Autism and Depression – How Can We Help?

Tom Asks

We have a 24-year-old son, Alfred, who lives at home. He was diagnosed with autism at 17 and also experiences depression. He’s tried medication and therapy in the past, but hasn’t found a good fit with any of the professionals he’s seen.

He successfully completed elementary school, high school, and earned a bachelor’s degree. Currently, he isn’t taking any medication, and frankly, he’s not doing well. He’s adamant about not wanting to try medication or seek professional help again, feeling it hasn’t been effective for him.

Our biggest concern right now is that he consistently says he’s unhappy – although he does laugh occasionally – and believes this is simply how things will always be. He’s deeply worried about the future.

We believe he might benefit from medication to help improve his mood, and we were hoping he could connect with someone like you, someone who understands his experiences and has found a way to feel happy and hopeful.

What advice can you offer us as parents? We’re trying to reach him, but it feels like we understand what he needs, and he’s unwilling to take any steps to address it. He spends a lot of time in his room, lost in thought. We want more than anything for him to be happy and have a more positive outlook on life. He does have a good circle of friends, but even that doesn’t seem to be enough.

Paula Responds

I understand your concern. Since he’s made it clear he doesn’t want professional help, I think the best approach is to respect his decision rather than try to convince him otherwise. I’d suggest focusing on listening to him and validating his feelings, instead of arguing with him. Saying things like, “You have nothing to be sad about, you have such a wonderful family and friends,” can actually make him feel more misunderstood, as if no one is taking his feelings seriously.

Understanding His Feelings

Instead, show genuine curiosity about what he’s going through. Let him know you want to understand his struggles and offer support. Encourage him to share what’s causing his depression, and acknowledge his feelings without dismissing them. Avoid saying things like, “Oh, everyone feels that way sometimes,” which can come across as insensitive. It’s also perfectly okay if he can’t fully articulate why he’s feeling down. Never pressure him to seek help if he’s not ready. Some people are hesitant to let their parents interfere, so allow him to decide how much he wants to share.

Medication or Lifestyle?

I also wonder if medication is the only answer, or if it might be more helpful to focus on adapting his life to better suit his needs and promoting self-acceptance. If someone hasn’t managed to adjust their lifestyle, expectations, and demands to accommodate their autism, it can contribute to depression, as they may be living in a way that simply doesn’t fit. I’m not saying he doesn’t need medication – sometimes it is necessary – but it’s worth considering.

Still Feeling Down

When I was struggling with depression as a young adult, I took antidepressants for years, but didn’t experience much improvement. What finally helped me break free was realizing I didn’t need to conform to other people’s expectations, and that I had the right to live my life as I choose. It’s not essential to have a bustling social life, and it’s okay to lower expectations at work and accept help from support workers. It’s also fine to not share everyone’s interests and instead focus on the things you genuinely enjoy – what are known as “special interests.” Looking back, it seems strange that I tried to “medicate away” my body’s signals that my life wasn’t right for me, but I didn’t realize that at the time!

What Would a Good Life Look Like?

You could ask him what it would take to make him feel better. What would his ideal life look like? Sometimes people have more options than they realize. Of course, you can’t have everything you want, but perhaps he needs to move to a different city, change careers, or apply for disability benefits. The psychologist at the rehabilitation center helped me understand that I had more choices than I thought. And even if I couldn’t get exactly what I wanted, I could still create a life that suited me.

Connecting with Others

I understand he’s reluctant to talk to a therapist, but is there anyone outside the family he might be willing to connect with? Perhaps he could apply for a peer support worker through LSS (a social services organization)? Or would he be open to meeting other autistic people? Unfortunately, I’m only available for lectures, not one-on-one coaching, but he might benefit from connecting with other thriving autistic individuals in a support group. It could be inspiring for him.

Medication Options

If he does change his mind about seeking help, remember that the therapists he’s seen in the past may not have had enough experience with autism. It can be difficult for an autistic person to find a therapist who truly understands them! CBT doesn’t always work, so it’s important he finds someone who can provide the right support. If medication does become an option, remember there are different types to try, as not every medication works for everyone. Some people don’t respond to SSRIs but feel much better on SNRIs.

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Book Me

Please reach out to me via the contact form if you’d like to book me for a lecture on autism or an interview about my life with autism. You can find more information about me and my lectures here.

Don’t be afraid to reach out for help if life feels hopeless! Here’s a list of helplines and phone support services in the US you can contact if you need assistance. For people outside the US this page lists helplines for people in need of immediate mental help support during a mental health crisis.

Diet and Wellbeing

As odd as it may sound, I’ve found that a healthy diet can also contribute to mental wellbeing. I’ve noticed I become depressed if I eat poorly for a prolonged period. For example, if I don’t get enough healthy fats, I feel unwell, both physically and mentally. I’m not saying that simply eating healthy is a cure-all, or that all problems will magically disappear if you cut out junk food and address any vitamin or mineral deficiencies, but in my experience, it can help. It might be worth a try!

The Benefits of Exercise

Furthermore, research has shown that physical activity can help with depression, and the effect on mild to moderate depression is comparable to that of antidepressants or talk therapy (though exercise isn’t sufficient for severe depression). It’s worth considering! Some people find jogging more helpful than walking, but it’s good to experiment. I understand it can be difficult to exercise when you’re depressed, and you should never force anyone. But it might be helpful to mention it to him, as many people aren’t aware of this.