How Do People With Autism Spectrum Disorder Experience Depression? Signs And Symptoms

Medically reviewed by Corey Pitts, MA, LCMHC, LCAS, CCS
Updated April 17, 2024by BetterHelp Editorial Team

Imagine navigating a world where the ordinary becomes extraordinary — a world where the rhythm of daily life dances to a different beat. In this world, individuals with autism spectrum disorder (ASD) face unique challenges and celebrate remarkable strengths.

Recent studies indicate that individuals with autism are four times more likely to have depression compared to the general population. As many as 40% of adults with autism are diagnosed with depression at some point in their lives. Though many of the symptoms of ASD and depression may seem similar, they’re two distinct conditions that require specialized treatment.

By gaining insight into these mental health challenges, we can offer more impactful support and understanding to Autistic individuals who may be silently living with depression. This article explores the relationship between autism and depression, including how to recognize signs of depression in someone with autism and strategies for managing it.

Depression can present differently in autism spectrum disorder

Understanding autism spectrum disorders

Autism spectrum disorders are developmental disorders characterized by a range of challenges in social interaction, communication, and repetitive behaviors. They affect both children and adults, with varying degrees of severity.

Autistic individuals often possess unique strengths and talents but may face specific difficulties navigating the world around them. Learning, flexibility, attention to detail, communication, and social skills may all be affected.

Though each person with autism has a unique experience of the condition, many individuals share similar traits and symptoms. These may include repetitive movements or speech patterns, difficulty understanding others' emotions, intense focus on one item or activity for extended periods, impaired eye contact, and avoidance of social activities.

Differences in the experience of depression in individuals with ASD

Research from Frontiers in Psychiatry has shown that depression and anxiety are commonly experienced by people with autism, with rates significantly higher than those seen in neurotypical peers. It’s often helpful to recognize that these conditions aren’t merely byproducts of the challenges posed by the disorder but rather distinct and significant mental health concerns that warrant attention and support.

People living with autism may experience depression differently than their neurotypical counterparts. While the core symptoms of major depression may manifest similarly, there are unique challenges that individuals with neurodivergence may face, which can influence the expression and experience of depressive symptoms. Recognizing and understanding these differences may help provide appropriate support and interventions.

  • Emotional symptoms: People with autism may have difficulty identifying and expressing their emotions, making it challenging to communicate their depressive feelings. Instead of openly expressing feelings of sadness or hopelessness, they might exhibit irritability, increased sensitivity, or emotional meltdowns.
  • Behavioral manifestations: Individuals living with autism and depression might demonstrate changes in behavior and routines. They may become more withdrawn, losing interest or pleasure in previously enjoyed activities. Additionally, they may experience difficulties with sleep, appetite, or self-care routines.
  • Cognitive symptoms: Cognitive symptoms, such as poor concentration or indecisiveness, can further compound the challenges faced by Autistic individuals who are also experiencing depression. Moreover, they might have greater difficulty interpreting social cues, which can lead to further isolation and distress.
  • Physical symptoms: Headaches, stomach pains, and fatigue are common physical symptoms of depression — yet they may be overlooked or dismissed as side effects of autism. 

The importance of differentiating ASD and depression symptoms

Identifying depression in individuals with autism can be particularly challenging due to overlapping symptoms and communication difficulties. Many of the symptoms of ASD, such as social withdrawal, reduced eye contact, and diminished verbal communication, can mimic depressive behaviors.

Differentiating between the core symptoms of ASD and the presence of co-occurring depression allows for targeted interventions and prevents potential misinterpretation or neglect of depressive symptoms.

Treatment for depression in people with autism should be individualized, considering their unique needs and challenges. A multidimensional approach that combines psychotherapy and supportive interventions may effectively address both the symptoms of autism and depression.

Employing comprehensive assessment tools and strategies to ensure accurate diagnosis and appropriate support can be beneficial. Some people with ASD may struggle with effectively communicating their emotions, which can lead to underreporting or misrepresentation of depressive symptoms. 

Existing assessment tools may need to be adapted or supplemented to account for the unique characteristics of autism. For example, incorporating visual supports, simplified language, or alternative response formats can enhance the accuracy of depression assessments for Autistic individuals.

Understanding the complexities of the relationship between ASD and depression can help ensure that those on the autism spectrum receive the care and treatment they deserve. With further research into how ASD influences mental health conditions like depression, we can create more effective management strategies.

Strategies for supporting individuals with ASD and depression

Supporting individuals living with autism and depression often requires a holistic approach that encompasses their social, emotional, and sensory needs. As we explore ways to support Autistic people living with depression, it may help to consider the impact of environmental factors and tailor strategies to each individual.

  • Creating supportive environments: The home and school environment can play a significant role in managing depression among individuals with ASD. Establishing routines, creating clear expectations, providing structure, and promoting social engagement are ways caregivers or educators can help foster an emotionally secure space for those on the autism spectrum.
  • Promoting self-expression: Offering augmentative and alternative methods of communication can encourage those with autism to share their feelings and experiences. Visual supports like picture cards or social stories may help them communicate more effectively. Role-play activities and other sensory interventions can further enhance self-expression and improve emotional regulation.
  • Facilitating connections: Building relationships can help manage depression among individuals with autism. Encouraging social engagement with peers, family members, or mentors can help prevent isolation and provide emotional support.
  • Addressing sensory needs: Sensory needs vary from person to person. Considering the individual's sensory preferences can help when managing depression. Providing a calming environment, controlling noise exposure, and engaging in activities that promote relaxation can help those with ASD regulate their emotions.
  • Encouraging communication and self-advocacy: Dispelling the stigma around mental health can help individuals with autism and depression feel more comfortable sharing their feelings. Developing practical communication skills and teaching them how to advocate for their needs may also improve the quality of life for those on the ASD spectrum who are experiencing depression.

By understanding the complexities of how depression may manifest in individuals with autism, we can develop targeted strategies to support them. With comprehensive interventions and dedicated resources, we can help those on the ASD spectrum achieve improved mental health outcomes and increased well-being.

Getty/Xavier Lorenzo
Depression can present differently in autism spectrum disorder

Manage depression symptoms in online therapy

Online therapy through services like BetterHelp can offer a safe and supportive space for individuals with autism and depression to receive care. With online psychological support, they can identify their needs and develop coping strategies to manage their mental health successfully. Additionally, the online format may also reduce anxiety and sensory overload.

According to a 2023 Frontiers in Psychiatry study, online therapy may be as effective as in-person therapy for individuals with depression. Studies have shown significant improvements in depressive symptoms and quality of life following participation in online therapy programs. Through online therapy, clients can use evidence-based interventions such as cognitive behavioral therapy (CBT), which has shown success in treating the symptoms of major depressive disorder.

The prevalence of depression among people with ASD highlights the need for increased awareness. Comprehensive assessments, tailored interventions, and dedicated resources can help people on the autism spectrum receive the care they need to manage their mental health effectively. With an understanding of the unique challenges faced by individuals with autism and depression, we can ensure that those on the ASD spectrum receive the support they deserve.


Understanding the intersection of ASD and depression can be necessary for providing meaningful support to Autistic people. As we expand our knowledge in this field, it’s beneficial to advocate for increased research and resources that focus on the mental health needs of individuals with autism.

While people may experience the symptoms of depression differently, varying by age and degree of impairment, the core elements remain largely the same. By working together, we can create a world that embraces and supports the diverse experiences of autistic individuals, fostering their overall well-being and empowering them to thrive.

Online therapy may offer a more effective solution for treating the symptoms of depression in individuals with ASD.

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