Teenagers suffer from depression more often than any number of adults who live their entire lives with it. Parents are generally dismissive of their teens’ low moods because they think the teens are just “moody”, “hormonal”, or “tired and cranky”. This dismissive attitude generally results in teens being even more depressed because they think their parents don’t care and leads them to do unthinkable things.
Take that in combination with teenagers with autism who have very little impulse control as it is, and you have a horrible combination. Medical treatment for both can stop the downward spiral. Early recognition by parents who are proactive is vital.
Children and teens with autism already have emotional highs and lows. Their emotions can be very erratic, such that some parents worry that their children may be bipolar. Autism also has impulse control issues, making it next to impossible for children and teens to stop and consider the repercussions of their actions before they even do something rash. Teens have stabbed peers with pencils and other potential weapons, used their fists like champion pugilists, and attacked teachers who have otherwise been effective mediators. Children with depression do not act; instead they resist acting at all or are so depressive suicide seems like the only option.
Think about that for a second. If you take the extremes of autism, the impulsivity and lack of consequential forethought, and combine it with suicidal depression, it’s a recipe for something akin to the school slaughters that strike the news with regularity. Such horror stories can be turned around. The first step is getting your autistic teen to a therapist who specializes in working with dual diagnosis teens.
The next step is getting them a mild antidepressant. This is a trial and error process. (Personally I’m not an advocate for pharmaceuticals, but teenagers with autism and depression need more help than any behavior modification program and cognitive therapy can provide). Because the brains of children with autism are already so different, teens with autistic brains respond vastly different to brain and mood altering medications than their peers. Every one of the regularly prescribed medications for depression needs at least two weeks to work up to therapeutic level, but after two months your autistic teen’s mood hasn’t improved, a new med may be needed. Additionally, if their mood worsens or new symptoms appear, a new med change is needed immediately. Doctors are aware of the meds that have been shown to improve moods and impulsive behavior, and this is the starting point to work from.
The third, and most important step, is keeping the lines of communication open with your autistic teen, if he or she is verbal. Even if they communicate using other devices or sign language, it’s still important to try and talk to them about how they are feeling. If they are nonverbal, keeping a very close eye on their behavior and how they do in school is important. Do not be dismissive of any little nuance that suggests a change in mood or behavior and always document what you see. You can’t help your autistic teen with depression if you’re not tuned in to them.
It’s important to remember: autism alters brain structure, development and function. Hormones alter brain function. The two together means a much altered brain is walking around in a body the size of an adult. Ergo, this may be the most difficult time in your life as well as theirs.
Read about, “Autism and Bad Behavior” and “How to Manage Behavior in Children With Autism“
A little more than a year ago, my 12 year old son told his pediatrician that he wanted to kill himself. He now is about to turn 14 and has been receiving psychotherapy and taking several antidepressants. Since school seems to be the main problem, do you recommend homeschooling? His therapist strongly recommends it but we have been reluctant, not to mention we both have to work. I am really worried about the approach of 8th grade in the fall — will he survive?
I have considered home schooling in the past for my son. I would have done it too, had my ex husband not put up such a fit and then find ways to turn our lives completely upside down in order to enforce what he wanted, but that’s another issue altogether.
You have a spouse you can talk to about this. You need to consider what is more important–your job, or your son’s well-being. If both of you agree that homeschooling could help his mood and help him get through school in the coming year, then you need to decide who will stay home with him. Somebody would have to be at home with him regardless, since the home environment will not remove any suicidal tendencies he is experiencing. People who feel like they want to kill themselves will find a way, and your son needs to be watched carefully for the next several months. If you are homeschooling him, that means one of you needs to stay home and be the vigilant caretaker or hire a vigilant caretaker who has the skills and ability to intercede should a crisis situation arise.
If he continues in the public school system, you may want to ask your son’s therapist if the problem is bullying. A transfer to another middle school or a private middle school may be the answer. At least at school teachers are watching him carefully and you can make them aware of his current emotional and mental state. If anything happens on their watch, it’s their failure because they knew and they should have done all they could to support your son. Hopefully, none of that would be the case, but at least you could still go to work. While expensive, a private middle school would have significantly fewer students and might be less stressful and overwhelming to your son, who is having problems adjusting to his current educational surroundings.
Also, consult with his IEP team. All of these people are responsible for providing a safe, secure and personalized education that helps your son in all aspects of his daily life. If he is not getting the support he needs, you have a right as a parent to request a reevaluation of the current IEP, and perhaps a rewrite of safety and crisis protocols.
Your son is your flesh and blood. It is very hard to raise a child on the spectrum, but his needs should take precedence over all others, especially if he has expressed a desire to end his own life. There are ways to support him and have your employment cake, too, like working from home, or working a different shift than your spouse works, so that your son is monitored effectively, protected, and supported. The last thing you want is for some well-meaning mandated reporter to tell CPS and the cops that your son attempted suicide because you were not there to support and protect him.