Autism Spectrum Disorder (ASD) encompasses five developmental disorders including Autistic Disorder, Asperger’s syndrome, Pervasive Developmental disorder Not Otherwise Specified (PDD-NOS), Rett’s Disorder, and Childhood Disintegrative Disorder (CDD). According to the National Institute of Mental Health (2011), symptoms of ASD generally fall into the areas of social impairment, communication difficulties, and repetitive and stereotyped behaviors. A person diagnosed with ASD faces a myriad of potential challenges that may increase his or her likelihood for anxiety and depression and ultimately, suicidal ideation. However, through understanding the early warning signs and employing effective intervention strategies for suicide risk for individuals with ASD, greater success can be achieved in preventing suicide in this population.
These developmental disorders greatly influence people’s thinking, how they relate to certain situations, their work, and how they relate to others. Consequently, these factors may increase stress, difficulty with relationships, and difficulty managing emotions (Autism Speaks, 2010). People with ASD may also lack the appropriate skills for dealing with the problems they encounter. It is not uncommon for an individual to feel isolated and helpless as a result of these difficulties. A person with ASD may often express himself or herself in a way that is different than others around them. The school aged ASD population often faces harsh criticism, intolerance, or abandonment as a result of their idiosyncrasies and unique and hyper focused interests. The National Autistic Society (NAS, 2012) explains that some people with Asperger’s syndrome have difficulties with personal space when interacting with others. They have been accused of harassment in their attempts to socialize, adding to their depression and anxiety.
A 2001 NAS study in England revealed that 56% of its Autistic participants suffered with depression (www.icare4autism.org, 2010). The diagnosis of depression depends primarily on people’s verbal and communication skills in order for them to convey their depressive symptoms. Those with ASD may have high difficulty expressing themselves to others and being understood. Even in the higher-functioning group, expression of feelings and emotions such as sadness and hopelessness is challenging (Ghaziuddin et al., 2002). As a result, it is extremely important to be aware of other signs of depression from someone with ASD. An increase in an obsessive or ritualistic behavior may signal the onset of depression. Additionally, a total loss of interest in the usual Autistic preoccupations may be an indication of depressive symptoms, as well (Ghaziuddin et al., 2002).
According to the International Center for Autism Research and Education (2010), suicide rates among those with Autism have skyrocketed. The suicide rate among people on the Autism spectrum is considerably higher than the suicide rates in the general United States population (Gaus, 2007). Children and teenagers with ASD can be susceptible to thoughts of suicide because of the challenges they face fitting in and interacting with their peers on a daily basis. Kim et al (2000) found that depression was more prevalent in children between the ages of 10 and 12 with Autism or Asperger’s syndrome than in the general population of children of the same age. Bullying or constant feelings of failure may contribute to helplessness and depression. Suicide might present itself as an option to someone who believes he or she is faced with an unsolvable problem. According to Autism Speaks (2010), “The choice may appear preferable to circumstances such as enduring emotional distress or disorder, which the person may fear more than death.”
The absence of the necessary skills to effectively communicate about their problems and emotions makes it difficult for those diagnosed with ASD to express their suicidal thoughts. According to Bonnie Sayers, editor of Autism Spectrum Disorders (2008), there are several suicide risk factors to look for with children and adolescents. These include: changes in personal hygiene, different sleeping patterns, a drastic change in clothing styles, eating less or more, verbal outbursts, losing or gaining weight, sleeping in class, not taking their prescribed medication, an increase in distractibility, grades plummeting, driving tickets, and the loss of interest in sports or hobbies that were once of major importance. Some may engage in self-harming behavior, make threats about committing suicide, or make statements similar to; “It would have been better if I had died” (www.autism-help.org, 2008). These are also common warning signs for both the neurotypical population and those with other mental illnesses. However, it is more crucial to actively search for these symptoms for those with ASD because of their great difficulty in self-awareness as well as advocating for themselves.
As a family member, friend, teacher, or mental health professional, it is important to remain hyper-vigilant in monitoring possible depressive feelings and thoughts of suicide in someone diagnosed with ASD. In a 2002 study of depression in persons with Autism, Ghaziuddin et al. concluded that it is important to maintain a high index of suspicion, especially when there is a history of a recent change in the level of functioning, particularly around puberty. It is also important to note that this population may utilize unconventional methods of suicide that may not be initially associated with intent. For example, youngsters may wander off into traffic or display head banging in an effort to end their life. If you suspect a high risk of suicide, immediate support includes medical or psychiatric treatment, hospitalization, psychological therapy, mental health case management, or linking into family and community organizations. Telephone counseling or moving the person to a less stressful environment are other options to alleviate the suicidal symptoms (www.autism-help.org, 2008).