What is it?
Clinical depression is a type of mood disorder that can range from mild to severe. Depression can have many symptoms including psychological, physical and social.
The psychological symptoms can include: a persistent low mood, feelings of guilt, low self-esteem, feeling hopeless, struggling to concentrate, being tearful, feeling easily irritated, thoughts of suicide and/or self-harm.
The physical symptoms can include: headaches, feeling tired, a change in appetite, low/no libido, insomnia, moving or speaking slowly and unexplained achiness.
The social symptoms can include: less interest in usual hobbies, struggling more than usual with partaking in social occasions and keeping in contact with friends and family.
Why might autistic people have depression?
Anyone can experience depression, but autistic people are four times more likely than our non-autistic peers to develop depression. While the definitive reason for this is still being researched, it is not particularly surprising given the single greatest predictor for whether someone will develop depression is loneliness.
There are many reasons autistic people are likely to be lonelier than the wider population. Not only do we often struggle to successfully communicate with non-autistic people, they also struggle to communicate with us (this is known as Dr Damian Milton’s Double Empathy Problem). This can mean, even in ideal circumstances we may end up isolated.
And autistic people are often not in ideal circumstances in the first place. We are less likely to be in employment, meaning fewer opportunities to befriend colleagues and less money for social activities even if we do have good relationships, and we need to consider our sensory needs when finding times and places to socialise.
Another reason autistic people may be more likely to be affected by depression is because experiencing trauma increases the likelihood someone will become depressed. Since autistic people have often suffered trauma – whether through traumatic ‘treatments’ for their autism, abusive relationships, which we’re more likely to experience or traumatic social experiences – it stands to reason we are more likely to have depression.
Of course, while they might increase the chances, you do not need to be isolated or have suffered trauma to be depressed and if you think you have depression you should take it seriously.
Depression or autistic burnout?
One thing autistic people need to consider when we think we might be depressed is the possibility that we are experiencing autistic burnout rather than depression. The two can look very similar. Autistic burnout occurs when an autistic person has been under intense and/or prolonged stress (often involving the need to mask and/or large changes) and generally after several crisis points (meltdowns, shutdowns and elopement) have occurred in a relatively short space of time.
Someone going through burnout will tend to feel exhausted, have a reduced tolerance to sensory stimuli and find certain things like masking and executive functioning much more difficult or impossible. The loss of (or difficulty performing) certain skills means autistic burnout is often referred to as a ‘regression’, especially in children, although the skills are generally regained once support is put into place and the autistic person is able to recover from the burnout.
If you are unsure whether you are experiencing depression or burnout, ask yourself whether you have been under a lot of pressure recently (burnout tends to happen when life stressors become too high for too long), and whether you still get pleasure from your hobbies and special interests (depression often leaves you uninterested in these things whereas focusing on special interests can actually help during burnout).
What can I do if I think I have depression?
It is certainly not inevitable that you will suffer from depression if you are autistic, and there are various treatments and strategies to help if you think you are depressed.
If you do think you may be depressed, the best first step is to see your GP (or another health care professional if you are already under their care – like a midwife or psychiatrist).
Your GP should assess you and talk through your treatment options, which may involve medication, some sort of therapy, or both.
If you feel unable to tell your GP or another health care professional, try to tell someone else you trust.
What can I do myself?
Alongside the advice given by your GP, there are some things you can try to help.
Try to get into a good sleep routine. Both autism and depression can affect sleep cycles so this may be difficult (or even impossible for some people) but there are certainly things that might help like:
- Avoiding caffeine after 4pm (though, if you are ADHD as well as autistic this may be less effective).
- Avoiding screens for an hour before bed (unless a screen/TV show/music on in the background allows a smoother sleep transition).
- Keeping your bedroom cool but not cold.
- Only using your bedroom for sleep/avoiding using it for anything stressful if space allows.
Try to spend some time outside every day. This doesn’t have to mean a two hour long hike; hanging the washing up outside, wandering round the garden for 10 minutes or going for a short walk to the shop all help to build up the amount of time you spend outdoors.
Try to exercise several times a week. While going to the gym, joining exercise classes and playing team sports are all excellent forms of exercise, not everyone has the time/money/inclination for such things. However, local walks, online yoga classes , swimming, fitness videos and jogging round the garden are all great alternatives.
A really important step to take is to try to find emotional support. While doctors and professionals can often offer specific support to get you through certain periods, finding peer support you can turn to at any time is invaluable. It is worth seeing what there is in your area (try looking on notice boards in community centres, GP surgeries, town halls and libraries and at your council’s website) but if there is nothing available or you are unable to attend there are many online support groups.
What can I do if I think I am experiencing autistic burnout?
If you think you are in autistic burnout you could support yourself by looking at the possible current stressors in your life. It is possible some of these stressors can be eliminated entirely or reduced/changed. Acknowledging that you may need support with certain areas as an autistic individual and finding helpful adaptions and supports can help reduce some stressors. For example: using alarms to remind you to complete certain tasks, asking for help when you need it, taking regular breaks when feeling overwhelmed can all help.
Acknowledging and accepting sensory differences can reduce the chance of sensory overload. Exploring your sensory preferences and discovering sensory input you find soothing, as well as identifying those you find triggering, can help you avoid sensory difficult situations and leave you better equipped to put in to place sensory soothing activities.
Spending time immersed in your special interests (SpIns) can also help bring you out of burnout sooner. And accepting your autistic identity – and surrounding yourself with other people who are supportive of you as an autistic person – can also both help during burnout. Finding some autistic peer support, either online or locally, can help. Hearing the lived experiences of other autistic people can be hugely validating.
Please feel free to contact us if you feel you need support with potential burnout.