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.