Autism and Depression

by Guy Shahar

Published: 24th April, 2016

This very moving testimony of a 9 year old “high-functioning” autistic boy who suffers from depression and suicidal thoughts was broadcast on Wednesday morning on the Today programme on BBC Radio 4.

How harrowing it must be for the parents of such a young child who is so overwhelmed by the world that he doesn’t want to continue to live, as well as for the child himself.

It must be so difficult to know what to do to make them feel that they want to go on. As the mother said, she is just doing all she can to show her son that he is loved and valued and is important to her. His condition is so deep that her most sincere efforts to help him, love him, understand him and show him the positive in life make no difference.

Why would a child so young be affected by such a profound condition as suicidal depression? In his own words, he is can’t face getting up and facing another day, feeling so lonely, and also disturbed by the cruelty that exists in the world – how wars take place, how we can allow people to remain homeless, how people are treated differently based on the colour of their skin, and so on.

Of course, depression can and does occur in young children and its source cannot usually be clearly identified, but in the case of an autistic child, it might be helpful to understand what it is about the characteristics of an autistic person that, under the wrong circumstances, might lead to despondency.

I have said many times (and will continue to say) that whatever autism looks like from the outside, one of the things at the root of it is a fundamental idealism – felt deeply in the heart – that the only sort of world that makes any sense is one in which people are unconditionally caring and supportive of each other, where the greatest joy comes from helping and boosting others, where is it natural to put others’ needs before our own and to ensure the welfare of all. This idealism is a tremendous quality, and in a kinder world, autistic people – who have so much to offer in this area – would not be having meltdowns or needing Occupational Therapy or getting depressed – they would be deeply integrated into society and at the forefront of running the show, selflessly and in the interests of others.

I have seen  this idealism in my son.  I have seen what happens when those ideals are validated and what happens when they are violated. On the extreme end of the autistic spectrum at 2 years old, we were lucky enough to find a very effective treatment for him and he is now a happy and thriving 6 year old, whose idealism is inspiring. He is not only deeply disturbed by any harm or misfortune that may befall anyone, but he is equally concerned for animals, and even plants. As a very recent example, just a few days ago, in the playground, a friend of his was knocking some weeds out of the way  with a stick, and our son found this so painful to witness that he cried, implored his friend to stop and then, courageously, grabbed the stick from him and ran away with it. The incident made a deep impression on him – not only was he hurt of behalf of the weeds, but he was also baffled and saddened that his friend could have perpetrated such cruelty knowing that plants are alive, and was personally hurt by the fact that his friend didn’t listen to him even when he could see how upset he was.

This deep sensitivity and admirable idealism – which we all share, but which, unlike an autistic person, we allow to recede into the background to accommodate “the hard reality of life” – is a phenomenal strength that could allow them to bring so much to the world in this area. But how can they maintain it in the face of everything that goes on around us? In the case of my son’s experience in the playground – an event so insignificant in the face of the scale of misfortune and cruelty that takes place in the world – he was knocked severely off balance by it. If such “small” (to our understanding) adversities can create such pain and destabilisation in an autistic person, imagine the cumulative effects on them of an endless succession of much worse events as the backdrop to daily life – some of which are directed personally at them.

In view of this, it is not surprising that they are overwhelmed by the unrelenting onslaught of negativity that they are subjected to simply by existing in this world, and that they need to resort to coping mechanisms which hide from our sight the true wealth that exists within them. To complete the injustice, we then label them “disabled” and treat them as if they have a problem, when the real problem is the harshness of the environment around them, which we all play a part in creating, and from which they have no respite. All of this is bound to lead to a much higher risk of depression in an autistic person.

We cannot hide the world from them, and we cannot change it by ourselves. All we can do is to understand and acknowledge their commendable values, and find the part of ourselves that shares these so that we can relate with them naturally and on the same level. We can help them come to terms with the fact that the world is not perfect, but that however imperfect it is, there is great good in it as well, and we can make a great contribution to it by doing all we can to add to this good.  We can even help them find ways they can meaningfully do so – like volunteer work for a charity that can show them tangible results,  or even just the difference that they can make to somebody’s life with some words of kindness.

Life for an autistic person who makes the brave choice to engage with this world in spite of its cruelty, will inevitably involve a great deal of pain. But if we are able to create supportive conditions around them and give them real understanding, hope and confidence, which we can do if we recognise and value their inherent good nature, then this pain can be balanced by very much joy.

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