The Relationship Between Asperger's and Depression

Man sitting with head in his hands.

Asperger's syndrome and depression are known to be related conditions; we know that in general, people with Asperger's are more likely to also be diagnosed with other mental health conditions.

Although the diagnosis of Asperger's syndrome was removed from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the term is still often used by people with the diagnosis.

Therefore, in this article, for simplicity's sake, the term Asperger's syndrome will be used with the understanding that it refers to a diagnosis of high functioning autism spectrum disorders.

What Is Asperger's Syndrome?

Asperger's syndrome is the former name for a diagnosis that corresponds to high functioning autism. It's usually diagnosed when you are an older child, teen, or in early adulthood.

A person with Asperger's tends to have abnormal social functioning and repetitive behaviors, while having normal levels of intelligence and development of verbal skills. In other words, people with this diagnosis tend to be intelligent but struggle with social situations.

People with Asperger's also tend to become obsessed with a topic to the point that it is all they will talk about and focus on for long periods of time.

Signs and Symptoms

While the symptoms of Asperger's tend to be less severe than for other Autism Spectrum Disorders, people with it struggle to make eye contact and don't know how to react in social situations.

They may miss social cues, appear awkward, not understand body language or expressions, and show few emotions.

They might not smile when they are happy and may not laugh at a joke. They may also speak in a monotone or sound like a robot.

Those with Asperger's who become obsessed with a particular topic may talk about it at length without noticing that their conversation partner has lost interest.

For example, if you have Asperger's you might become obsessed with sports statistics or rock collecting and want to talk about those topics at length with other people, without thinking about give and take in the conversation.

People with Asperger's also tend to dislike change; for example, you might prefer to eat the same food every day.

Common Characteristics of Asperger's Syndrome

Below is a list of some other common traits of people with Asperger's syndrome:

  • lacking empathy or being unable to take the perspective of someone else
  • struggling to make eye contact and missing nonverbal cues
  • not reacting or empathizing with other people's stories or struggles
  • trouble understanding humor
  • being awkward or clumsy
  • having trouble making or keeping friendships
  • needing to do routines that seem to serve no purpose
  • having repetitive physical mannerisms such as hand waving
  • having a fascination with letters or numbers
  • functioning best when you follow routines and rituals
  • sensitivity to bright light, loud noise, or certain textures
  • higher than average intelligence and verbal skills (e.g., having a large vocabulary)
  • experiencing emotional outbursts especially in response to changes in routines or shifting
  • hyperfocusing (losing track of time) on things that interest you
  • insisting on talking only about a single topic
  • being told that you appear weird or awkward
  • missing context cues (e.g., not lowering your voice in a library)
  • not outwardly sharing in the happiness or distress of others when they share stories or news

Causes of Asperger's

We know that Asperger's, as with all autism spectrum disorders, is the result of brain differences and has a genetic component. We also know that there are certain factors that increase the risk of having Asperger's such as being born to older parents, being exposed to the drug valproate in utero, and having a low birth weight.

Some have argued that Asperger's and autism spectrum disorders are a reflection of neurodiversity and not a disorder per se. In other words, there is value in seeing the world differently, and individuals with these brain differences also possess strengths that those with a "neurotypical" brain do not have.

How Do Asperger's and Depression Relate?

Now that we understand what is meant by Asperger's, we can consider how it relates to depression.

For reference, a depressive episode typically consists of the following types of symptoms over a two-week period that cause an impairment in your normal daily functioning:

  • feeling sad or hopeless, guilty, or worthless
  • losing interest in things you usually like to do
  • noticing changes in your appetite (wanting to eat more or less)
  • losing weight or gaining weight without explanation
  • feeling like you can't concentrate or focus on anything
  • having low energy or fatigue
  • sleep disturbance (sleeping too much or too little)

While we know that Asperger's and depression tend to co-occur, it can be hard to diagnose depression in someone with Asperger's, because of an overlap of symptoms.

For example, a person with Asperger's may have flat affect, meaning that they appear to be sad or down. However, this affective state may not match what they feel on the inside; rather, they might actually feel normal or like nothing is wrong. The issue is that their outward state doesn't match what they feel on the inside.

In addition, a person with Asperger's might naturally withdraw from social situations because they are made difficult due to symptoms of autism. This is different from someone who withdraws due to feeling depressed.

Primary Depression

Primary depression refers to depression that develops independently of another diagnosis. What this means is that a person with Asperger's becomes depressed not due to life stress related to autism symptoms, but rather because of direct factors that cause depression.

Secondary Depression

On the other hand, depression can also develop secondary to Asperger's syndrome. In this case, life experiences such as sensory overload or social rejection contribute to the development of depressive symptoms.

Treatment for Overlapping Asperger's and Depression

How are overlapping Asperger's disorder and depression treated? In general, there hasn't been much investigation into methods of treating depression among those with Asperger's specifically.

For that reason, we generally consider treatments individually for each condition. Below are some of the treatments that you may be offered for each mental health issue.

Social Skills Training

Social skills training involving modeling appropriate behavior is used to learn how to adapt to social situations among those struggling due to Asperger's.

Speech-Language Therapy

Speech language therapy is used to help people with Asperger's practice modulating their voice (instead of using a monotone), as well as how to use hand gestures and make eye contact.

Cognitive Behavioral Therapy (CBT)

CBT may be used to manage emotions, outburts, meltdowns, and repetitive behaviors among those with Asperger's. It can also be helpful to manage negative thought patterns that are part of depression.

Applied Behavior Analysis (ABA)

ABA is generally used to reinforce positive behaviors among those with autism, particularly among children with more severe symptoms.

Medication

While there is no medication specifically for Asperger's or autism spectrum disorders, medication may be prescribed for depression, such as selective serotonin reuptake inhibitors (e.g., Prozac). Some medications may also help reduce the repetitive behaviors that are characteristic of Asperger's.

Occupational Therapy/Physical Therapy

Occupational therapy and/or physical therapy can be used to improve problems with motor coordination such as being clumsy or awkward. If people comment that you sit or walk in an awkward way, this type of therapy could be helpful.

Coping with Asperger's and Depression

If you are struggling with both Asperger's and symptoms of depression, the best course of action is to receive treatment from a professional. However, if you are wanting to manage symptoms of depression on your own as well, doing things such as eating healthy food, getting regular exercise, and practicing mindfulness can help. These types of coping strategies can also be implemented during therapy to ensure that you are optimally supported.

A Word From Verywell

If you or someone you know is struggling with mood symptoms along with Asperger's syndrome, it is important to have your symptoms evaluated to determine whether you are living with clinical depression. Depression is a serious illness with potential complications that should not be ignored. While you may feel comfortable living with Asperger's, depression is a life-threatening disorder with effective treatment available to help you.

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