Compared to the general population, people living with autism are four times more likely to experience depression. This might be due, in part, to the stress of living in a neurotypical world, along with some other shared risk factors.
Symptoms like a flat affect or social withdrawal could indicate the presence of autism, depression, or both. This can make it difficult to receive an accurate diagnosis.
Many of the depression treatments used with non-autistic people can be used for people with autism. However, it’s important that these treatments are delivered by a provider who can modify them effectively.
Depression is one of the most common mental health conditions in the U.S. Recent data shows it affects over 8% of adults age 18 and older. However, for people living with autism spectrum disorder (ASD), or autism, this rate is estimated to be nearly four times higher.
Depressive symptoms can manifest differently in people with autism, so getting an accurate diagnosis can be a challenge. Left untreated, depression can worsen over time and lead to significant challenges in daily functioning.
But fortunately, researchers are working to create new tools to identify depression in people with autism. It’s hoped that through increased awareness and new options for specialized care, more people living with autism can access the mental healthcare they need.
Why depression is more likely in people with ASD
We don’t yet have a full understanding of the relationship between autism and depression. But to better understand the connection, it might be helpful to examine some of the symptoms these conditions share, including:
Depressed mood
Challenges with social communication
Frequent worry
Diminished sense of mastery, or not feeling in control of one’s life
Difficulty coping with stress
Flat affect, or a lack of expressiveness
Social withdrawal
Technically, if a person has these symptoms, it could be a sign of depression, autism, or both, depending on other factors. But it’s important to remember that autism symptoms like flat affect or social difficulty don’t automatically indicate depression.
We can’t assume that a person’s outward appearance or communication style directly correlates with their inner experience. This is one of the reasons why it’s so important that providers use specialized tools to screen for mood disorders like depression when working with autistic people.
There’s no established causal relationship between depression and autism. But it’s worth mentioning that the stress of being a neurodivergent person in a world designed for neurotypical people can have an effect on mental health. For example, a person with autism may have a hard time “fitting in” with their peers. Feeling like an outsider can lead to increased worry and stress and put a person at greater risk for depression.
Genetics also may help explain why autism and depression co-occur so frequently. Evidence shows that both depression and autism tend to run in families. So, you may have a greater likelihood of developing one or both conditions if you have a close relative who lives with them.
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What depression looks like in autistic people
People living with autism and depression experience many of the same depression symptoms as non-autistic people. These include:
Persistent sad, anxious, or empty mood
Feelings of hopelessness and worthlessness
Irritability, frustration, or restlessness
Fatigue
Sleep problems
Changes in appetite or weight
Loss of interest in activities or hobbies
Trouble with focus and concentration
Difficulty making decisions
In addition to these symptoms, people with autism and depression may be more likely to exhibit:
Social withdrawal
Reduced emotional or behavioral regulation (i.e. more meltdowns)
Increase in compulsive or repetitive behaviors
A shift in interest, specifically toward thoughts of death or dying
People living with co-occurring autism and depression may also be at greater risk for experiencing something called autistic burnout. Autistic burnout is caused by intense and ongoing stress brought on by a mismatch of expectations and abilities without adequate support. It typically lasts over three months and leads to exhaustion, loss of function, and greater sensory sensitivities.
Again, some of these symptoms mirror those associated with depression, emphasizing the importance of working with a provider who can identify the underlying causes and provide support that accurately reflects your experiences. In addition, depressive symptoms can evolve across the lifespan. Children and adults may need different forms of support for autism and depression.
Because autistic burnout and depression can look similar, it's important to work with a provider who can identify the underlying cause of your symptoms and recommend the most appropriate treatment. Children and adults may also experience depression differently, so support should be tailored to each person's needs.
*A note on safety: If you’re having thoughts of harming yourself, don’t hesitate to ask for help. Dial 988 from any phone to contact the National Suicide and Crisis Lifeline. Their counselors will provide confidential support and resources to help keep you safe.
Can autism cause depression?
No. Autism doesn’t directly cause depression. However, autistic people are more likely to experience depression than the general population.
Researchers don’t yet know exactly why these conditions occur together so often. Current evidence suggests it’s likely due to a combination of biological, psychological, and environmental factors rather than autism itself.
Some factors that may increase the risk of depression include:
Chronic stress from navigating a world designed for neurotypical people
Social isolation or difficulty building supportive relationships
Bullying, discrimination, or feeling misunderstood
Masking autistic traits to fit in with others
Shared genetic and biological factors that may increase the likelihood of both autism and depression
Why depression gets mistaken for autism
Depression and autism can sometimes look similar from the outside, making it difficult to tell them apart. For example, both can involve social withdrawal, changes in emotional expression, reduced interest in activities, and difficulty with communication.
The difference is that autism is a lifelong neurodevelopmental condition, while depression is a change from a person’s usual way of thinking, feeling, or behaving. A mental health professional will look at when symptoms began and whether they’re new or represent a noticeable change.
For example, an autistic person who has always preferred spending time alone may not be experiencing depression. But if they suddenly lose interest in favorite hobbies, become more withdrawn than usual, or seem persistently sad or hopeless, depression may be contributing to those changes.
Because autism and depression often occur together, it’s important to work with a provider who has experience assessing both conditions. A thorough evaluation can help identify whether symptoms are related to autism, depression, or both so you receive the most appropriate support.
Five tips for dealing with co-occurring depression and autism
If you’re living with co-occurring depression and autism, know that there are things you can do to advocate for yourself and manage your symptoms.
First, begin familiarizing yourself with the signs of depression. As we’ve discussed, these can be mistaken for symptoms of autism. So, the more information and detail you can give your therapist about what you’re experiencing, the easier it’ll be for them to provide an accurate diagnosis. We recommend taking notes on your symptoms in a journal or on your phone. That way, it’s easier to keep track of changes and share them with your provider.
From there, your therapist can create a treatment plan that reflects your unique needs and any other co-occurring conditions you’re living with. Many depression treatments used for non-autistic people can be used for people with autism. However, these treatments must be delivered by a provider who can modify them effectively. Depending on the severity of your symptoms and your exact diagnosis, you may benefit from a combination of talk therapy and medication.
In addition, the following self-care strategies can help you strengthen your mental health and navigate the symptoms of co-occurring depression and autism:
Expand your support network. Whether it’s talking to a friend, family member, or a support group, sharing your experiences can help you feel less isolated and alone.
Find a group activity. Think about the hobbies and interests you most enjoy. Look for ways to build connections with other people who share your passions.
Prioritize your physical health. Getting plenty of rest, eating a balanced diet, and staying hydrated are good for your body and your mind.
Go outside. Even if it’s just a quick walk around your neighborhood, leaving your house can boost your mental health.
Get moving. Making time for movement you enjoy can help you manage stress and improve your mood.
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The societal pressure and standards that have been created by a neurotypical society can be difficult for a neurodivergent person to meet. If a person with ASD is unable to meet these expectations, it can impact how they view themself.
Ashley Ayala, LMFT
Clinical reviewer
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If you’re living with co-occurring autism and depression, know that you’re not alone. Managing your symptoms can be challenging, so it’s important to find treatment that reflects your unique preferences and needs. With an accurate diagnosis and care plan, your provider can help improve your mood, daily functioning, and quality of life.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Ashley Ayala, LMFT
Ashley is a Licensed Marriage and Family Therapist who specializes in generational healing and family dynamics. Ashley has worked in schools, clinics, and in private practice. She believes that people’s relationships, including our relationship with ourselves, greatly shape our experiences in life.
Ashley is committed to empowering others to show up authentically and deepen their self understanding. This passion stems from taking a critical lens on her own life story and doing inner healing. One of her favorite quotes is “Be yourself and the right people will love the real you.”
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