How can we better recognise depression in autistic adults?

Depression can involve familiar indicators, but autistic adults may describe or experience depressive symptoms in ways that are not always recognised.

This website shares findings from three connected PhD studies examining how depressive symptoms are reported in existing research, described by autistic adults and supporters, and identified by psychologists.

What the research found

1. Depression can involve more than sadness

Autistic adults described anger, irritability, hopelessness, despair, emotional emptiness and numbness. Sadness was not always the predominant experience.

2. Continuing an interest does not always mean it remains enjoyable

Some participants described continuing their usual interests despite experiencing less enjoyment, emotional reward or connection.

3. Depression can affect thinking and everyday functioning

Participants described brain fog, difficulties concentrating, slowed thinking and difficulties initiating tasks. Some also experienced profound fatigue and physical heaviness.

4. Worthlessness may involve feeling like a burden

Participants described feeling defective, believing everything was their fault or perceiving themselves as a burden to others.

5. Suicidal thoughts may be intense or escalate suddenly

Some participants described suicidal thoughts in a direct or matter-of-fact way, despite severe distress. Others reported sudden episodes of intense hopelessness and rapidly escalating suicidal thoughts, which they called 'depression attacks'.

6. Changes in autistic characteristics may accompany depression

Participants and psychologists described changes in communication, sensory experiences, routines, focused interests, stimming and social engagement.

These findings do not suggest that all autistic adults experience depression in the same way, or that these indicators alone establish a diagnosis. Understanding changes from a person's usual experiences may help inform recognition and assessment.

Explore the research