Depression in People with ASD: Can Occupational Therapy Help?

A look at the potential benefits of occupational therapy for the treatment of depression in people on the autism spectrum.

It is common for autism spectrum disorder (ASD) to co-occur alongside mental health disorders, such as depression. In fact, one study concluded that those with ASD are four times more likely to experience depression than those who are neurotypical (Pezzimenti et al., 2019).

However, despite its prevalence, depression is often misdiagnosed or not diagnosed at all in those with ASD. This is because ASD and depression share several similar symptoms, such as social withdrawal, sleeping or eating difficulties, a flat affect, or low motivation (Pezzimenti et al., 2019).

In addition, depression is an internalizing disorder, meaning it is characterized by feelings. Therefore, it may be difficult to diagnose depression in those who are nonverbal or cannot easily articulate their emotions (Weinstock, 2019).

Interventions for autism comorbidities

Treating depression in those with ASD can be challenging, because each person experiences symptoms differently. Since this is the case, occupational therapy (OT) can be helpful as OT practitioners follow the idea of client centered care (World Federation of Occupational Therapists, 2010). This means they are especially skilled at getting to know their clients, and adapting tasks and interventions to fit their abilities. In other words, they can tailor fit treatment to their clients.

Another way OT can be beneficial to those with ASD and depression is through universal services, which are interventions that can be used for anyone with a mental health or behavioral disorder. One of these treatment options includes teaching clients how to use coping and self-regulation strategies through yoga or mindfulness training. Another is encouraging clients to participate in healthy behaviors and occupations, such as getting enough sleep, eating healthy, exercising, and participating in activities that they enjoy (American Occupational Therapy Association, 2016).

One of the most commonly used treatment options is called cognitive behavioral therapy (CBT). This is a type of treatment often administered by certified OT practitioners.

In CBT, the goals are to change both the way the client thinks and their behavioral patterns. This might include helping to change negative thinking and improving self-confidence. It may also involve teaching the client how to use problem solving skills when facing difficulties, coping strategies to calm oneself, and how to face their fears instead of avoiding them (American Psychological Association, 2017).

A study undertaken to test the effectiveness of CBT found a significant drop in the number of depressive symptoms in a group who received nine CBT sessions, compared to the control group who did not receive any (Chandrasekhar & Sikich, 2015).

In closing

It can therefore be assumed that there is a greater risk for those with ASD to also have depression. While it can be difficult to diagnose and treat, there are several options available that occupational therapists and other health practitioners can provide. Treatment options vary and include therapy like CBT that must be administered by a certified practitioner. Alternatively, simple interventions like mindfulness training or encouraging participating in healthy behaviors may also be effective for some individuals on the spectrum. Consult your OT for more information and guidance.