increased depression and suicide rates in autistic adults

The average life expenctancy of people with Asperger's is 54.  The main cause of early death is suicide.  The incidence of suicide is, so I've read, 9 times higher for autistic people without a learning disability than for the rest of the population.

I live in a constant state of depression - low-level for the most part, but always there.  I take comfort from the thought that suicide is always there as an option for me.  That's not a 'normal' or particularly rational thing to say.  I have a young colleague who survived cancer and is living with the thought that the likelihood is high that it will come back at some stage in the future.  She soaks up every moment of life... and tells me that I should do the same.  It feels churlish to disagree with her.  But the circumstances otherwise are entirely different.  She has a partner, a wonderful family, loads of friends - in short, a lot to live for.  I sometimes wonder what I still have to live for, apart from simply getting older and probably having some age-related disease come upon me.  I'm already showing early signs of arthritis in some of my finger and toe joints.  I drink too much, but it's a comfort.  It's the one thing, really, that gives me some release.

I attended a workshop the other week on 'Autism and Mental Health', run by my local authority.  It was good to see a lot of autistic people turning out and telling the panel how they felt, what they needed, etc.  At one point, the terminology shifted from 'mental health' to 'mental illness'.  I pointed out the qualitative differences between them.  I asked, too, for some clarification on how they reached their definitions.  I said that I function relatively 'normally'.  I hold down a job.  I keep a home.  I pay my bills and meet all my responsibilities.  On the surface, there's little to indicate that I have any problems.  But then I pointed out that the idea of suicide is ever-present in my mind, and that I find my daily life increasingly exhausting.  But I carry on with it.  What does that make me?  Depressed?  Mentally ill?  I couldn't get a clear answer on that one.

I haven't attempted suicide since my diagnosis, because it gave me more of a sense of personal validation and vindication.  But before it, I made several attempts.  I was lucky to survive two of them.

I carry on with the thought that I can never know if life can get better unless I give it the chance to get better.

The average age of people with Asperger's is 54.  The main cause of early death is suicide.  The incidence of suicide is, so I've read, something like 60% higher for autistic people than for the rest of the population.

I just want to pick holes in these stats. I think MT meant the average age of death (ie life expectancy) is 54 (across all autistic diagnoses). That would mean the average age of a random group of autistic people is likely to be around 27. The same large-scale 2016 Swedish study mentioned in that link is now available in full online and reported in the Washington Post among other places.

And the stats from Autistica are worse: Autistic adults with a learning disability are 40 times more likely to die prematurely due to a neurological condition, with epilepsy the leading cause of death. Autistic adults without a learning disability are nine times more likely to kill themselves (compared to the general population). So that's 800%, not 60% by my reckoning.

The average age of people with Asperger's is 54.  The main cause of early death is suicide.  The incidence of suicide is, so I've read, something like 60% higher for autistic people than for the rest of the population.

I just want to pick holes in these stats. I think MT meant the average age of death (ie life expectancy) is 54 (across all autistic diagnoses). That would mean the average age of a random group of autistic people is likely to be around 27. The same large-scale 2016 Swedish study mentioned in that link is now available in full online and reported in the Washington Post among other places.

And the stats from Autistica are worse: Autistic adults with a learning disability are 40 times more likely to die prematurely due to a neurological condition, with epilepsy the leading cause of death. Autistic adults without a learning disability are nine times more likely to kill themselves (compared to the general population). So that's 800%, not 60% by my reckoning.

Cassandro said:

The time period between registered ASD diagnosis and suicide was on average 2.86 years (s.d. = 2.41) in the low-functioning ASD group and 2.53 years (s.d. = 2.65) in the high-functioning ASD group.

Interesting.  Might be material for research there. 

I'm 5 years over the average age, and my diagnosis was made 3.31 years ago.  I suppose I'm relatively content to be on the planet.  Just.  I've come so close to death a few times - twice by my own hand, three times as a result of near-miss accidents.  I have this thing in my head that I've survived for a reason.  I wondered if being able to be there for my mother at the end of her life, and then to write about it, was reason enough.  I still think there's something else, though.  I should cling onto that.  I think if I can allow alcohol not to get the better of me, and can get through these final few years of work, maybe I'll have chance to find out what it is.

A 100% increase is a doubling. A 200% increase is a tripling, and so on. That's why I said 800%.  The rest of this post may or may not be of interest.

The actual figures from Hirvikoski et al (2016) which is the source of most of the stories, are odds ratio of 9.40. Allowing for statistical error, a 95% chance of the ratio being between 7.43–11.90. This is based on 76 people with 'High Functioning ASD' killing themselves, 7 'Low-functioning ASD' and 1094 controls (non-autistic).

So to be pedantic with myself, I should probably have said there's statistical confidence that the suicide rate for 'Aspies' (in a narrow sense) is about 643 to 1090% higher than non-autistic people. (However, I'd still be wrong, because what I really want to compare is what's called the relative risk. I could work this out, I expect, it's just not given in the paper. It looks like they're very similar.) Also note absolute risk for autistic men and women is similar, about 0.3%, but since women generally succeed in killing themselves less often than men, this is a bigger increase in risk, about 13x, for Aspie women. Also, I'm not sure if the following suggests there should be much more support while waiting for and after diagnosis:

The time period between registered ASD diagnosis and suicide was on average 2.86 years (s.d. = 2.41) in the low-functioning ASD group and 2.53 years (s.d. = 2.65) in the high-functioning ASD group. [Note deaths were looked at over 22 years]

The 66% suicidal thoughts is from different studies :

Three recent high quality studies have uncovered shockingly high rates of suicidal thoughts, behaviours and completed suicide in autistic adults. Our recent research showed that 66% of autistic adults had contemplated suicide in their lifetime. This was significantly higher than patients with psychosis, a high-risk group in which suicide has been extensively studied.

Of course, it would be nice to know how many Aspies manage to stay relatively content to be on the planet.

Cassandro said:

Autistic adults without a learning disability are nine times more likely to kill themselves (compared to the general population). So that's 800%, not 60% by my reckoning.

At risk of seeming stupid (I've told you I'm not good with maths and stats!)... how do you get from nine times more likely to 800%?

Yes, sorry - I was getting confused.  It was the percentage of newly-diagnosed people who have considered suicide, according to research.  66%.

Comment duly amended.

Yes... sorry.  That's what I meant.  My mistake!

On the second point, I may have misunderstood something I recently read (trying to find it). I'm sure it said that suicide incidence is 63% higher for high-functioning autistic people than for the rest of the population.  The figure of 'nine times more likely' is something I heard from a researcher at the Autism and Mental Health workshop I mentioned before.  Forgive my understanding of maths and stats!  Not strong points for me - though I'm usually better with details.