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Depression in Older Teens and Young Adults with ASD

Question

Any info to help w/22 yr. old (recently diagnosed) college grad--floundering, drinking, depressed; appears high functioning, but truly isn’t... His father has asperger traits as well.

Answer

When diagnosis of the adult ASD (high-functioning autism) occurs, it is often as a result of a child being assessed with the disorder. It then becomes apparent to other family members that the un-diagnosed adult they have struggled for so long - to understand or relate to - also has the disorder.

When an adult is diagnosed with ASD as a result of a child within the extended family being diagnosed, it can come as a "double whammy" to the family. This is particularly the case when a child and a spouse are diagnosed, since the remaining member of the family group is now in the position of dealing with two people on the spectrum in the one home. 
 

Similarly, the diagnosis of a child may make the parent twig that one of the parents had the disorder too. This also causes intense personal suffering for the person concerned since finding out that one's parent has the disorder will open as many wounds as it will explain.

The problems in dealing with adult autism sufferers can be numerous, and include:
  • A sense of frustration that you cannot "get through" to this person
  • A sense of hopelessness that the person doesn't love you
  • Depression related to the knowledge that the individual won't get better
  • Difficulties accepting that the partner has the condition
  • Failure to understand why the person cannot relate to you in a "normal" manner
  • Feeling overly responsible for the person
  • Feeling a need to constantly explain their inappropriate behaviors and comments to others
  • A feeling of trepidation due to the effect of this constant vigilance
  • If the adult Asperger is a marriage partner, concerns over whether to stay in the relationship are at times overwhelming
  • Lack of intimacy in the relationship and a failure to have your own needs met
  • Lack of emotional support from family and friends who do not understand the condition

There is less information on ASD in adulthood. Most people with mild autism are able to learn to compensate. They become indistinguishable from everyone else. They marry, hold a job and have children. Other people live an isolated existence with continuing severe difficulties in social and occupational functioning.

People on the spectrum often do well in jobs that require technical skill but little social finesse. Some do well with predictable repetitive work. Others relish the challenge of intricate technical problem solving.

I knew a man, now deceased, who had many of the characteristics of Aspergers. He lived with his mother and had few social contacts. When he visited relatives, he did not seem to understand how to integrate himself into their household routine. When the relatives would explain the situation to him, he was able to accept it. However, he was unable to generalize this to similar situations. Although he was a psychologist, his work involved technical advisory work, not face-to-face clinical sessions. 
 
Summary of interventions:
  • Adults may benefit from group therapy or individual behavioral therapy.
  • Some speech therapists have experience working with grown-ups on pragmatic language skills.
  • Behavioral coaching, a relatively new type of intervention, can help the adult with ASD organize and prioritize his daily activities.
  • Adults may need medication for associated problems such as depression or anxiety.
 
It is important to understand the needs and desires of that particular adult. Some grown-ups do not need treatment. They may find jobs that fit their areas of strength. They may have smaller social circles, and some idiosyncratic behaviors, but they may still be productive and fulfilled.

Resources for parents of children and teens on the autism spectrum:
 
 
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