DEPRESSION, PARENTING AND AUTISM

Being the parent of a child on the autism spectrum does not cause depression, nor will these parents necessarily experience the negative feelings that go with depression. But in an effort to provide the best possible care for their child, parents often sacrifice their own physical and emotional needs and the emotional and physical experiences involved can strain even the most capable person. The resulting feelings of anger, anxiety, sadness, isolation, exhaustion — and then guilt for having these feelings — can exact a heavy toll.

Feeling down is natural

Everyone has negative feelings that come and go over time, but when these feelings become more intense and leave parents totally drained of energy, crying frequently or easily angered by their child, it may well be a warning sign of depression. Concerns about depression arise when the sadness and crying don’t go away or when those negative feelings are unrelenting.

Unfortunately, feelings of depression are often seen as a sign of weakness rather than a sign that something is out of balance. Comments such as “snap out of it” or “it’s all in your head” are not helpful, and reflect a belief that mental health concerns are not real. Ignoring or denying your feelings will not make them go away.
Early attention to symptoms of depression through exercise, a healthy diet, positive support of family and friends, or consultation with a trained health or mental health professional may help to prevent the development of a more serious depression over time.

Symptoms of depression

People experience depression in different ways. Some parents may feel a general low-level sadness for months, while others suffer a more sudden and intense negative change in their outlook. The type and degree of symptoms vary by individual and can change over time. Consider these common symptoms of depression. See if you have experienced any of the following for longer than two weeks:

• A change in eating habits resulting in unwanted weight gain or loss
• A change in sleep patterns—too much sleep or not enough
• Feeling tired all the time
• A loss of interest in people and/or activities that once brought you pleasure
• Becoming easily agitated or angered
• Feeling nothing you do is good enough
• Thoughts of death or suicide, or attempting suicide
• Ongoing headaches, digestive disorders, chronic pain etc that don't seem to go away.

Special parenting concerns

What do lack of sleep, Austism Spectrum Disorders, and whether you are male or female have in common? Each can contribute in its own way to a caregiver’s increased risk for depression. Parenting a child with autism or Asperger's syndrome can have many additional stresses compared to looking after a child with physical disabilities. Cognitive issues such as developmental delays, challenging behaviours, aggression and emotional dependency can easily take caregivers to the edge of their coping abilities without consistent and dependable support.

Women, primarily wives and daughters, provide the majority of parenting, despite the inroads of feminism over the decades. In the United States, approximately 12 million women experience clinical depression each year, at approximately twice the rate of men. A National Mental Health Association survey on the public’s attitude and beliefs about clinical depression found that more than one-half of women surveyed still believe it is “normal” for a woman to be depressed during menopause.

The study also found that many women do not seek treatment for depression because they are embarrassed or in denial about being depressed. In fact, 41% of women surveyed cited embarrassment or shame as barriers to treatment.

Men are less likely to admit to depression and doctors are less likely to diagnose depression in men. Men will more often “self treat” their depressive symptoms of anger, irritability or powerlessness with alcohol or overwork. Although fathers tend to be more willing than mothers to hire outside help for assistance with home care duties, they tend to have fewer friends to confide in or positive activities outside the home. The assumption that depressive symptoms are a sign of weakness can make it especially difficult for men to seek help.

importance of sleep

While sleep needs vary, most people need around eight hours a day. Loss of sleep as a result of parenting an autistic child one can lead to serious depression. The important thing to remember is that even though you may not be able to get your child to rest throughout the night, you can arrange to get much needed sleep. Hiring a respite worker to be with your child while you take a nap, or finding a care center or scheduling a stay over with another family member for a few nights, are ways to keep your caregiving commitment while getting the sleep you need.

Depression after placement

Making the decision to move your child into a residential facility can be very stressful, even if they are adult children. While many parents are finally able to catch up on much needed rest, loneliness, guilt and monitoring the care a loved one receives in this new location can add new stress. Many parents feel depressed at the time of placement and some continue to feel depressed for a long time after.

What to do if you think you have depression

Depression deserves to be treated with the same attention afforded any other illness, such as diabetes or high blood pressure. If you feel uncomfortable using the term depression, tell the professional that you are “feeling blue” or “feeling down.” The professional will get the message. The important thing is to seek help.

The first step to getting the best treatment for depression is to meet with a mental health professional such as a psychiatrist, psychologist, or social worker. At the same time, schedule a physical exam with your doctor. Certain medications, as well as some medical conditions such as viral infection, can cause the same symptoms as depression, and can be evaluated by your physician during an exam. The exam should include lab tests and an interview that tests for mental status to determine if speech, memory or thought patterns have been affected.

Although it’s not unusual for a physician to prescribe antidepressant medication, medication alone may not be the most effective treatment for depression. The guidance of a mental health professional throughout your treatment is strongly recommended. The therapist or counsellor will listen to your concerns, screen you for symptoms of depression and assist you in setting up an appropriate course of treatment. Nowadays the usual approach looks at some counseling first and possibly add some medication.

One way to find a professional is to ask a friend for the name of someone they know and trust. You may also find someone by asking your minister or rabbi, your doctor. In addition, national organisations can provide contact information for mental health professionals in your community.

It is important to trust and feel comfortable with the professional you see. It is not uncommon to request a free introductory phone or in-person meeting to help determine if the professional is the right match for your particular needs and style. It is appropriate to clarify what the cost will be, how much your insurance will pay and how many scheduled sessions you should expect to have with the mental health therapist. Any treatment should be evaluated regularly to ensure that it continues to contribute towards your improved health and growth.

Physical Exercise

Exercise has been found to reduce the effects of depression. Walking three times a week for 30 to 45 minutes has been linked to reducing or alleviating symptoms of depression. It is unknown whether physical activity prevents the onset of depression or just helps modify the effects. Arranging time for exercise is sometimes difficult for parents. It is often seen as a “value-added” activity — something to do when everything else is done. You might consider adding it to your “to do” list, asking a friend to give you a “walk date” each week as a gift, or requesting that your doctor write a prescription for walking or joining an exercise class. All the research shows that for a healthier life, it makes good sense to make time for exercise.

Strategies to help yourself

Depressive disorders can make one feel exhausted, helpless and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realise that these negative views are part of the depression and may not accurately reflect the situation. Here are some useful self-care tips for dealing with depression:

• Set realistic goals and reasonable amounts of responsibility
• Break large tasks into small ones
• Confide in someone instead of being alone and secretive
• Participate in activities that may make you feel better like exercise or a movie
• Expect your mood to improve gradually
• Postpone important decisions until the depression has lifted
• Remember that positive thinking replaces the negative thinking as depression lifts
• Let your partner, family and friends help you.

Direct assistance in providing care for your loved one, such as respite care relief, as well as positive feedback from others, positive self-talk, and recreational activities are linked to lower levels of depression. Look for classes and support groups available through caregiver support organisations to help you learn or practice effective problem-solving and coping strategies needed for caregiving. For your health and the health of those around you, take some time to care for yourself.

See the Family and Carer issues section of the website for more information.

Click here to read a fact sheet on self-care strategies for parents.

Click here for the full range of Asperger's and autism fact sheets at www.autism-help.org
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