Teens: Anger, Depression, and Autism

Stephanie Loo, M.Ed.

About the Author

Stephanie Loo, M.Ed. is the Senior Family Support Specialist at AANE and draws upon her wealth of personal and professional experience to provide valuable information, resources, and support by phone through Parent Coaching. She initiated the AANE/NESCA Transition Roundtable, which resulted in expanded programming focused on transition planning and preparing our teens for college.


Additional Crisis Resources:
988 National Suicide and Crisis Lifeline:


A parent in our community asked if it was common for an Autistic teen to become increasingly angry, irritable, or violent, while also becoming more suicidal. The parent wondered whether or not these emotions were connected to being Autistic.

Before we look more closely at the question, it’s imperative to say that children or teens who seem depressed, or who talk about suicide or not wanting to live, get help immediately. Ideally, they will have in place a mental health team—a therapist plus a psychiatrist experienced in working with Autistic teens—who can offer treatment and also help parents decide whether the child needs to be hospitalized.

In general, however, the combination of feelings described can be fairly typical in Autistic teens. As they become teenagers, it’s very common for Autistic children to become more anxious, and even seriously depressed, as new social pressures and academic demands increase their stress levels. Keep in mind that although most teens experience turmoil regardless of their neurotype, Autistic teens may be less developmentally ready than their neurotypical peers to handle the multiple challenges of their high school years. If they have less awareness of their feelings than other teens, and fewer sources of comfort or strategies for resolving their problems, Autistic teens may act out. They may vent their worries in hostile speech, withdraw, become surly, or refuse to engage or co-operate.

Even before adolescence, Autistic children’s stress levels tend to be higher than average. Autism itself doesn’t cause changes in a teen’s mood and behavior. However, the continuous struggle of living in a world not built for Autistic people — a world they often find confusing, frustrating, or disappointing, a world where people often misunderstand, reject, tease, or bully them —  takes a cumulative toll on a teen’s mental health. Even Autistic children who previously seemed able to cope can be pushed beyond their limits when internal, hormonal changes combine with the new challenges of high school. The teens can lose their sense of familiarity, security, control, and mastery.

A new source of stress for Autistic teens is worrying about their future. They hear classmates talking about dating, college, or future careers. They may have unrealistic fears about what will happen after high school, and unrealistic expectations of themselves. For example, one Autistic teen finally revealed his worry that immediately after graduation he would be expected to move out of the house and get a full-time job. He had no idea how he would do that, and naturally he was terrified. His parents did not realize their son had such a distorted and harsh view of what high school graduation would mean. He did not realize that his parents expected to provide help for many years to come, and would be glad to discuss his concerns and together develop some realistic plans.

While other high school students facing such pressures and worries may be able to find relief and reassurance by drawing upon deep reserves of self-esteem, or through close relationships with family members and friends, Autistic teens often have fewer emotional/social resources. Many Autistic children may have depended primarily upon academic achievement to feel good about themselves, but as academic demands intensify in high school, that source of self-esteem may falter —or Autistic teens may become more aware of the importance of areas where they feel less competent.

Seek Help from Mental Health Professionals and from AANE

The teen years can be hard for everyone in the family, but you don’t have to struggle through them alone. Well-trained, experienced mental health professionals, AANE staff, and other caregivers in the AANE community can support you and your family on your journey.

Does your teen have a good therapist and psychiatrist in place? If not, please contact the teen’s pediatrician, or contact AANE about how to find and interview professionals in your area. Both members of the teen’s professional mental health team should have extensive training and experience working with Autistic children and teens. As a caregiver, you do not want to be alone when assessing how much your child or teen is at risk. You need to be able to consult the teen’s therapist and psychiatrist to ensure that your child receives timely and effective help.

A teen who seems highly anxious, seriously depressed, or despairing, including teens who talk about suicide, may need to be evaluated for possible medication (or changes in medication), at least on a temporary basis. If a pediatrician has been prescribing antidepressants, anti-anxiety medication, or other psychotropic medication for your teen, consider seeking a second opinion from a psychiatrist very experienced in prescribing medication for Autistic teens. 

Resources

An AANE staff member would be glad to speak with you about your teen’s situation. AANE offers Parent Coaching sessions by video conference or phone.

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