
- Agitation or restlessness (e.g., pacing, hand-wringing or an inability to sit still)
- Changes in appetite (e.g., decreased appetite and weight loss, or increased cravings for food and weight gain)
- Disruptive or risky behavior
- Extreme sensitivity to rejection or failure, and the need for excessive reassurance
- Feelings of sadness, which can include crying spells for no apparent reason
- Feelings of worthlessness, guilt, fixation on past failures or exaggerated self-blame or self-criticism
- Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
- Frequent thoughts of death, dying or suicide
- Insomnia or sleeping too much
- Irritability, frustration or feelings of anger, even over small matters
- Loss of interest in, or conflict with, family and friends
- Loss of interest or pleasure in normal activities
- Neglected appearance (e.g., mismatched clothes and unkempt hair)
- Ongoing sense that life and the future are grim and bleak
- Poor school performance or frequent absences from school
- Self-harm (e.g., cutting, burning, or excessive piercing or tattooing)
- Slowed thinking, speaking or body movements
- Tiredness and loss of energy
- Trouble thinking, concentrating, making decisions and remembering things
- Use of alcohol or drugs
It can be difficult to tell the difference between (a) ups and downs that are just part of being a young person and (b) full-blown depression. Talk with your teenage son or daughter. Try to determine whether your youngster seems capable of managing challenging feelings, or if life seems overwhelming. If depression symptoms continue or begin to interfere in your HFA/AS adolescent's life, talk to a physician or a mental health professional trained to work with these teens. Your adolescent's family physician is a good place to start. Your adolescent's school may recommend someone as well.
==> Discipline for Defiant Aspergers and HFA Teens
- Seek help from your physician, a mental health provider or other health care professional.
- Reach out to family members, friends or spiritual leaders for support as you seek treatment for your HFA/AS adolescent.
- Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor or encourage your HFA/AS adolescent to do so.
- Learned patterns of negative thinking. Adolescent depression may be linked to learning to feel helpless — rather than learning to feel capable of finding solutions for life's challenges.
- Inherited traits. Depression is more common in individuals whose biological (blood) relatives also have the condition.
- Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.
- Early childhood trauma. Traumatic events during childhood (e.g., physical or emotional abuse, loss of a mother or father, etc.) may cause changes in the brain that make a teenager more susceptible to depression.
- Biological chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. When these chemicals are out of balance, it may lead to depression symptoms.
- Abusing alcohol, nicotine or other drugs
- Being a female (depression occurs more often in females than in males)
- Being bullied or rejected by peers
- Being gay, lesbian, bisexual or transgender (becoming socially isolated or experiencing bullying may increase the risk of depression)
- Having a chronic medical illness (e.g., cancer, diabetes or asthma)
- Having been the victim or witness of violence (e.g., physical or sexual abuse)
- Having certain personality traits (e.g., low self-esteem or being overly dependent, self-critical or pessimistic)
- Having few friends or other personal relationships
- Having issues that negatively impact self-esteem (e.g., obesity, peer problems, long-term bullying or academic problems)
- Having other conditions (e.g., anxiety disorder, anorexia or bulimia, attention-deficit/hyperactivity disorder or learning disabilities)
- Having a dysfunctional family and conflict
- Having a family member who committed suicide
- Having a mother or father, grandparent or other biological (blood) relative with autism, depression, bipolar disorder or alcoholism
- Having experienced recent stressful life events (e.g., parental divorce, parental military service or the death of a loved one)
- Academic problems
- Alcohol and drug abuse
- Family conflicts and relationship difficulties
- Involvement with the juvenile justice system
- Low self-esteem
- Social isolation
- Suicide
- Questions that you and your HFA/AS adolescent want to ask the physician
- Key personal information, including any major stresses or recent life changes your HFA/AS adolescent has experienced
- Any symptoms your adolescent has had, including any that may seem unrelated to the reason you scheduled the appointment
- All medications, vitamins, herbal remedies or supplements that your HFA/AS adolescent is taking
- Are there any possible side effects with the medications you're recommending?
- Are there any printed materials that we can take home?
- Are there any restrictions that my adolescent needs to follow?
- How will we monitor progress and effectiveness of the treatment?
- Is depression the most likely cause of my youngster's symptoms?
- Is there a generic alternative to the medicine you're prescribing?
- My adolescent has these other health conditions. Could they be linked to depression?
- Should my adolescent see a psychiatrist or other mental health provider?
- What are other possible causes for my youngster's symptoms or condition?
- What are the alternatives to the primary approach that you're suggesting?
- What kinds of tests will my youngster need?
- What treatment is likely to work best?
- What websites do you recommend?
- Will making changes in diet, exercise or other areas help ease depression?
- Are you using any mood-altering substances, such as alcohol, marijuana or street drugs?
- Do you ever have suicidal thoughts when you're feeling down?
- Do you generally always feel down, or does your mood change?
- Do you have a history of significant weight gain or loss?
- Do you have any biological (blood) relatives — such as a mother or father or grandparent — with depression or another mood disorder?
- Does your mood ever swing from feeling down to feeling extremely happy and full of energy?
- How long have you felt depressed?
- How much do you sleep at night? Does the amount change over time?
- How severe are your symptoms? Do they interfere with school, relationships or other day-to-day activities?
- What is your diet like?
- What other mental or physical health conditions do you have?
- What, if anything, appears to worsen your symptoms?
- What, if anything, seems to improve your symptoms?
- When did family members or friends first notice your symptoms of depression?
- Lab tests. For example, your HFA/AS adolescent's physician may do a blood test called a complete blood count, or test your teen’s thyroid to make sure it's functioning properly.
- Physical exam. The physician may do a physical exam and ask in-depth questions about your HFA/AS adolescent's health to determine what may be causing depression. In some cases, depression may be linked to an underlying physical health problem.
- Psychological evaluation. This evaluation will include a discussion with your son or daughter about thoughts, feelings and behavior, and may include a questionnaire. These will help pinpoint a diagnosis and check for related complications.
To be diagnosed with depression, your teenage son or daughter must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
- Diminished interest or feeling no pleasure in any or most activities
- Depressed mood, such as feeling sad, empty or tearful (in adolescence, depressed mood can appear as constant irritability)
- Fatigue or loss of energy
- Feelings of worthlessness, or excessive or inappropriate guilt
- Insomnia or increased desire to sleep
- Recurrent thoughts of death or suicide, making a suicide plan or a suicide attempt
- Restlessness or slowed behavior that can be observed by others
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in adolescence, failure to gain weight as expected can be a sign of depression)
- Trouble making decisions, thinking or concentrating
- Symptoms are not caused by grieving (e.g., temporary sadness after the loss of a loved one)
- Symptoms are not due to the direct effects of something else (e.g., drug abuse, taking a medication or having a medical condition such as hypothyroidism)
- Symptoms aren't due to a mixed episode, which is mania along with depression that sometimes occurs as a symptom of bipolar disorder
- Symptoms must be severe enough to cause noticeable problems in day-to-day activities (e.g., school, social activities or relationships with others)
- Psychotic depression. This is severe depression accompanied by psychotic symptoms, such as delusions or hallucinations.
- Dysthymia. Dysthymia is a less severe, but more long-term form of depression. While it's usually not disabling, dysthymia can prevent your teenage son or daughter from functioning normally in a daily routine and from living life to the fullest.
- Atypical depression. In this type of depression, key signs and symptoms include increased hunger, weight gain, sleeping a lot, feeling that your arms and legs are heavy, and difficulty maintaining relationships.
There are several other conditions with symptoms that can include depression. It's important to get an accurate diagnosis so that your HFA/AS adolescent gets appropriate treatment. Your physician or mental health provider's evaluation will help determine if the symptoms of depression are caused by one of the following conditions:
- Adjustment disorder. An adjustment disorder is a severe emotional reaction to a difficult event in your life. It's a type of stress-related mental illness that may affect feelings, thoughts and behavior.
- Bipolar disorder. Bipolar disorder is characterized by mood swings that range from the highs of mania to the lows of depression. It's sometimes difficult to distinguish between bipolar disorder and depression, but it's important to get an accurate diagnosis because treatment for bipolar disorder is different from that for other types of depression.
- Cyclothymia. Cyclothymia, or cyclothymic disorder, is a milder form of bipolar disorder.
- Schizoaffective disorder. Schizoaffective disorder is a condition in which a person meets the criteria for both schizophrenia and a mood disorder such as depression.
- Seasonal affective disorder. This type of depression is related to changes in seasons and diminished exposure to sunlight.
- explore relationships and experiences
- find better ways to cope and solve problems
- learn how to identify and make changes in unhealthy behaviors or thoughts
- learn about the causes of depression
- set realistic goals
You are your adolescent's best advocate to help her or him succeed. Here are some steps you and your “special needs” child can take that may help:
- Encourage communication with your HFA/AS adolescent. Talk to your son or daughter about the changes you're observing and emphasize your unconditional support. Create an environment where your youngster can share concerns while you listen.
- Help the HFA/AS adolescent avoid alcohol and other drugs. Your son or daughter may feel like alcohol or drugs lessen depression symptoms, but in the long run they worsen symptoms and make depression harder to treat.
- Learn about depression. Education can empower your teenage son or daughter and motivate her or him to stick to a treatment plan. It can also benefit you and other loved ones to learn about your adolescent's depression and understand that it's a treatable condition.
- Make sure your HFA/AS adolescent adopts healthy habits. Even light physical activity can help reduce depression symptoms. Sleeping well is important for all adolescents, especially those with depression. If your teenage son or daughter is having trouble sleeping, ask the physician for advice.
- Pay attention to warning signs. Work with your HFA/AS adolescent's physician or therapist to learn what might trigger depression symptoms. Make a plan so that you and your child know what to do if symptoms get worse. Ask family members or friends to help watch for warning signs.
- Stick to the treatment plan. Make sure your HFA/AS son or daughter attends appointments, even if he or she doesn't feel like going. Even if your adolescent is feeling well, make sure he or she continues to take medications as prescribed. If your child stops taking medications, depression symptoms may come back. Quitting suddenly may cause withdrawal-like symptoms.
- Acupuncture
- Guided imagery
- Massage therapy
- Meditation
- Music or art therapy
- Relaxation techniques
- Spirituality
- Yoga or tai chi
- Ask for help. Adolescents may be reluctant to seek support when life seems overwhelming. Encourage your son or daughter to talk to a family member or other trusted adult whenever needed.
- Connect with other adolescents who struggle with depression. Talking with other adolescents facing similar challenges can help your son or daughter cope. So can learning skills to manage life's challenges. Local support groups for depression are available in many communities. And support groups for depression are offered online (but check them out to make sure they're credible and trustworthy sites).
- Encourage your HFA/AS adolescent to keep a private journal. Journaling may help improve mood by allowing your child to express and work through pain, anger, fear or other emotions.
- Have realistic expectations. Many adolescents judge themselves when they aren't able to live up to unrealistic standards (e.g., academically, in athletics, in appearance, etc.). Let your teenage son or daughter know that it's OK not to be perfect.
- Make and keep healthy friendships. Positive relationships can help boost your HFA/AS adolescent's confidence and stay connected with others. Encourage her or him to avoid relationships with peers whose attitudes or behaviors could make depression worse.
- Simplify life. Encourage your son or daughter to carefully choose obligations and commitments, and set reasonable goals. Let your child know that it's OK to do less when she or he feels down.
- Stay active. Participation in sports, school activities or a job can help keep your teenage son or daughter focused on positive things, rather than negative feelings or behaviors.
- Stay healthy. Do your part to make sure your child eats regular, healthy meals, gets regular exercise and gets plenty of sleep.
- Structure time. Help your child plan activities by making lists or using a planner to stay organized.
- Boost low self-esteem by recognizing small steps toward getting better.
- Get treatment at the earliest sign of a problem to help prevent depression from worsening.
- Maintain ongoing treatment, if recommended, even after symptoms let up, or have regular therapy sessions to help prevent a relapse of depression symptoms.
- Reach out for friendship and social support, especially in times of crisis.
- Take steps to control stress, for example, not committing to too many obligations at once.
==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder
==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance
==> Teaching Social-Skills and Emotion-Management to Children with Autism Spectrum Disorder
==> Parenting Children and Teens with High-Functioning Autism: Parents' Comprehensive Handbook
==> Unraveling the Mystery Behind High-Functioning Autism: Audio Book
==> Crucial Research-Based Parenting Strategies for Children and Teens with High-Functioning Autism