Depression is a common mental health challenge. Many autistic people struggle with depression, and autistic people are four times more likely to develop depression compared to non-autistic people.¹

Through research, we can learn more about depression and autism and find tailored solutions to help autistic people struggling with their mental health.

Key facts about depression and autism

• Depression and autism can co-occur at high rates. Depression is more common in autistic people than in non-autistic people.
• Symptoms of depression can sometimes look different in autistic people compared to non-autistic people.
• There are several treatment and support options available for depression. Through research, we can know more about what will be helpful for autistic people, and how to adapt existing interventions so they are more effective and easier to access.

About depression

It is normal to feel sad and low from time to time. However, if these negative feelings continue for an extended period, such as weeks or months rather than days, it's possible that you might be struggling with depression.

Depression is the most common mental health difficulty worldwide.³

Symptoms of depression can include:

• Feeling sad, low or hopeless for an extended period
• Losing enthusiasm about hobbies or activities you normally enjoy
• Changes in appetite
• Sleep problems, such as sleeping too much or not enough
• Avoiding your friends or family
• Lack of optimism for the future
• Suicidal thoughts or ideation

Depression and autism

Autistic people experience depression at higher rates than the general population. Research suggests up to 40% of autistic adults will experience depression in their lifetime.¹ 

If you are autistic and struggle with depression, or are worried that you may develop depression in the future. It’s important to know that hope and treatment options are available. We’ve signposted some resources at the end of the article.

Symptoms of depression can look similar in autistic and non-autistic people, but there may be some differences. If an autistic person experiences any of the following distress-related behaviours, they can become more pronounced if they have depression:

• Hyperfixations
• Stimming (self-stimulating behaviour), such as body rocking or hand flapping.
  
• Social withdrawal
• Self-harm
• Problems with sleep

Depression also increases suicidal thoughts. Sadly, autistic adults are nine times more likely to consider suicide than non-autistic people.⁴

A study found that suicidal thoughts and feelings in autistic people were related to camouflaging or masking autistic traits, self-injury and unmet support needs. In non-autistic people, masking and unmet support needs were not related to suicidality. Still, having autistic traits were, as well as living arrangements, self-injury and feelings of anxiety and depression.⁵

Many autistic people have unmet support needs. By 2030, we want to see all autistic people to have proven support from day one.

Many autistic people experience alexithymia, so they may struggle to identify their emotions. Alexithymia is strongly linked to depression. One study suggested the alexithymia trait of difficulty identifying feelings, may be a predictor of depression in autistic people.⁶ Their research suggests that alexithymia traits outweigh autistic traits as an explanation for depression in autistic adults.

Depression is an internalised disorder; it relates to internal thoughts and feelings such as sadness and hopelessness. It can be more difficult for clinicians to recognise the signs of depression in autistic people because of communication differences between autistic and non-autistic people. This means many autistic people may be struggling with depression without adequate support.

Learning disabilities and epilepsy are more common in autistic people than in non-autistic people. They are both linked to higher rates of depression than people without learning disabilities or epilepsy. It is not known whether autistic people with learning disabilities and/or epilepsy are at greater risk of depression.

What you can do about depression if you are autistic

 splitting them into self-management and options to get support from others.

What you can do about depression if you are autistic

Jump to: See your doctor Medication Talking therapy CBT Talking to friends, family or support groups Social prescribing Getting the basics right Spending time in nature Finding movement that you enjoy

If you are autistic and have depression, there are lots of options available. We've listed a few examples below.

See your doctor

Autistic people tell us that going to the doctor can be stressful because they feel that health professionals do not understand their needs. But seeing your doctor when you’re experiencing symptoms of depression is an important step towards looking after yourself. Using tools like health passports, or writing down what you'd like to talk about in advance may help your doctor learn about you and your needs.

The law states that reasonable adjustments must be made in health and social care. You can tell your doctor what reasonable adjustments you need. They can use the reasonable adjustments digital flag, so you don’t need to explain every time you use an NHS service.

Medication

Some people take medication, such as antidepressants or mood stabilisers, to manage their depression. Some small research studies report that medication improves low mood, sleep disturbance and self-harm in autistic people.

Some autistic people may react more (or less) strongly to medication compared to non-autistic people. If you feel comfortable, talk to your doctor to discuss your options.

Talking therapy

Talking to a therapist who can adapt their approach to suit your needs can help you find ways to manage your depression. If you choose private therapy, you may want to consider a therapist who specialises in autism or is neurodivergent themselves.

CBT

If you struggle with depression, you are likely to be offered Cognitive Behavioural Therapy (CBT) by the NHS. Cognitive behavioural therapy is a type of therapy where you break down your problems into different thoughts, behaviours, and actions and explore whether they are helpful to you or not. CBT can be a useful tool, but it is not suitable for everyone. 

Most of the evidence for the effectiveness of CBT will be based on studies that did not ask whether participants were autistic or not. Some research suggests that CBT tailored specifically to autistic people can be helpful. However, we need much more research to improve our understanding of the effectiveness of CBT to improve autistic people’s mental health.⁷

Talking to friends, family or support groups

Many autistic people find that sharing their experiences with other autistic people helps their mental health. It might be difficult to tell people how you are feeling, but talking to someone who understands can help you to feel better. 

If you can’t talk to a family member or a friend, a support group might help you. You can visit the National Autistic Society's service directory to find a support group or mental health service near you.

Social prescribing

Social prescribing is where health professionals prescribe a sociable group activity, based on your preferences and needs. This could be group activities such as walking groups, gardening groups, choirs or craft clubs. Your doctor will work with you to learn about your interests and prescribe an activity based on your needs and preferences.

Find out about the research we funded about social prescribing for autistic people. 

Getting the basics right

If you are struggling with depression, it can sometimes be hard to look after your basic needs. However, eating enough, staying hydrated and getting the right amount of sleep are important steps towards looking after yourself.

Spending time in nature

Getting outside into nature can help reduce your cortisol levels, making you feel less stressed and helping boost your mental health. Not everyone can easily access nature, but even going to a park can help.

Finding movement that you enjoy

It can be hard to find the motivation to exercise at the best of times, and especially so if you are struggling with your mental health. However, research suggests that exercise can be highly effective at helping lessen the severity of feelings of depression.

Exercise doesn’t have to be pushing yourself to your limits at the gym to have mental health benefits. The most important thing is to find something you enjoy enough to do regularly.

Some people may have to moderate exercise if they have a physical disability. An occupational therapist can help find exercise that works best for your needs.

References

[1] Hudson, C. et al., (2019) Prevalence of depressive disorders in individuals with ASD: a meta-analysis

[2] Lever, A. & Geurts, H. (2016) Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with ASD.

[3] Vos, T et al., (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease study.

[4] Cassidy, S. et al. (2014). Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic: a clinical cohort study.

[6] Bloc, C et al., (2021) Alexithymia traits outweigh autism traits in the explanation of depression in adults with autism

[7] Linden, A. et al., (2022) Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials.