As every parent knows, teenage life is full of challenges, from stress over academics to social relationships and physical changes due to puberty. This stage of life can be particularly challenging for those with autism spectrum disorder (ASD). A recent study found that teenagers and young adults with ASD are nearly three times more likely to develop depression than same-age peers without ASD.
What are typical symptoms of depression?
While occasional sadness is a normal part of life, persistent sadness can be a sign of depression. Other common signs and symptoms of depression can be grouped into thinking patterns, changes in behavior, and physical symptoms. Common thinking patterns seen in depression include guilt, hopelessness, worthlessness, excessive worrying, and thoughts of death or dying. Behavioral changes include social withdrawal, increased irritability, and decreased interest in preferred activities. Physical symptoms include appetite changes, sleep problems, and low energy.
If someone has ASD, recognizing their symptoms of depression can be challenging
There are several aspects of ASD that overlap with symptoms of depression, including difficulty identifying and accurately reporting mood, constricted range of facial expression, sleep problems, and social withdrawal. Because of this overlap, an assessment of depression should involve multiple observers (caregivers who understand a teenager’s ASD, teachers, healthcare providers). An assessment should also take into account whether there is a change in your teenager’s usual behavior and functioning. Symptoms of depression typically persist for at least two weeks and represent a clear change from their typical behavior.
Some features of depression that may be more prominent in teenagers with ASD include an increase in ASD-related behaviors, irritability, and self-injurious behaviors. Many teenagers with ASD have very specific interests. These interests can become less appealing to the teenager, or shift to become more morbid during depression; for example, someone who enjoys drawing cartoon characters may draw more unhappy characters. You may also notice more crying, aggressive behaviors, and a decline in self-care, like refusing to bathe or eat meals. Although many parents worry that puberty itself may cause worsened aggression, this is often not the case, and the possibility of depression should be taken seriously.
What should parents and caregivers do if they are concerned a teenager with ASD may be depressed?
If parents suspect their teenager with ASD is depressed, they should try asking about his/her mood. Some teenagers with ASD will be able to say how they are feeling, while others may have difficulty with this. It is common for teenagers with ASD to respond by saying they feel hungry, tired, or bored. If parents remain concerned about depression, a pediatrician or mental health clinician can conduct a more in-depth evaluation.
It can be helpful to prepare your teenager for an evaluation by telling him/he