Depression and Anxiety: Common Companions to Autism
Living with autism can sometimes feel like navigating the world with a different map than everyone else. While this unique perspective brings many strengths, it often comes with additional challenges. Among these, depression and anxiety frequently appear as unwelcome companions on the journey.
At Sagebrush Counseling, we see many clients who are managing this complex intersection of conditions. Let's talk about why these conditions often occur together, how they might look different in autistic individuals, and what can help.
Why Depression and Anxiety Are So Common in Autism
It's not just coincidence that many autistic individuals also experience depression and anxiety. Several factors contribute to this relationship:
Navigating a neurotypical world can be exhausting when you process information differently
Sensory sensitivities can create constant stress in environments that weren't designed with autism in mind
Social challenges might lead to feelings of isolation or misunderstanding
Masking (hiding autistic traits to fit in) requires tremendous energy and can lead to burnout
Executive functioning differences can make daily tasks more challenging, potentially leading to feelings of inadequacy
What’s the Difference Between Autism and Co-occurring Mental Health Conditions?
It's important to understand that autism is a neurodevelopmental difference, not a mental illness. Depression and anxiety, on the other hand, are mental health conditions. They can co-exist with autism, but they’re not the same thing. Understanding that distinction helps avoid the mistake of assuming autistic traits are "symptoms" that need to be treated or fixed.
Why Masking Makes Everything Harder
Many autistic individuals—especially women and marginalized folks—become masters of masking. That means copying social behaviors, forcing eye contact, suppressing stimming, or memorizing scripts for conversations.
While masking can help someone get by in certain environments, it often comes at a steep emotional cost. It’s exhausting, can lead to identity confusion, and contributes significantly to anxiety, depression, and autistic burnout.
The Role of Sensory Overload in Mental Health
Imagine going through your day in a world that feels too loud, too bright, too crowded, or too chaotic—and no one else seems to notice. For many autistic people, that’s a daily reality.
Over time, this constant sensory strain can lead to chronic anxiety, irritability, shutdowns, and emotional exhaustion. If your nervous system is constantly in overdrive, it’s no wonder that mental health can start to suffer.
Is It Depression—or Autistic Burnout?
Depression and autistic burnout can look very similar: fatigue, disinterest, social withdrawal, low motivation. But the causes and recovery strategies are different. Burnout is often the result of prolonged masking, overstimulation, or unmet support needs—and it requires rest, decompression, and sensory relief.
If therapy or medication for depression hasn’t helped, it’s worth considering whether autistic burnout might be at play.
What Depression and Anxiety Can Look Like in Autistic Individuals
Depression and anxiety often present differently in autistic people than they do in neurotypical individuals:
Depression might appear as withdrawal from special interests rather than classic sadness
Anxiety may show up as increased stimming, shutdowns, or meltdowns
Sleep disturbances or changes in sensory tolerance are common
Executive dysfunction may worsen
These unique presentations are why autism-informed care is so important.
Signs It’s Time to Reach Out for Help
It can be hard to know when to seek support, especially if you’ve been masking for a long time. Here are some signs it might be time:
You feel emotionally exhausted or disconnected for weeks at a time
You’ve stopped engaging in your special interests or routines
Anxiety is making it difficult to function or connect with others
You feel like you’re always "on edge" or waiting for something to go wrong
You’re feeling overwhelmed more often than not
How to Talk About Mental Health with an Autistic Loved One
If someone you care about is autistic and seems to be struggling, here are a few tips:
Approach conversations with curiosity, not assumptions
Use direct, respectful language and avoid vague questions
Validate their feelings, even if you don’t fully understand
Avoid pushing solutions—ask what kind of support would actually help
Being supportive doesn’t mean fixing everything. It often just means listening and respecting someone’s pace.
What to Look for in an Autism-Affirming Therapist
Not all therapy is helpful—especially if it doesn’t recognize neurodivergent needs. Here's what to look for:
A therapist who sees autism as a difference, not a defect
Comfort with alternative communication styles and sensory needs
Willingness to adapt therapeutic approaches to the client’s pace
Knowledge of autistic burnout, masking, and co-occurring conditions
At Sagebrush Counseling, we work with many neurodivergent adults. Our approach is affirming, adaptable, and designed to help you feel safe, not scrutinized.
What Kind of Support Actually Helps?
The good news: things can get better with the right kind of support. Here’s what often helps most:
Autism-informed therapy that honors your brain and your boundaries
Sensory-friendly environments
Finding community with others who "get it"
Learning self-advocacy skills
Building routines that actually work for you
You’re Not Alone—And You Don’t Have to Do This Alone
If you or someone you love is navigating the intersection of autism, depression, and anxiety, please know this: it’s not just you. You’re not broken. And you deserve support that understands your unique experience.
At Sagebrush Counseling, we’re here to support neurodivergent clients with compassion, curiosity, and care. Whether you’re looking for help managing overwhelm, exploring identity, or just needing space to be yourself—we’re ready when you are.
You deserve to feel understood. And things really can get better.
