Be faithful in the small things because it is in them that your strength lies.” Mother Teresa
Sadly, our world lost a talented and gifted individual. Robin Williams was a dynamic individual who brought much laughter and joy to us. Unfortunately, he silently suffered with severe depression and Monday he surrendered to the depression.
This brings me to the topic of depression in teens, autism, Asperger’s, and those on the spectrum. Depression is a debilitating condition that often causes physical symptoms, socially impacts the sufferer, and is emotionally overwhelming.
For teens, isolation is a ripe environment for depression to grow. Teens struggle to speak out for help, recognize the signs of depression, and tend to fear peer judgment. For teens with autism and Asperger’s communication challenges add an additional element. Individuals on the spectrum do not lack feelings and emotions. Rather they struggle to articulate and communicate feelings. Most individuals on the spectrum also view life in concrete and literal terms. This may mean the teen with autism or Asperger’s may mislabel depression for “sadness”. The non-verbal may select the emotion identifier (faces with emotional expressions) as “sad”.
Difference between Depression and Sadness
Kids Health describes depression as lasting for weeks, months, or longer. It is feeling hopeless, alone, self-abuse, isolation, and loneliness. Depression can have physical symptoms: weight loss, loss of sleep, stomach pain, diarrhea, and illness.
Sadness is described as a brief, normal emotion felt by everyone. It lasts minutes, hours, or a few days at most. Often sadness is associated with a loss or disappointment. It does not cause physical symptoms, despondence, or lose of interest in family and friends.
Watch this YouTube video to hear real experiences with depression.
Depression on the Spectrum
According to the National Autism Society, 65% (1 in 15 teens) of those on the spectrum suffer from depression or anxiety during late teen and early adulthood.
Teens on the spectrum struggle with social acceptance, emotions, self-expression, self-esteem, teasing, bullying, academic struggles, and additional challenges. Many of these challenges are the same as those facing average teens; some challenges (such as communication or behaviors associated with the spectrum) are different. In particular, communication challenges can create a difficult situation for the teen and young adult to identify an emotional need and communicate it to the appropriate people.
Those around the teen, such as a parent, caregiver, teacher, psychiatrist, doctor, and therapists must continue to look for signs of depression. It is the responsibility of family members to work with a team to help a teen with autism or Asperger’s receive the help he or she needs to address the depression, express the emotions, and treatment.
Signs of Depression
- Poor concentration and memory
- Thoughts of death, suicide
- Self-harm – cutting, hitting, scratching, and biting
- Tearfulness, crying for prolonged periods
- Withdrawn more than usual, difficult to draw out
- Tired, sleeping, napping, doesn’t want to get out of bed
- Disinterest in normally enjoyable tasks
- Agitation, anger
- Difficulty sleeping (more than usual)
- Hopelessness – verbal or non-verbal (i.e. drawings) of despair, hopelessness, despondence
- Development of or increased incidents of obsessive compulsive behavior
- Periods of mania
- List courtesy of the National Autism Society
Asperger’s explained by a teen with Asperger’s.
Seek medical treatment from an autism, Asperger’s, or spectrum specialist to avoid a misdiagnosis. For my son, we worked very closely with a child psychiatrist specializing with kids on the spectrum. This relationship made a huge difference in our son’s treatment and subsequent recovery from depression.
Though family physicians care about your loved one, without a complete understanding of autism and Asperger’s it is difficult to properly diagnose depression, communicate with the teen, and treat the depression.
Off Spectrum Symptoms
According to Kids Health these are primary symptoms of depression:
- Negative feelings or moods – these last for longer than a day or two. They often center on negative feelings about oneself.
- Negative thinking – again this is a method depression uses to continue the breakdown of self-esteem and confidence. Negative thinking is often centered on the teen but can encompass the way the world and society are part of the teen’s life.
- Low energy, difficulty concentrating, lack of motivation. They simply do not want to get out of bed. They will sleep more than usual. They do not see a reason to get up and live life.
- Withdrawal – Teens will avoid friends, activities, family, and any other social activity. This is the isolation aspect of depression and where it has the most power.
- Self-Harm – cutting, drugs, alcohol, fighting, and other actions to hurt
- Anger – Pain will often manifest with anger
- Thoughts of suicide and death – Like teens on the spectrum, these thoughts can be verbal and non-verbal
My family has a long history of depression. My father was depressed and untreated. I did not recognize his depression until I became an adult. Suddenly, some of his behaviors during my childhood made sense. His drinking, anger, and withdrawal can be attributed to his depression.
My youngest brother suffered from depression. It is still surprising to me that he suffered silently for so long. He was always so happy and joyful; at least outwardly he was happy. I enjoyed talking to him, having him over for dinner, and had many fun times. My brother suffered silently for a long time and finally he reached his limit. He passed away 21 years ago in November. It still causes me physical pain – the grief is still strong.
I suffer from depression. I have suffered with depression since a teenager. I never understood why I cried so much, felt isolated, lost, in a deep hole with no way out. The bouts of depression were terrible because I physically hurt. I faked my way through each day and appeared to be a healthy teen. Despite the 3.8 GPA, college-bound, rule-abiding life I led on the outside, inside I was miserable.
My depression continued, undiagnosed until my oldest daughter asked me to go to the doctor. I took her words to heart and sought medical help. My depression is now treated and I can honestly say I understand what happiness feels like for the first time. To me, it is like getting glasses for the first time and actually “seeing” the details and colors in the world. Before everything was blurred and dull. Now I feel happiness, joy, and fulfillment. I have purpose and worth.
Finally, my son, HFA, suffered with depression. He was 8 when the autism was diagnosed and his subsequent depression. I can tell you the depression diagnosis was devastating; not the autism. The autism seemed like an adjustment to living with him as he was — nothing more nothing less. The depression was scary because of my history with the condition. I know the damage depression is capable. Teaming with an experienced child psychiatrist with spectrum experience saved my son. He is depression free today.
Depression is treatable. Finding a good medical team to assist with the diagnosis; either spectrum or not; is important to the health and outcome.
Often the sufferer does not want treatment – do not take “everything’s ok” or “no, I’m alright” for an answer. Sadly, my oldest son (non-spectrum) lost a classmate yesterday to suicide. It is preventable. It is treatable. It does not have to claim another person’s life.
Resources and Supports
Physician, psychiatrist, psychologist
Local mental health and teen support services
National Mental Health Association (NMHA)
NMHA works to improve the mental health of all Americans through advocacy, education, research, and service.
National Alliance for the Mentally Ill (NAMI)
NAMI offers resources and help for those with a mental illness.
American Foundation for Suicide Prevention
This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
ANAD is a national nonprofit organization for people with eating disorders and their families. In addition to its hotline counseling, ANAD operates an international network of support groups and offers referrals to health care professionals who treat eating disorders. Contact them at: ANAD Box 7 Highland Park, IL 60035 (847) 831-3438
Depression and Bipolar Support Alliance
The mission of this group is to educate patients, families, professionals, and the public about depressive and manic-depressive illnesses.
National Institute of Mental Health (NIMH)
NIMH offers information about the symptoms, diagnosis, and treatment of mental illnesses, and supports research to help those with mental illness.
National Strategy for Suicide Prevention (NSSP)
This site provides information, a listing of events, and publications on suicide prevention.
Teen Issues Help Guide : http://www.helpguide.org/topics/teens.htm
Teen Depression: A Guide for Parents : http://www.helpguide.org/mental/depression_teen.htm
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