Understanding Anxiety and Depression in Autistic Teenagers: An Overview

The prevalence of mental health issues like anxiety and depression is notably higher among autistic teenagers compared to their non-autistic peers. Anxiety and depression in autistic teenagers might not always be present in ways seen in non-autistic individuals. They might exhibit symptoms such as increased repetitive movements or actions, changes in routines, or heightened sensory sensitivities, which can sometimes mask the underlying mental health issues (Rhodes et al., 2023; Kerns et al., 2014).

This article explores the various factors that may contribute to the development of anxiety and depression in autistic teenagers, drawing on recent research and insights. This article is not intended solely for teenagers but also for adults.

The School Environment’s Role

Academic pressures, inconsistent staffing, and non-sensory-friendly environments in schools can significantly exacerbate stress and anxiety in autistic teens. The lack of predictability and understanding in such environments can lead to feelings of being overwhelmed and misunderstood, heightening the risk of anxiety and depression (Hill et al., 2023; Mukherjee & Beresford, 2023).

Socio-Environmental Influences

Family dynamics, peer relationships, and community interactions can significantly influence the mental health of autistic teenagers. Difficulties in social communication and forming connections can lead to feelings of isolation and misunderstanding, while supportive and understanding relationships can provide crucial emotional support and resilience against mental health challenges (Rhodes et al., 2023; Mukherjee & Beresford, 2023).

Life Events

Significant life events such as bereavement or parental separation can deeply affect autistic teenagers. The disruption of routines and the emotional toll of such events can lead to increased anxiety and depression, especially when compounded by challenges in processing and expressing complex emotions (Mukherjee & Beresford, 2023).

Loneliness and Lack of Connection

Loneliness and a lack of meaningful social connections are significant issues for many autistic teenagers. This isolation can lead to feelings of alienation and sadness, exacerbating symptoms of depression and anxiety. Fostering social connections and providing inclusive social opportunities can be vital in mitigating these feelings (Hymas et al., 2022).

Self-Image

Struggles with self-image and identity, particularly with being autistic, can significantly impact the mental health of autistic teens. Negative self-perception and internalised stigma can lead to lowered self-esteem and increased vulnerability to depression and anxiety (Cresswell & Cage, 2019; Berkovits et al., 2020).

Navigating a World Not Designed for Autistic Individuals

Living in a world that often does not accommodate their needs can be a constant source of stress for autistic teenagers. Daily challenges in communication, sensory processing, and social interaction can lead to a persistent state of anxiety and frustration, potentially leading to the onset of depression (Rhodes et al., 2023).

Developmental Transitions

The numerous changes and developmental transitions during adolescence can be particularly challenging for autistic teenagers. Navigating puberty, shifting social dynamics, and preparing for adulthood can create additional anxiety and stress, impacting their mental health (Gotham et al., 2015).

Executive Functioning Challenges

Challenges in executive functioning, such as organising, planning, and adapting to changes, can lead to increased frustration and anxiety for autistic teenagers. These difficulties can make everyday tasks and academic demands more daunting, contributing to feelings of inadequacy and heightened anxiety (Kenworthy et al., 2008).

Misunderstanding and Stigma

Societal misconceptions about autism and the accompanying stigma can lead to feelings of alienation and misunderstanding. This societal attitude can exacerbate feelings of anxiety and depression as autistic teens struggle to find acceptance and understanding (Kinnear et al., 2016).

Co-occurring Health Conditions

Autistic teenagers often experience co-occurring health conditions such as ADHD, gastrointestinal issues, and sleep disorders, which can complicate and worsen their mental health. These additional health challenges can contribute to a higher overall stress level, exacerbating anxiety and depression (Oakley et al., 2021; Simonoff et al., 2008).

Pressure to Conform

The pressure to conform to societal norms and expectations can be a significant source of stress for autistic teenagers. This pressure, especially in social and educational settings, can lead to increased anxiety and feelings of inadequacy (Cage et al., 2018).

Impact of Technology and Social Media

The use of technology and social media can have nuanced impacts on the mental health of autistic teenagers. While it can offer a means of connection, it can also lead to issues with self-esteem, social comparison, and decreased real-life social interactions, contributing to anxiety and depression (Mazurek et al., 2012).

Understanding the multifaceted causes of anxiety and depression in autistic teenagers is crucial for providing effective support. Recognising these nuances and providing tailored support are key to improving their well-being. With increased awareness and suitable interventions, we can make a significant difference in the lives of these young individuals.

Where to From Here?

Our online courses focus on a range of areas known to be important to autistic young people including the transition into high school, the learning profile and specific strategies to encourage academic and social success, the management of anxiety, stress, anger and depression, friendships, relationships and sexuality, what to do about bullying, and transition into a career or tertiary education.

References

1. Rhodes, S. M., Eaton, C. B., Oldridge, J., Rodgers, J., Chan, S., Skouta, E., McKechanie, A. G., Mackie, L., & Stewart, T. M. (2023). Lived experiences of depression in autistic children and adolescents: A qualitative study on child and parent perspectives. Research in Developmental Disabilities, 138, 104516. https://doi.org/10.1016/j.ridd.2023.104516

2. Kerns, C. M., Kendall, P. C., Berry, L., Souders, M. C., Franklin, M. E., Schultz, R. T., Miller, J., & Herrington, J. (2014). Traditional and atypical presentations of anxiety in youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(11), 2851–2861. https://doi.org/10.1007/s10803-014-2141-7

3. Mukherjee, S., & Beresford, B. (2023). Factors influencing the mental health of autistic children and teenagers: Parents’ observations and experiences. Autism, 27(8). https://doi.org/10.1177/13623613231158959

4. Cresswell, L., & Cage, E. (2019). ‘Who am I?’: An exploratory study of the relationships between identity, acculturation and mental health in autistic adolescents. Journal of Autism and Developmental Disorders, 49(9), 2901–2912. https://doi.org/10.1007/s10803-019-04016-x

5. Berkovits, L. D., Moody, C. T., & Blacher, J. (2020). “I don’t feel different. But then again, I wouldn’t know what it feels like to be normal”: Perspectives of adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(3), 831–843. https://doi.org/10.1007/s10803-019-04309-1

6. Hymas, R., Badcock, J. C., & Milne, E. (2022). Loneliness in autism and its association with anxiety and depression: A systematic review with meta-analyses. Review Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s40489-022-00330-w

7. Gotham, K., Unruh, K., & Lord, C. (2015). Depression and its measurement in verbal adolescents and adults with autism spectrum disorder. Autism, 19(4), 491-504. https://doi.org/10.1177/1362361314536625

8. Kenworthy, L., Yerys, B. E., Anthony, L. G., & Wallace, G. L. (2008). Understanding executive control in autism spectrum disorders in the lab and in the real world. Neuropsychology Review, 18(4), 320-338. https://doi.org/10.1007/s11065-008-9077-7

9. Kinnear, S. H., Link, B. G., Ballan, M. S., & Fischbach, R. L. (2016). Understanding the experience of stigma for parents of children with autism spectrum disorder and the role stigma plays in families’ lives. Journal of Autism and Developmental Disorders, 46(3), 942-953. https://doi.org/10.1007/s10803-015-2637-9

10. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 921-929. https://doi.org/10.1097/CHI.0b013e318179964f

11. Cage, E., Di Monaco, J., & Newell, V. (2018). Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 48(2), 473-484. https://doi.org/10.1007/s10803-017-3342-7

12. Mazurek, M. O., Shattuck, P. T., Wagner, M., & Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42

13. Karim F, Oyewande AA, Abdalla LF, Chaudhry Ehsanullah R, Khan S. Social Media Use and Its Connection to Mental Health: A Systematic Review. Cureus. 2020 Jun 15;12(6):e8627. doi: 10.7759/cureus.8627. PMID: 32685296; PMCID: PMC7364393.

14. Jedrzejewska, A., Dewey, J. Camouflaging in Autistic and Non-autistic Adolescents in the Modern Context of Social Media. J Autism Dev Disord 52, 630–646 (2022). https://doi.org/10.1007/s10803-021-04953-6

15. Hill, C., Keville, S., & Ludlow, A. K. (2023). Inclusivity for children with autism spectrum disorders: Parents’ reflections of the school learning environment versus home learning during COVID-19. International Journal of Developmental Disabilities, 69(4), 546-554.

16. Oakley B, Loth E, Murphy DG. Autism and mood disorders. Int Rev Psychiatry. 2021 May;33(3):280-299. doi: 10.1080/09540261.2021.1872506. Epub 2021 Mar 1. PMID: 33648430.