Recognizing depression in individuals with ASD can be challenging as some characteristics of ASD can resemble some of the signs of depression. For example, some individuals with ASD may not interact much with peers or identify many friends, which may also be signs of depression in adolescents. Another challenge is that some of the characteristics of ASD may actually mask signs of depression. Some teens with ASD may not show much emotion, so depression may not be as observable as a look of sadness on the teen’s face. Additionally, the communication difficulties of individuals with ASD may impact one’s ability to recognize depression in this population. Even students with ASD who communicate in full sentences may have difficulty communicating their feelings.
The behavioral examples below illustrate how some of the more common symptoms of depression may look in teens with ASD.
Emotions and mood
Increased moodiness which may include anger, irritability, sadness, and tearfulness. In the past two weeks, Terri has been crying for her mom and dad to come pick her up from school every
day after lunch.
Feelings of worthlessness or fixation on mistakes
Alex is noticing that he is different from his peers and
this awareness is causing great concern. He often
makes comments that he is “not normal” and “will
never be normal.”
Need for excessive reassurance
Joel is increasingly fearful of black holes and requires
frequent reassurance that he will not disappear.
Loss of interest or pleasure in previously favorite
Rolando always enjoyed swimming at the YMCA but
recently is resisting the pool and does not even want to
put his swimsuit on.
Caleb is not typically aggressive, but in the past month
has hit his younger sister several times and pushed his
mom when he became frustrated.
The choices in the cafeteria suddenly seem
overwhelming for Taneisha, and she has been getting
“stuck” in line.
Noticeable decrease in self-care
Adam has started to move very slowly during his
morning routine and is often leaving for school without
brushing his teeth, washing his face, or combing his hair.
Regression of previously learned skill
Charity, who usually navigates to the cafeteria and back
without assistance, lately is found wandering the halls
telling everyone she is lost.
Changes in autistic symptoms which may include
increased stereotypic behavior or decreased interest in
Kevin used to flap his hands and rock on the floor
when he was young. Since he started high school, he
is rocking again every day after school.
Abe usually enjoys reviewing meteorology reports in detail each evening. Lately, however, he has not been able to settle and concentrate in the evenings, and has given up this favorite activity altogether.
Fatigue or loss of energy
Xavier keeps falling asleep in class, even when the class is watching YouTube videos about space, his favorite topic in science.
Sleeping too much or too little
Eli, who is usually the first one up, is having great difficulty getting out of bed in the morning.
Changes in appetite leading to weight loss or gain
Jackson has stopped eating some of his favorite foods and is coming home with the food in his lunchbox half eaten.
Complaints of unexplained body aches and head aches; increased visits to the school nurse
Sophie has asked more than once this week to go to the school nurse saying that her arm hurts, but the nurse keeps sending her back saying there is nothing wrong with her.
Changes in Behavior
Look for changes in behavior. Since individuals with ASD often have characteristics that can mimic or mask depression, it is important to look for changes in behavior. Pay attention to eating and sleep habits, and look for changes in mood and behavior around the home and community. Look for changes in mood or behaviors during activities and transitions, lunch, or day program.
Youth with Asperger’s syndrome often struggle with anxiety and depression. This causes Asperger’s meltdowns. The video below discusses symptoms, treatments, causes and solutions to relieve these negative effects of Asperger’s syndrome.
Asperger’s: Struggling with Anxiety and Depression
“Asperger’s: Struggling with Anxiety and Depression.” YouTube , uploaded by Aspergers Guide, 17 Oct. 2009,
Hedges, S., White, T., & Smith, L. (2014, May).
Depression in Adolescents with ASD (Autism at-a-Glance Brief). Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, CSESA Development Team,
The Center on Secondary Education for Students with Autism Spectrum Disorder (CSESA) is a research and development project funded by the U.S. Department of Education that focuses on developing, adapting, and studying a comprehensive school and community-based education program for high school students on the autism spectrum.