Tag Archives: depression

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Resources for Depression and ASD: Now that we know, what do we do?

Depression is more frequent in those with AS than the general population, and the struggles of those with AS often contribute to the development of depression. The obvious question is, what resources are available and what do we do? First, we should not accept depression as just a normal part of AS, especially if it’s interfering with everyday life. Secondly, we need to recognize the symptoms to help as early as possible. And lastly, we need to research the supports that are available – how you can help yourself or others right now – and what resources still need much improvement so that you can call upon action in your community.

Being aware of the symptoms of depression is critical:

  • sleep difficulties, either sleeping more or less (insomnia, early morning waking);
  • changes in appetite (either more or less hunger);
  • weight gain or loss;
  • a failure to enjoy normal sources of pleasure;
  • difficulty concentrating;
  • sadness, guilt or hopelessness;
  • crying or unusual irritability.

Someone who is clinically depressed sees the world in the above ways each day. It’s important for the individual or those around to seek professional help.

Medication can help many with depression, as can Cognitive Behavioral Therapy. Although CBT is a slower process with AS individuals and needs to be adapted to their thought process. Some studies suggest neurobiofeedback can be helpful with depression and there are a few early studies of its use with ASD patients. For those who prefer to avoid medication, this is certainly worth exploring. It is best to come to your medical sessions with the knowledge of various treatments so that you can be prepared to discuss what is best for you.

It’s important to think about addressing the factors that can result in depression.

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Asperger’s, Depression and College Students

Depression is most common in adolescents and young adults with Asperger’s, and particularly in those with stronger intellectual and verbal skills. That means college students with Asperger’s are at a very high risk for depression. This is particularly true for freshmen, who are transitioning to the college experience. Although I’ve seen this in later years as well when students are dealing with more challenging classes, social issues, and upcoming graduation as triggers.

Let me tell you about one college student’s experience with depression:

Franklin went off to a good college based on his excellent academics in high school. However, he’d been provided with executive function scaffolding all through high school. His parents and a teacher had helped him organize his time and initiate his work. The school counselor and his parents had feedback from teachers if he was falling behind on assignments.

In college, he was on his own.

He was supposed to check in with the disability office, but he resisted being seen as needing help. Franklin had challenging classes and had taken on a very full load of five classes; he had always set his standards and expectations of himself very high. Franklin began falling behind in writing papers for his English literature class because writing was difficult and he wrote slowly. His effort was going into writing, so he fell behind on the reading. He tended to procrastinate as the pile of work grew. Franklin was embarrassed at being behind, so he stopped going to English. He also was stressed by feeling at a loss in terms of the 24/7 social demands.

As you might expect, all of this stress was a trigger for depression. In Franklin’s mind, one was either a success or a failure, and he was a complete failure.

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What are the Main Causes of Depression for Those with Asperger’s Syndrome?

Why are there higher rates of depression in those with AS? There may be some genetic predisposition to depression for some, but this doesn’t explain most cases of depression. One reason for depression is isolation and loneliness. Despite the misconception that people with AS prefer being alone, research shows that many with AS want friends. Children and teens with AS are often lonely and feel their friendships aren’t “quality.” They’re looking for company, safety and acceptance to give them a sense of confidence. Those who have friends may have a lower tendency towards depression. However, many with AS who experience social anxiety or lack social skills in joining, starting, and maintaining friendships don’t have the tools to have the friends they want.

Another reason for depression is the experience of being bullied.

Studies have suggested that a majority of those with AS experience bullying. This isn’t surprising given the drive towards conformity and the emphasis on social status among middle school children in particular, but also among high school students and even older individuals.

There isn’t a cultural norm of tolerance of neurodiversity, or even of most kinds of diversity.

Qualities of those with AS that engender bullying are

  • lack of awareness of social cues;
  • cognitive rigidity;
  • interests or behavior labeled ‘odd’;
  • and hypersensitivity.

AS individuals have difficulty flexibily and astutely responding to bullies. Some with AS tend to be submissive and anxious in response, which empowers bullies to continue. Still others lash back, which gets them in trouble.

In my own practice, my Asperger’s teenagers and young adults have often been bullied and carry the wounds of bullying deeply ingrained in their sense of self-esteem.

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Easing the Mind and Relaxing the Body, Yoga as a Practice for ADHD

Attention deficiency can become a barrier for many things to many people. Children diagnosed with Asperger’s Syndrome often times are also diagnosed with Attention-deficit/Hyperactivity disorder and may have a hard time concentrating in class, have a hard time sitting still during dinner, or may lack consistency. Adults diagnosed with ADHD may struggle with organization at work or home.

Silhouette of a beautiful yoga woman at sunset (in surreal colors)

ADHD is defined by the Mayo Clinic as a chronic condition that affects millions of children and often persists into adulthood. ADHD includes a combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Besides proper medication, practicing Yoga can be another support to help ease the mind and relax the body.

Yoga is an ancient art based on a harmonizing system of development for the body, mind, and spirit. Practicing yoga can help in slowing down the mind, relaxing the body, and becoming aware with your immediate present. In other words, for someone whose mind is racing, has a difficult time concentrating, and has extra energy, yoga can be a good support to help in reducing these emotions.

The question is how do I even begin doing yoga? Well, get ready because here are your first 3 steps into beginning your journey to calmness and relaxation!

Beginner’s Steps to Yoga

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Seeking Help For Depression with Aspergers: The Specifics

If you have: lost interest in your usual activities; trouble sleeping, wake up early or sleep all the time; a change in appetite (more or less); withdrawn from people with a down mood (for Aspies it might be sad, irritable or a sense of hopelessness – whatever negative mood or thoughts you recognize), you have what we call major depression.

Depression, Aspergers, Help, Resources

For this, you probably need professional help. Things are not hopeless but being depressed is like looking through dark glasses. While people with Asperger’s are prone to depression because of challenging life experiences, clinical depression is not part of Asperger’s Syndrome and usually responds to treatment. For those struggling with lower level depression, you might still consider therapy to look at ways to make life changes and feel better.

Professional Help

For finding professional help and other resources, Autismsource.org is a gold mine of resources including lists of local therapists in your area.

Online directories:

Psychologists, social workers, psychiatrists, advanced practice registered nurses (APRN), and other specialties all can provide therapy. Individuals should be licensed providers in their states. You can find this information by looking at their websites.

Only psychiatrists, other MDs (medical doctors), and APRNs can provide medication. Medication has been demonstrated to be effective in treating depression. Often a combination of medication and therapy are most useful. The form of therapy most recommended is CBT (cognitive behavioral therapy). MBCT (mindfulness-based cognitive therapy) has been shown to be effective for depression although there isn’t research on it with people on the spectrum. Most therapists specializing in working with those with ASD know how to modify traditional CBT to best work with those on the spectrum.

It can be very challenging, certainly in parts of the US, to find therapists who take insurance.

The prevailing cost of therapy varies widely across the country. Some therapists (usually psychologists) offer sliding scale fees or have some lower fee slots, so it’s worth calling and asking. Clinics generally take insurance but you want to be sure that the therapist is familiar with ASD. The first thing you should do is call the number for patient or customer service on your insurance card and ask for a list of providers (psychologists/psychiatrists/social workers) in your area. This way you can know all the providers near you who are in network with your insurance plan before you call around clinics. In network providers have more affordable rates than out of network providers. It is important to inform yourself about your insurance plan and coverage before you begin the search.

Also, check providers with Medicaid if you have it. Any MD or APRN will know about treating depression with medication. Some therapists who accept Medicaid might be experienced with ASD even if they’re not on a directory for ASD.

Self Care Strategies

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Is Mindfulness Logical for Asperger’s and Depression?

Mediation and Self-Talk

Mindfulness, meditation and self-talk are important ways of helping yourself when you’re depressed, stressed out, anxious or emotional. They’ve been shown to help handle feelings and are actually often used as components of the most helpful forms of therapy, cognitive therapy.

Why is it important to talk about these three techniques, especially for those with Asperger’s?

Two typical traits for those with Asperger’s are black and white thinking and a tendency to ruminate, to stew thinking about something. With black and white thinking, we see things in extremes, all bad or all good. When we’re depressed, that tends to be all bad.

Mindfulness, Meditation, Self-Talk

All bad isn’t realistic; life is always a mix. Things don’t always go wrong. People aren’t always hostile or rejecting. Ruminating means dwelling on something, usually negative when we’re depressed. As we dwell on our thoughts, they tend to become more dramatic, more overwhelming, more conclusive of our negativity. It’s like a downward spiral.

Both black and white thinking and rumination focus on the past, revisiting what has happened, or in the future, anticipating what might happen. We’re rarely in the present. Most often, at this exact moment, nothing too stressful is happening.

The point of mindfulness as an outlook, a way of being, is that it focuses on the present moment – our awareness of what’s happening right now.

Mindfulness exercises include activities that force us to focus on the here and now. Focus can be on attending to our breath, what we hear, bodily sensations, or what we’re doing, like the feelings of washing dishes, the soap on our hands, the feeling of the water, the texture of the plate and glass. This pulls us out of the past and future into the present, which tends to be calmer.

Meditation is a practice for both the body and mind.

When we’re emotionally aroused or stressed, our entire autonomic nervous system is activated. Blood pressure goes up, breathing changes, stress hormones race through our bodies, and every system is affected.

We can be stressed in this way both by what goes on in the moment and by what goes on in our minds – thinking about something can trigger the same physical stress response as being in that moment. Emotionally we’re at a high level of arousal, regardless of what’s happening in the moment. Meditation turns off the stress response, and teaches our bodies what Herbert Benson of Harvard calls the “relaxation response.” Meditation has actually been scientifically proven to structurally change the brain to be more stress-resilient.

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Three Necessities for the High Functioning Autistic to Combat Depression

If you are a High Functioning Autistic (HFA), the odds are troublingly high that you also suffer from some form of depression. As someone who suffers from depression myself, I’ve spent a great deal of time thinking about how to find happiness when you struggle with the burdens of having an autistic brain. One possibility for the prevalence of depression in autistic brains is that HFAs, for reasons distinct to their neurological condition, are innately more likely to feel depressed.

My sense, though, is that we tend to be depressed because life is difficult for us in ways that are somewhat different from the experiences of the Neurologically Typical (a satirical term for non-HFAs). As such, any discussion of why HFAs tend to be depressed must be approached as a social justice issue, with a clear statement of ethical axioms that, if followed, would help HFAs and non-HFAs alike.

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Are You an Aspie and Depressed? That’s Not Unusual

Asperger’s Syndrome and Depression: Part 1

As most teens and adults with Asperger syndrome know, people with Asperger syndrome can be significantly depressed. The rates of diagnoses of depression vary among studies, from 18% to 22%. The most commonly quoted rate of a depression in the general population of the US  is 6.7%. Most of the research shows both genders have these high rates of depression.

Studies focused on males and females and not those who are transgender. There are more people who identify as transgender in the AS population than in the general population and transgender people have a higher rate of depression. One would guess that someone who is both AS and transgender might have a high tendency towards depression.

Interestingly, non-autistic full siblings and half-siblings of individuals with ASD (not just Asperger syndrome) also had higher rates of depression than the general population, although at half the rate of those with ASD. Studies of suicide attempts are also very troubling. In studies of suicide, the rate of suicidal thoughts and attempts are prevalent, especially in adolescence and young adulthood.

It’s critical to identify depression, since it can be treated.

It’s obviously important to understand why rates of depression and suicidal thoughts are so high. One factor, given the findings in siblings, is that there is an increased genetic vulnerability to depression, although large studies haven’t supported a common genetic overlap. We have to look to other factors to account for these high rates of depression.

It’s important to diagnose clinical depression for anyone for a simple reason – depression is treatable with a variety of modalities:

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Living with a Roommate to Counteract Isolation and Depression

Learning Independence and Community

Many factors play into a person’s mental health. Communication styles can even be tied into mental health. Having roommates that you must learn to communicate with on a regular basis can be a helpful treatment for depression and isolation. Having roommates can also offer the opportunity for learning valuable social skills that living alone would not. Learning how to live with someone else is an important step in development. Both independence and community involvement go hand in hand for successful living skills, especially for those with ASD.

Roommate, Aspergers, Depression, Adulthood

I began working with a young man I will call Buddy to work on social skills and making connections with others. Buddy recently moved out into the community for the first time and was provided a roommate with a similar profile.

Buddy has lived most of his life in a rural area and was able to remain in his room for long periods of time playing video games. He often had thoughts that would provoke a tense look on his face and he would start punching in the air. Buddy is an extremely kind and gentle young man, however this characteristic causes others to get concerned.

The first step that took place was a dinner with the new roommate so that they could get acquainted with each other.

During this time the two were asked to turn off their phones and openly talk to each other. Buddy is very quiet and his new roommate is very social and does not do well with confrontation. The two were asked open ended questions. Buddy would answer the questions, but his answers were short. His roommate had long animated answers. Despite these communication differences they seemed to get along well. After dinner they were asked to exchange phone numbers since they were going to live together and would be relying on each other.

Buddy will not mention that he gets depressed or anxious but his body language will show it.

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Suicide Prevention for Those with Aspergers: Understanding Common Triggers

As dramatic as it may sound to some, the challenges aspies face can lead them to have countless reasons to give up on themselves and their lives. This can often lead to thoughts of suicide and attempts, too many of which are successful. Bullying, grave misunderstandings, absent and abusive relationships of any kind, long-term unemployment, and mental illness are all common reasons why suicide occurs among aspies.

suicide prevention

Aspies often tend to keep quiet about their troubles, typically under the belief that no one will truly understand what they experience; not only in a given environment, but also in their mind. Therefore, even though an aspie appears happy and productive in their life, they can still anonymously harbor difficult thoughts and emotions; sometimes until it is too late.