High functioning Autism & Depression: What you need to know

A Quick Guide

The lifetime prevalence of depression is about 4 times higher in individuals with ASD (high functioning autism) than in the general population. Quality of life has been proven to be significantly impacted by depression in ASD. The requirement for medicine is raised in patients with a dual diagnosis, and the risk of self-harm and suicide is elevated in the carer population.

Autism is classified as a spectrum disorder. As a result, people with autism have various requirements and capabilities. High functioning autistic people may not require as much assistance as other autistic people but may still have difficulties with daily tasks. Adults and kids with high-functioning autism (HFA) may experience symptoms that are difficult to manage, such as:

• Difficulties with verbal communication
• Going through sensory overload
• Inability to regulate one’s emotions
• Inadequate organization
• Mood or anxiety issues
• Not being aware of social signs

Learn more about the link between Autism Spectrum Disorder and Anxiety.

What is High functioning Autism?

Unofficially, those with autism who appear to have mild symptoms are referred to as having high-functioning autism. Level 1 of Autism Spectrum Disorder (ASD) is the recognized diagnostic designation. A scale from 1 to 3 has been used to indicate the level of autism spectrum disorder based on the extent of assistance a person requires:

• Level 1 requires some assistance.
• Level 2 requires significant assistance.
• Level 3 requires extensive assistance.

Labels that describe functioning are avoided in the autism community because they might be deceptive. In some situations, a person may be able to function alone, but in others, they may need a lot of help. High-functioning individuals frequently have important needs that go unmet.

The hidden difficulties of High – functioning Autism should be made clear to educators and other professionals. These include sensory problems, emotional control, interpersonal abilities, verbal communication, executive functioning, and mood disorders.

Here we will be discussing more on how people with Autism are affected by Mood Disorders.

High-functioning autistic adults develop from high-functioning autistic children. Although many adults with ASD-1 can lead successful, independent lives, the majority will need some kind of continuous help.

Causes Of High functioning Autism

We are aware that High Functioning Autism, results from genetic abnormalities in the brain. We also know that several circumstances can enhance the likelihood of developing High Functioning Autism, such as:

• Having older parents,
• Being subjected to the drug valproate during pregnancy
• Being delivered prematurely

The link between High functioning Autism & Depression

Now that we know what High Functioning Autism is, we can think about how it links to depression.

To give you some context, a depressed episode usually comprises the symptoms listed below across a two-week period that interfere with daily functioning normally:

• Feeling like you’re unable to focus or concentrate on anything.
• Feeling worn out or lacking any energy.
• Gaining or losing weight without reason.
• Having feelings of Sadness, hopelessness, remorse, or worthlessness.
• Losing interest in activities you often enjoy.
• Observing fluctuations in your hunger (wanting to eat more or less)
• Sleep disruption (sleeping too much or too little).

Although High Functioning Autism and depression frequently co-occur, it can be challenging to diagnose depression in a High Functioning Autism patient because the symptoms often overlap.

Overlapping of Symptoms

For instance, a person with High Functioning Autism may look depressed because they have a flat affect. While people may appear to be in this affective state, they may actually feel normal or as though nothing is wrong. Their internal feelings don’t match their external behavior, which is the problem. A person with High Functioning Autism may also naturally avoid social interactions since they are challenging because of autistic symptoms. This is distinct from a person who withdraws because they are depressed.

Early case studies of depression in ASD patients have shed some light on the potential diagnostic approaches that doctors may use to treat these individuals’ depression. According to research, in 2 cases when patients wept for the first time ever, depression was later identified as a comorbidity. Before being diagnosed with depression, some people begin to ignore their personal hygiene, while others show rising morbidity in their writing and artwork.

Depression is frequently proven to make ASD symptoms and traits worse. Patients become more irritated, hostile, and socially isolated. They also start or engage in more self-harming behaviors. Additionally, they could suffer from increased sleeping problems, psychomotor impairment, and more drastic fluctuations in appetite and weight.  These case studies were assembled by researchers who advise that people with ASD who have severe and noticeable changes in functioning and maladaptive behaviors over time should be evaluated for depression.

Primary Depression

Depression that arises without the influence of another diagnosis is referred to as a primary depression. This means that a person with high-functioning autism experiences depression related to things that directly cause depression rather than life stress related to autism symptoms.

Secondary Depression

On the other side, High Functioning Autism can also result in depression. In this case, life events like sensory overload or social rejection have a role in the emergence of depressive symptoms.

Understanding Alexythymia in ASD

ASD frequently includes alexithymia. It is characterized by difficulties in explaining and identifying one’s emotions as well as an inclination to place more emphasis on external than on internal experiences. People with  Alexithymia have been described as having a flat, unemotional affect that can resemble ASD presentations. Data indicates that alexithymia and ASD are distinct, despite the fact that some characteristics of alexithymia—such as a lack of emotional recognition and diminished empathy—overlap with diagnostic characteristics of ASD. 

To give an example, not all people with ASD exhibit the emotional deficits associated with alexithymia, such as reduced emotional face recognition. Furthermore, research suggests that alexithymia, not autism, is the cause of the difficulty with emotional face identification. Additionally, there is neuroimaging proof that autism and alexithymia affect different brain networks that underpin socio-cognitive and socio-affective functions separately.

It’s likely that alexithymia is a distinct trait that develops from autistic symptoms and contributes to people with ASD experiencing emotional difficulties that eventually lead to mood disorders.

Even in people without ASD, alexithymia is linked to psychological disorders. Alexithymia is more common in people with anxiety and depressive disorders. People with Alexythimia who also have co-occurring depression or anxiety disorders frequently have lesser emotional intelligence than those who do not. Additionally, people with alexithymia frequently respond less well to treatment for a variety of psychiatric conditions, including mood disorders. The increased prevalence of mood disorders in people with alexithymia may be due in part to this condition’s association with emotional control.

Alexithymia, Emotional Control & Depression in ASD

Identifying emotions, choosing responses to those feelings, and putting those responses under control all fall under the category of emotional regulation. Alexithymia may contribute to more severe anxiety and depressive symptoms in ASD through its connection to emotional regulation, and this may happen in connection with the social difficulties in ASD, according to research. The relationship between ASD and alexithymia may be complicated, as initial autistic symptoms may include poor social communication, which could obstruct the growth of emotional intelligence and worsen alexithymia. As a result of its connection to emotional regulation, alexithymia may have a significant impact on the mental health of people with ASD. 

Treatment for High Functioning Autism and Depression

How are High functioning autism and depression managed when they coexist? There hasn’t been much research into how to treat depression in people with High functioning autism. Because of this, we often assess therapy for each condition separately. The treatments that may be suggested to you for each mental health condition are listed below.

Applied Behavior Analysis (ABA)

Generally, ABA is used to encourage positive actions in people with autism, especially in those who have more severe symptoms.

Cognitive Behavioral Therapy (CBT)

CBT can help people with High functioning autism control their emotions, outbursts, meltdowns, and repetitive behaviors. The management of depressive negative thought patterns can also be beneficial.

Medication

While no medicine is available, particularly for High functioning autism depression medication such as selective serotonin reuptake inhibitors may be used (e.g., Prozac). The repetitive behaviors that are typical of Mild autism may also be decreased with the help of some drugs.

Occupational Therapy & Physical Therapy

Clumsiness or awkwardness that is caused by poor motor coordination can be improved with occupational therapy and/or physical therapy. This kind of therapy may be beneficial if people notice that you sit or walk awkwardly.

Social Skills Training

People with High functioning autism are taught social skills training that involves modeling appropriate behavior in order to help them adjust to social circumstances.

Speech language therapy

Speech language therapy is used to educate people with High functioning autism on how to establish eye contact, use hand gestures, and modulate their voice (instead of speaking monotonously).

Outlook

The best course of action is to get professional help if you suffer from both High functioning autism and signs of depression. However, if you wish to manage your depression symptoms independently, making appropriate food choices, exercising frequently, and practicing mindfulness can all be helpful. These coping mechanisms can also be used in treatment to give you the best possible support.

It’s crucial to have your mood symptoms tested to see if you or someone you know has clinical depression or if you also have High functioning autism. It is important to recognize that depression is a serious illness with potential side effects. Although you may feel at ease with having High functioning autism, depression is a potentially fatal condition that is in fact treatable.

We hope you found this article useful in learning more about the link between High Functioning Autism and Depression along with its treatment options.