Mental disorders like autism and depression seem to be running rampant in today’s society. But when those two appear side by side — worse, when your child is the victim — things start to become complicated.

Approximately 72% of all Millennials drink liquor, beer, or wine. Another less cheerful statistic is that Millennials are known to commonly suffer from depression. But it isn’t restricted to Millennials only: many people from Gen Z, and even younger, are suffering from depression, and it sometimes feels like it becomes more common every day.

While depression in children alone is a serious cause for concern, it becomes a much more difficult problem when it strikes a child with autism. Unfortunately, little research has been done so far on depression as it involves people with autism, even though it affects autistic people differently from neurotypical individuals.

If you have an autistic child whom you suspect may be dealing with depression as well, or if you’re reeling from a recent diagnosis and wondering what to do about it, this article is for you.

Understanding Childhood Depression

Washington, D.C. is famous for many things, including having 20 different universities (and over 100 including neighboring states Maryland and Virginia). Another thing it could be known for is that 8.7% of teens in the D.C. area experienced a major depressive episode in 2016 alone.

A common misunderstanding is that being depressed is no different from being sad. The truth is, depression isn’t an emotion; it’s a disorder. A child can seem sad without necessarily having depression. But if that sadness becomes persistent, interferes with their daily activities, or causes them to lose interest in past enjoyment, it could indicate that they have a depressive illness. Fortunately, although it is a serious illness, it is also a treatable one.

Symptoms of childhood depression can vary from one child to another, just like children themselves are different. A downside to this is that depressed behavior is often brushed off or ignored as normal emotional and psychological changes occurring as a result of their growth.

Some children display “masked depression,” where their depressed mood is expressed through acting out or angry behavior. This is more likely to occur in younger children. Others express similar symptoms as adults with depression, simply displaying low mood or sadness.

Signs and symptoms of childhood depression can include the following:

  • Near-constant feelings of sadness or hopelessness
  • Anger or irritability
  • Enhanced sensitivity to rejection
  • Social withdrawal
  • Significant increase or decrease in appetite
  • Either sleeplessness or excessive sleeping
  • Crying or vocal outbursts
  • Fatigue or low energy
  • Difficulty thinking and concentrating
  • Physical complaints that won’t respond to treatments, such as stomachaches or headaches
  • Lessened ability to function during activities and events, or in hobbies and interests
  • Feelings of guilt or worthlessness
  • Thoughts of death or suicide

Keep in mind that not all children will display every one of these tendencies, and they probably won’t happen all at once. Typically children will express different signs and symptoms in different settings.

Some children continue to function normally in school and social activities in spite of having depression. However, most will experience a noticeable change in their social behavior, from losing interest in friends or activities to falling behind in school. Children who are depressed may turn to drugs and alcohol, especially if they’re over 12 years old.

One of the darkest aspects of depression is the suicidal tendencies it can cause in people, children being no exception. While it’s rare for children under the age of 12 to attempt suicide, it has happened. When a suicide attempt is made, it is often done impulsively, in response to something that has upset them. Girls are more likely to attempt suicide than boys, but boys are more likely to actually kill themselves when they do try. In addition to children with obvious depressive symptoms, children in a family with a history of abuse, violence, or alcoholism are at a greater risk for suicide.

Now that you’re equipped to understand depression in general as it affects children, we’ll turn to its implications for children with autism.

Recognizing Depressive Traits in Autistic Children

Mood disorders like depression appear to be more common among those with developmental disabilities. Unfortunately, that sometimes means depression is more difficult to understand, diagnose, or treat for people of unusual neurotypes.

Recognizing depression amid the symptoms of autism can be especially challenging. Many autistic individuals have difficulty speaking, or may not be able to speak at all, which makes communicating their feelings directly very difficult. Additionally, people on the autism spectrum show little facial emotion. If a neurotypical child suddenly ceased to display any outward emotion, it would be a serious cause for concern, and it might even be a sign of depression for them. But for an autistic child who doesn’t express much emotion in general, it can be difficult to identify their feelings. Outwardly they may appear indifferent, but that’s no indication of what they’re feeling — and you can be sure they’re feeling something.

If you’re very familiar with an autistic child’s moods and behavior, you may be able to pick up on symptoms of depression that exist for neurotypical people. For example, a sudden change in appetite or sleep patterns, or suddenly losing interest in pleasurable activities. But children with autism won’t necessarily display the same symptoms of depression as a child who isn’t on the spectrum.

What often makes diagnosing depression in children with autism is that the symptoms of both disorders tend to overlap. Symptoms of depression can include a flat, depressed expression, reduced appetite, low energy, sleep disturbance, reduce motivation, social withdrawal, and a lessened desire to communicate. However, these same symptoms are not uncommon for all individuals with autism, regardless of whether they’re clinically depressed or not. When you consider that autistic people are four times more likely to experience depression at some point in their lives, the close similarities between the two become worrying indeed.

Besides all that, individuals with autism are considerably more likely than neurotypical people to commit suicide, even when depression isn’t involved. When depression does become a factor, their risk of suicide can increase dramatically. Because of this, if you so much as suspect your autistic child suffers from depression, it’s a matter you can’t afford to not take seriously.

Between the likelihood of autistic individuals experiencing depression and the heightened risk of depressed autistic people face, you would hope the medical community had a solution equal to the threat. But unfortunately, depression in autistic individuals isn’t understood very well, and no treatments targeting these specific cases have been developed. Even worse, medications that are traditionally used for depressed people can have severe adverse effects on people with autism. It should be noted, however, that some autistic people have received significant value from medications for depression with no adverse effects. The differences from one individual case to another is part of what makes the problem so complex, but it also means conventional treatments may indeed work for your case.

Whether traditional treatment methods will work for your autistic child or not, it’s very important to have hope in your child and their future. The fact that you’re reading this article now indicates that you take your child’s wellbeing seriously, which is the most important thing. With the help of a good doctor and therapist, your child can absolutely receive the treatment they need to thrive.

Since there can be some difference between a depressed child with autism and one without, you can keep an eye out for the following telltale symptoms of depression in an autistic child:

  • Aggression
  • Quickly-shifting moods
  • Hyperactivity
  • Decreased self-care
  • Less adaptive
  • Regression of previously-learned skills
  • Self-harming behavior
  • Increased compulsiveness
  • Fluctuations in recognized autistic symptoms (such as increased stereotypic behavior)
  • Abnormal movement or behavior of any kind

One sign you can look out for in your child that may signal depression is a rumination on negative situations or feelings. Many autistic individuals have intensely focused interests and repetitive behaviors, which cause them to fixate on certain things. If the target of an autistic child’s attention becomes something negative, it can be detrimental to their wellbeing and send them into a depressive episode. Again, this is not an uncommon experience for individuals with autism, and it doesn’t necessarily mean the individual is depressed. Like the other recognized signs of depression, this one overlaps with traditional symptoms of autism. But together with the other depressive symptoms discussed, watching out for this kind of behavior may give you a clue about whether your child has depression.

How to Help an Autistic Child with Depression

For an otherwise-functioning adult, there are many things that can be done to help cope with mental disorders like depression. Some may find that caffeine seems to help boost their mood. It certainly contains neurological benefits, as it leads to a 65% decrease in the likelihood of developing Alzheimer’s and other age-related mental conditions. But that wouldn’t be helpful, or healthy, for your autistic child. So what can you do for a child with autism and depression?

First things first, if you suspect your autistic child may be depressed, you should make it a priority to find a medical professional who can diagnose your child. Children with depression and autism aren’t always correctly diagnosed, which means their depression can go on for years without ever being recognized or treated. You want to avoid this at all costs, so find a doctor with a good reputation and experience with patients like your child.

After seeking medical help, it’s important to consider the options your doctor gives you carefully. Medications can sometimes have adverse effects on autistic people, and they don’t always work as intended. You will need to decide whether it’s worth it to give medications a try, depending on what your doctor recommends. You might be given a few different medications to try over the course of several months to find one that works.

Next, one of the most important things you can do for your child is simply to watch them closely. Try to keep track of their activities without becoming a source of frustration to them. If they become involved in behavior that brings harm to them or anyone else, you need to know about it so you can take appropriate action quickly. Even more important, your child needs to feel like you’re present that you care for them. Taking interest in them and what they’re doing, and being there when they need support (whether they voice this need or not) is critical to any child’s wellbeing.

Keep track of changes in your child’s behavior, appetite, and sleep patterns. It may be difficult to tell what they’re thinking or feeling most of the time, but you can at least take note of what they’re doing. This is especially important if you’ve put them on medication for depression. Some autistic children will act out or experience aggressive tendencies as a result of certain medications. You will want to monitor your child so you notice any negative behavior, and whether their condition seems to be improving with the medication.

Especially keep a close eye on your child if they’ve ever displayed suicidal tendencies in the past. While suicidal tendencies could technically become a problem at any time, if it’s something you feel may be an issue already, you should definitely watch out for such signs showing up again.

Even though the medical community has some catching up to do when it comes to autistic people with depression, we’ve already come far enough that help is well within reach of those who look for it. Above all, never lose faith in your child, and commit to helping them have the best life possible. Besides being the best thing a parent can do for their child, it just might save their life.