Autism and chronic depression are two distinct conditions that often co-occur. While autism primarily affects social communication, behaviour, and sensory processing, chronic depression involves persistent feelings of sadness, hopelessness, and loss of interest in activities.
Generally speaking, biological women (non-autistic) are twice as vulnerable to feelings of depression and loneliness compare to biological men due to the periodical hormonal shifts they experience. This risk augments dramatically in autistics. It has been found that autistics seem to have predispositions for neuroticism.
Whether there is an association between depression and the level of autism is unclear, however factors such as a lack of diagnosis and support can significantly increase the odds of depression.
Here are some key points to consider:
Increased Risk: Autistics are at a higher risk of experiencing depression compared to the general population. The reasons are multifaceted. Difficulties forming and maintaining relationships, navigating social situations, and understanding social cues can exacerbate feelings of social rejection and isolation. A sudden and drastic change or circumstances can be particularly difficult to navigate for autistics and lead to depression. The most significant precursor to a depression, however, is a traumatic past.
Overlap: There can be overlaps between autism and depression, which can complicate diagnosis and treatment. Social withdrawal, changes in appetite or sleep patterns, irritability, and difficulties with concentration can be present in both autistic behaviours and depressive states.
Sensory Overload and Emotional Dysregulation: Sensory sensitivities can contribute to an almost constant dysregulation of the nervous system. This drastically increases the likelihood of a major depressive disorder occurring in the long term.
Barriers to Accessing Mental Health Services: Autistics often face barriers to accessing adequate mental health support. This can stem from difficulties in verbalising their emotions and needs, challenges in navigating healthcare systems, and limited availability of autism-informed mental health providers etc. These barriers prevent timely diagnosis and intervention for depression.
Tailored Interventions: Effective treatment of depression in autistics requires a tailored approach that address their unique needs. Adequate treatment may include therapy, sensory accommodations, social skills training, a change of diet, coaching, among others.
How does an autistic burnout differ from a non-autistic one?
Autistic burnout is a term used to describe a state of physical, emotional, and mental exhaustion as a result of prolonged exposure to stress, sensory overload, masking fatigue and social demands. It is especially common in undiagnosed people as there is an even greater lack of support and comprehension. An autistic burnout is extremely serious and can lead to suicidality. It can not be treated in the same way as a non-autistic burnout as this would likely induce adverse effects. It is characterised by a significant decline in functioning and coping abilities and can manifest in various ways.
Key points to consider:
Physical Symptoms: Exhaustion, muscle tension, headaches, digestive issues, and sleep disturbances are common physical symptoms of autistic burnout. Burned out autistics often remain bedridden for years, refuse to eat and take care of their personal hygiene.
Emotional and Mental Exhaustion: Feelings of overwhelm, irritability, anxiety, severe depression, suicidal ideation, social isolation and emotional dysregulation often exacerbate autistic meltdowns.
Reduced Executive Functioning: Executive functioning refers to cognitive processes such as planning, organizing, problem-solving, and decision-making. Autistic burnout impairs these functions, leading to even more difficulties in managing daily tasks and responsibilities.
Sensory Overwhelm: Sensory sensitivities are common among individuals on the autism spectrum, and sensory overload can exacerbate burnout symptoms. Exposure to loud noises, bright lights, crowded environments, or other sensory stimuli is particularly overwhelming and triggering during an autistic burnout.
Social Withdrawal: Autistic burnout leads to increased social withdrawal and isolation. Engaging in social interactions with non-autistic people requires masking which is exhausting on a good day and near impossible during a burnout. Maintaining ties with family members is often too difficult in case of a severe burnout.
Autistic burnout similarly to a non-autistic burnout can occur in response to various stressors, including academic or occupational demands, sensory overload, social expectations, and masking (camouflaging autistic traits to fit in socially). It often occurs after a period of prolonged stress or overexertion and may be exacerbated by changes in routine, transitions, or life events.
It’s important to recognise the signs of autistic burnout and take steps to prevent or mitigate its impact. This may include practicing self-care, setting boundaries, seeking support from friends and family but especially professionals, and finding strategies to manage stress and sensory overload.
Creating a supportive and inclusive environment that respects individual differences and accommodates the needs of autistics can also help prevent burnout and promote well-being.
Ultimately the best prevention is an early diagnosis to be able to adjust and avoid stressors accordingly.
Additional Resources
Depression in women: Understanding the gender gap – Mayo Clinic.
Loneliness in autistic adults: A systematic review – PMC
Unrelenting Depression and Suicidality in Women with Autistic Traits
Journey to diagnosis for women with autism | Emerald Insight