Depression
What It Is
Depression is a mood disorder characterized by persistent low mood, loss of interest, fatigue, cognitive changes, and in severe cases, thoughts of suicide. In autistic people, depression is frequently triggered by the cumulative cost of living in a neurotypical world — years of masking, exclusion, and mismatch.
How It Presents in Autistic People
Depression in autistic people may present with reduced engagement with special interests (a significant warning sign), increased shutdown behavior, withdrawal, reduced communication, and physical symptoms. The verbal expression of sadness common in non-autistic depression may be absent due to alexithymia.
Treatment and Support
Autism-informed therapy is essential — standard CBT approaches require adaptation. Reducing masking demands can significantly reduce depressive symptoms. Medication works similarly in autistic people as in non-autistic people, though sensory side effects require attention. Community and connection with other autistic people is a protective factor.