may do these things as a way to stimulate their senses, manage anxiety, or help calm down.

Intense Anxiety

Many people with autism prefer strict routines and schedules. Changes to their schedule can cause intense fear, anxiety, or distress. When these changes happen, they may become aggressive, may try to run away, or may become unresponsive. Some ask repetitive questions or be preoccupied with time and schedule. This is a natural response for anyone who experiences anxiety, but for an individual with autism it could be due to changes in their schedules or routines rather than due to an anxiety disorder.

Communication Difficulty

One of the core deficits of autism is communication. Some people have little or no verbal communication, while others can talk but may not respond well to vague or open-ended questions. Poor, or no response to communication attempts may seem like the person is being oppositional or “non-compliant’. For people with autism, it could mean that the person didn’t understand what was being said or asked of them, or is having a hard time expressing themselves verbally. Presenting information in verbal and visual ways can help by giving the person plenty of time and different ways to respond.

Types of Depression

Major Depressive Disorder

Major depressive disorder is one of the most common mood disorders. It is also called clinical depression. Signs of clinical depression include: changes in appetite (eating more or less), changes in sleep (sleeping more or less), losing interest in things you used to enjoy, having a low mood, and a lack of energy and motivation to do things. Children with clinical depression may be more angry or irritated than usual. Clinical depression can be mild, moderate, or severe.

Dysthymia

Dysthymia is a long-lasting depression. People with dysthymia have symptoms of clinical depression, but the depression lasts at least two years. Symptoms might get a little better or worse during that time, but they are depressed more often than not for two years or more.

Cyclothymia

Cyclothymia is when a person has ups and downs in their mood. The person will go back and forth between feeling depressed and periods of exaggerated happiness. The person’s low moods are somewhat mild and do not reach the level of clinical depression. The person might have a lot more energy than usual during their high moods. This might look like poor judgment, racing thoughts, and not needing to sleep. You may have heard people use the word “bipolar” to describe people who have ups and downs in their mood. This is different from cyclothymia. In bipolar disorder, the highs and lows are more intense and last longer than in cyclothymia.

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Other downloads

Name Description Type File
Recognizing Depression This resource describes some of the ways you may think or feel if you have depression. pdf Download file: Recognizing Depression
Signs and Symptoms of Depression in Individuals with Autism This resource provides information about depression in individuals with autism. pdf Download file: Signs and Symptoms of Depression in Individuals with Autism
Diagnosing Anxiety & Depression in Autism Spectrum Disorder This resource reviews how a mental health professional might check to see if an individual meets the criteria for a diagnosis of anxiety or depression. pdf Download file: Diagnosing Anxiety & Depression in Autism Spectrum Disorder
Symptoms of Autism that Could Be Misinterpreted This resource will review behaviors to look for to identify whether what you’re seeing is a symptom of autism or something else. pdf Download file: Symptoms of Autism that Could Be Misinterpreted
What is Depression This resource provides information on the different types of depression that individuals can be diagnosed with. pdf Download file: What is Depression

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.