The mental health experience of depression is extremely common in people with Asperger's Syndrome. Many otherwise brilliant and gifted adults are significantly derailed or crippled by its effects. They are stymied and unable to move forward, as their Asperger's experience is compounded by the symptoms of depression.
Your child may already be considered moody or sensitive. Indicators that may be linked to depression would be an increase in moodiness, irritability, or sadness. The problem is, this describes many typical kids caught up in classic teenage angst. The differences here must be a significant change from what is usual for your child in order to consider it a depressive episode.
Although the Diagnostic and Statistical Manual indicates that depression has a typical onset age in the twenties, parents should be mindful of the potential for depression in children with Asperger's starting earlier, from about age ten on (although, in some instances, environment and genetic predisposition can induce depression earlier). This is the age when, more than ever, typical children are propelled into preadolescence with lightening speed. They may:
Begin to define their personal individuality based upon older role models
Give more attention to personal appearance, style, and taste
Take on more mature interests typical of preteens
Pair up and develop cliques or specific circles of friends designated by certain criteria (athletic aptitude, superior physical appearance, or academic achievement)
Become more aware of differences in others
For the child with Asperger's who doesn't feel included, this is the time when, more than ever, she may become more aware of her own differences or be made to feel different by others. When this occurs consistently and she is without a solid, loving foundation from which to draw strength, she becomes vulnerable to depression.
What Causes Depression?
Like most mental health problems, depression is linked to a chemical imbalance in the brain. It may develop due to family genetics (a history of mental health issues on either side of one's lineage) or environmental factors, such as the child who falls victim to poor self-esteem through some form of abuse. It may be triggered by an event (or series of events) that so changes the way one is accustomed to being in the world that recovery and return to normalcy is difficult. And depression may be brought on by a chronic, deteriorating physical condition. (In fact, it is wise to start by getting a thorough thyroid check for your child; a thyroid imbalance can mimic symptoms of mood disorders like depression.)
If you sense that depression may be plausible for your child, it will be important to become savvy about its symptoms and how it may manifest through your child's words and actions. It will be equally important, especially at this time, to recall the positive philosophies as they apply to your child. And remember, mental health problems, including depression, are no one's fault.
Chronic endurance of physical pain and discomfort without adequate relief can induce depression. Think of those you've known grappling with cancer or some other intense, long-term physical ailment. It is easy for anyone to succumb to depression under such devastating circumstances.
Depression is defined using a list of symptoms. As an aid, those symptoms are indicated here as they may appear in any child, but they are embellished with specifics to show how depression may appear differently in the child with Asperger's. When examining the signs of depression or other mental health problems, it is very important to bear in mind that the symptoms:
Must be significant differences from what is typical demeanor for your child
Must occur in clusters or groups — single symptoms in isolation do not a syndrome make
Additionally, pay attention to the presence of any “cycles,” that is, times of year during which your child experiences differences in how he talks and acts. Genetics and family history can also affect your child's experience. This includes not only mental health history but also alcoholism or substance abuse in families. People in denial or who believe that accessing mental health services is stigmatizing will often self-medicate using these substances.
What Are the Symptoms?
The foremost symptom of depression is that of an overall depressed mood. This includes spontaneous crying and weeping (for no reason apparent to you), whining, moaning, or a general sense of sadness and melancholy longer than two weeks in duration. This type of behavior would not be considered a symptom if it followed a death or significant life-changing event (like the family moving and changing schools), after which it would be typical for your child to mourn.
Remember to be sensitive about how your child processes a loss. The child with Asperger's cannot simply “get over it” in reaction to a situation that others may consider insignificant. Be mindful that your child may grieve over losses that are not readily perceptible by you.
Abuse by peers can contribute to depression and even post-traumatic stress disorder. Additionally, if your child is severely depressed, he may feel such worthlessness that he deliberately antagonizes bullies or instigates further abuse by “offering” himself up to them, being well aware of the impending harm.
A depressed child may seem fascinated by morbid thoughts about funerals, disease, and death. The preteen or adolescent may despair, not wanting to be seen as “different.” Your child may make remarks that are self-deprecating such as “No one loves me,” “I hate myself,” “What's the use,” or “I'm not wanted here.” In extreme instances, your child may try to seriously harm himself by attempting suicide or recklessly placing himself in harm's way.
Another symptom of depression is a decreased interest in pleasurable activities. If your child is depressed, this symptom will likely be quite distinct because he has lost all or most desire for his most passionate area of interest. Your child may pass up opportunities to participate in activities related to his passion or intentionally withdraw from those activities in favor of isolation or seclusion from others. (This includes intentionally setting himself up to be forcibly excluded or grounded via parental discipline.) Your child may also give away or destroy items that you immediately recognize as personally valuable or meaningful to him.
Additional, supporting symptoms of depression may include:
Psychomotor retardation, which is an overall, noticeable “slowing down”
Fatigue and difficulty in physical movement (in which the smallest of feats requires great effort)
Clinginess, meaning that your child wants to physically “hang” on you and needs repeated assurances that everything is okay
Requiring too much or too little sleep or being difficult to rouse
Loss of appetite or feeling nauseated at the sight of food (Your child may also try to make himself feel better by eating too much food — especially sugary or fatty snack foods.)
Seeming confused, listless, or disoriented (He may urinate in places other than the toilet, such as a corner of his room or in a dresser drawer.)
Again, some or all of these symptoms may manifest in any child but may appear more peculiar or intense in the child with Asperger's.