If you have: lost interest in your usual activities; trouble sleeping, wake up early or sleep all the time; a change in appetite (more or less); withdrawn from people with a down mood (for Aspies it might be sad, irritable or a sense of hopelessness – whatever negative mood or thoughts you recognize), you have what we call major depression.
For this, you probably need professional help. Things are not hopeless but being depressed is like looking through dark glasses. While people with Asperger’s are prone to depression because of challenging life experiences, clinical depression is not part of Asperger’s Syndrome and usually responds to treatment. For those struggling with lower level depression, you might still consider therapy to look at ways to make life changes and feel better.
For finding professional help and other resources, Autismsource.org is a gold mine of resources including lists of local therapists in your area.
- Psychology Today: Has a list of all professions, not just psychologists https://www.psychologytoday.com/us/therapists/aspergers-syndrome
- American Academy of Child and Adolescent Psychiatrists has a child and adolescent psychiatrist finder.
- The American Psychiatric Association has a general psychiatrist finder.
- American Psychological Association Practice Organization has a psychologist finder
- The Canadian Psychiatric Association Canadian Psychiatric Association
Psychologists, social workers, psychiatrists, advanced practice registered nurses (APRN), and other specialties all can provide therapy. Individuals should be licensed providers in their states. You can find this information by looking at their websites.
Only psychiatrists, other MDs (medical doctors), and APRNs can provide medication. Medication has been demonstrated to be effective in treating depression. Often a combination of medication and therapy are most useful. The form of therapy most recommended is CBT (cognitive behavioral therapy). MBCT (mindfulness-based cognitive therapy) has been shown to be effective for depression although there isn’t research on it with people on the spectrum. Most therapists specializing in working with those with ASD know how to modify traditional CBT to best work with those on the spectrum.
It can be very challenging, certainly in parts of the US, to find therapists who take insurance.
The prevailing cost of therapy varies widely across the country. Some therapists (usually psychologists) offer sliding scale fees or have some lower fee slots, so it’s worth calling and asking. Clinics generally take insurance but you want to be sure that the therapist is familiar with ASD. The first thing you should do is call the number for patient or customer service on your insurance card and ask for a list of providers (psychologists/psychiatrists/social workers) in your area. This way you can know all the providers near you who are in network with your insurance plan before you call around clinics. In network providers have more affordable rates than out of network providers. It is important to inform yourself about your insurance plan and coverage before you begin the search.
Also, check providers with Medicaid if you have it. Any MD or APRN will know about treating depression with medication. Some therapists who accept Medicaid might be experienced with ASD even if they’re not on a directory for ASD.
Self Care Strategies
Self-help strategies can be very effective and most don’t cost anything, unless you opt for a membership in a gym or an activity that involves a fee or equipment of some kind. Remember not any one of these will “cure” symptoms but put into use alongside professional care can be incredibly beneficial. Some strategies I have used and recommend include:
- Exercise: Exercise is proven to help depression and anxiety. Find some kind of exercise you can tolerate and do it regularly.
- Self-care: Be sure you’re eating and sleeping healthfully. Body and mind are all part of the same system. If you’re not taking good care of your body, you’re not taking care of your mind and your emotional life.
- Be in nature: Research has shown that being outside in nature actually helps reduce anxiety.
- Get out and do what you would normally do: Even if this feels forced, participating in work or activities is important.
Don’t self-isolate: If you have friends, spend time with them. If you don’t, consider some of the options discussed below.
- This may sound odd to some, but research has shown that keeping a gratitude journal makes people happier. This practice can help us remember that there are positives in life, even small ones.
- Meditation has been scientifically documented to help anxiety: It can also help deal with emotional modulation or riding out those super emotional moments. Click here for a list of phone apps. There are specific meditations for depression and many other everyday life experiences. Insight Timer has thousands of guided meditations: the headphone symbol at the bottom is for guided meditations and courses, and you can search for meditations to deal with depression. Buddhify has specific short meditations for dealing with or replacing difficult emotions.
- Learn a skill that’s a basic part of cognitive therapy: talk to yourself. Because Aspies tend to be black and white thinkers, there’s a tendency to see only the worst at times. What would you want someone to say to you at a hard moment? Say it to yourself, something like: “I can deal with this” ; “I’m not a failure, I’ve had many things go well” ; “I do many things well” or whatever might work for you.
- There’s a good app made by the Yale Center for Emotional Intelligence called Mood Meter. It helps you define your feeling, recognize the trigger, and then offers strategies for feeling better such as quotes, actions you can take or images. You can add your own ideas, quotes, pictures, etc. so that it works best for you.
Meetups and Online Resources
It can be difficult to feel like you’re the only one having the experiences you have. It is important to seek out opportunities for connecting locally with other people you can relate to. Most Aspies have affinities or areas of interest. Find a group involved in that interest and do an online search for local groups.
Meetup.com provides opportunities for finding others that share your interests or that might meet your needs for shared understanding. On Meetup you can look under an interest area or health and wellness, where there can be groups specifically for people on the spectrum like yourself. Check out the Meetup page for Aspergers. Or you can create a meetup group that meets your own needs.
You can also find online groups that provide support and an opportunity to share experiences. But while you are looking on these websites and chat rooms be careful not to get bogged down in negative conversations that can do more harm than good.
You’ll find many of these resources have thousands of members. Reddit has specific communities for Asperger’s that have resources and chat rooms on Asperger’s generally, and on specific issues like social skills and dating. People also post about their experiences.
Wrong Planet has discussion forums as well as articles that might be helpful or interesting. There are also Facebook groups for people with Aspergers, such as Aspergers Support Network, Asperger Syndrome Support Group, Aspergers safe room: a safe haven for women on the autism spectrum, and Asperger’s Experts (a Facebook page). A search when you’re on Facebook will turn up others.
If you join a forum or chat group, be sure it’s constructive. As with anything online, there can be sites or groups where people vent or share ideas that might be unhelpful for someone wanting to feel better and have a better life experience.
For emergencies, there are suicide hotlines: 1-800-273-8255, Suicide Prevention Lifeline, and a crisis text line (text HOME to 741741).
66% of those with ASD have had suicidal thoughts. Adolescents and young adults with Asperger’s are at relatively higher risk. Suicidal feelings are definitely experiences that you can get through if you reach out for help.
Major depression is treatable with medication and therapy. Other kinds of depression can be helped by therapy, identifying (and improving) triggers, and seeking out connections. Professionals are there to provide treatment and there are resources for finding them. Self-care and self-help are important for coping and managing your own symptoms. Develop healthy habits, even if it’s difficult, it’s possible if you’re determined. And reach out. Making connections is important to everyone. Whether locally or online, interest based or shared experience based, having social connections helps. You can overcome depression.
by Marcia Eckerd, Ph.D.
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