Managing Depression in Individual's with Asperger's Syndrome

Eileen Bailey Health Guide
  • Adults with Asperger’s syndrome (AS) report a significantly higher frequency of suicidal thoughts than the general population according to astudy completed at the University of Cambridge. The researchers found that 66 percent of the participants with AS reported they had suicidal thoughts, as compared to 17 percent of the general population; 35 percent of those with suicidal thoughts had either planned or attempted suicide sometime during their life. Those with a history of depression were four times more likely to have such thoughts and twice as likely to attempt suicide.

    Previous studies have shown that those with AS are at a higher risk of developing depression, especially during the teen and early adult years. Because those with AS have a difficult time expressing their feelings, depression can go unnoticed. Social isolation, previous bullying, a constant sense of not fitting in, high anxiety levels and a predisposition for depression based on genetics all can contribute to the cause of depression.

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    Depression Can Be Difficult to Spot

    The signs of depression are frequently difficult to spot in those with AS until it becomes so severe it makes it difficult to function. One reason is because of difficulty in social communication. Those with AS have a hard time expressing emotions and communicating their feelings. Non-verbal language is often used to interpret feelings, however, this is also a problem area for people with AS. While people without AS might appear sad based on their non-verbal behaviors, people with AS don’t use non-verbal communication in the same way. They might state they are sad but their expression might convey something completely different. While a deep sense of sadness is a primary symptom of depression, this can be expressed in different ways. In those with autism and AS, depression might show up as apathy, lack of motivation and avoidance.  

    Another symptom of depression is also a withdrawal from social activities and self-imposed isolation. People with AS, while they crave social connections, also have a need for solitude. Even those with AS who have mastered social skills, have friends and participate in social activities, often find they also need time alone to process their thoughts and be away from crowds, loud noises or the constant barrage of sensory stimuli. It can be difficult for family members to distinguish when the need for solitude becomes isolation from depression.

    Those with AS might have obsessions and rituals as a way to reduce anxiety and cope with the world around him. These need for and frequency of these rituals might increase with the onset of depression. As with solitude, it can sometimes be difficult for family members to notice the increase until the depression has become severe.

    Because characteristics of AS can sometimes mask symptoms of depression, it is important to measure behavior against what is “normal” for that individual, rather than comparing behaviors to the general public. Some other signs of depression in those with autism and AS are:

    • Increase or reemergence of repetitive behaviors
    • Increase in obsessive thinking
    • Increase in rituals
    • Changes in sleep patterns
    • Loss of appetite or increased appetite
    • Changes in energy level
    • Changes in behavior including the frequency of social interactions

    For those on the spectrum, mood changes are rarely an early indicator.

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    Treatment of Depression in Individuals with Asperger’s Syndrome

    The treatments used for people without AS are effective for people with AS. Medications are available but, especially for teens, the pros and cons should be discussed with medical professionals. Antidepressants have been found to cause suicidal thoughts in some teens.

    Cognitive behavioral therapy (CBT) is a type of therapy that works to change patterns of thinking. While this can be effective for those with AS, the therapist should be very familiar with AS and understand the more rigid and black and white thinking of those with AS. The therapist should also understand the need to deal with situations on a intellectual and logical way rather than emotionally. Because CBT is a highly structured therapy, with some changes, such as decreasing the length of sessions, it can be helpful.


    “Asperger Syndrome and the Difficulties of Diagnosing and Treating related Conditions,” 2009, August, Alan Harchik and Lauren Solotar, EP Magazine

    “Depression or Mental Health Problems,” Date Unknown, Staff Writer, Aperger’s Syndrome Foundation

    “Depression in Persons with Autism: Implications for Research and Clinical Care,” 2002, August, MohammadGhaziuddin, Neera Ghaziuddin, John Greeden, Journal of Autism and Developmental Disorders



Published On: July 21, 2014