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Depression

It is very common to have times in our lives when we feel sad or low. However, when these feelings last for more than a few weeks and affect your daily life, it may be a sign of depression. Research suggests autistic people may be more likely to experience depression than non-autistic people and estimates that it affects up to half of all autistic people at some point in their life. Depression is treatable and with the right support, you can feel better. If someone is experiencing depression it is important to seek help. 

What is depression?

Depression is a mental health condition that can affect anyone. The NHS state it is

'more than simply feeling unhappy or fed up for a few days. Depression affects people in different ways and can cause a wide variety of symptoms. They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days.'

How do I know if I have depression?

Signs that you might be depressed include:

Changes in your mood

  • Continuous low mood or sadness
  • Feeling hopeless
  • Having suicidal thoughts or thoughts of self-harm

Physical changes

  • Changes in appetite or weight
  • Disturbed sleep
  • Lack of energy

Changes in how you connect with others

  • Avoiding contact with people
  • Difficulties at home, work or with family
  • Neglecting hobbies or interests.

Depression affects people differently, and symptoms can range from mild to severe. Mild depression may make you feel persistently low in mood, whilst severe depression may make you feel that life is no longer worth living.

Read more about depression on the NHS website. 

Autistic people usually have the same symptoms as non-autistic people, but they may be more likely to experience:

  • social withdrawal
  • increased repetitive behaviours
  • a change in interests (perhaps becoming more focussed on death or dying)
  • more frequent meltdowns
  • an increased risk of self-harming or suicidal thoughts.

Why might autistic people experience depression?

General causes of depression that can affect anyone include:

  • experiencing stressful events or trauma
  • a family history of depression
  • other mental or physical health conditions
  • drugs, alcohol, or medication.

There may be reasons for depression that are specific to autistic people. Daily life can be more challenging for autistic people. Differences in understanding social situations and relationships, and being misunderstood or not accepted by non-autistic people can all increase anxiety and stress. This can lead to low self-esteem, social isolation and loneliness. These can all contribute to depression.  

Other reasons include:

  • alexithymia (difficulty identifying, understanding and managing feelings)
  • a lack of adequate support.

A recent National Autistic Society survey found 50% of autistic people said depression had a high impact on their ability to get on with life.

For me the problems grew the more I disliked myself, the more I felt I was a failure for not making friends.
Anon (2017)

If you are feeling depressed, it is important to access support as early as possible.

How do I get help and support?

If you think you might be experiencing depression then try and speak about your feelings to someone you trust. If you think you need more support, then speak to your GP.

Treatment for depression will be the same for autistic and non-autistic people and will depend on whether you have mild, moderate or severe depression.   

If you have mild depression, your GP may suggest waiting to see whether it improves on its own, while monitoring your progress. They may also suggest changes you can make to your lifestyle, such as exercise.  

Your GP may suggest waiting to see whether it improves with some self-help strategies, while monitoring your progress. They may also suggest counselling, therapy, or medication to help. For severe depression, you may also be referred to a specialist mental health team.
 

Therapies

You can go for therapy through your GP or privately. There are many types of talking therapy, including cognitive behavioural therapy (CBT), that can be effective for some autistic people if adapted appropriately. 

Search our Autism Services Directory for details of counsellors and therapists in your area with experience of working with autistic people. 

Other approaches that might help include:  

  • mindfulness training
  • emotional awareness training
  • psychodynamic therapy (analytical talking therapy).

Ideally, all treatments and therapies should be delivered by someone with an understanding of autism. Most importantly, to be accessible and effective, support should be adapted to a person’s specific needs. Visit our Seeking help with mental health page for more advice.

In England, there is statutory guidance for adults that states autistic people should have support adapted to their needs if they have a mental health difficulty.

Medication

You may be offered medication, such as anti-depressants. Although guidelines consider antidepressants are generally useful and safe, there is very little research into whether they help treat depression specifically in autistic people. What research there is suggests autistic people may be more likely to experience side effects such as drowsiness, irritability and reduced activity. 

Antidepressants should be carefully considered and closely monitored by a medical professional.
 

Advice and tips

Different things work for different people. Here is some advice from autistic people on what helped them:

  • Try to have some structure and routine in your life
  • Spend time with family and friends
  • Try to exercise regularly: it doesn’t need to be really energetic, a walk in the park can help
  • Give yourself extra time to complete tasks – accept that some things will take longer, and that is okay
  • Spend time on activities you find calming and relaxing. This could be listening to music, watching television or gardening. 
Keep things simple. When you're feeling low, it is best to keep the tasks we have to do as simple as possible.
Purple Ella (2012)

Read some personal accounts below:

Links, resources and article sources

Related advice and support

Anxiety

More

Diagnosis

More

Seeking help with mental health

More

Sensory differences

More

Last reviewed and updated: January 2021

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