Autism assessments for ASD and depression association

Yes. I can imagine that without truly understanding it.  Most frustrating thing as a parent is I/we feel quite helpless and underprepared at this point. But thanks to this forum have a slightly better understanding/insight which is some comfort. 

Thanks for the explanation Ann.  It sounds quite scary really. It sounds entirely possible but I’m wary of fitting symptoms into a diagnosis as a layperson.   But it does fit almost entirely with my daughter’s position.  The scariest thing is if it is correct what the solution may be?   A lot of information to process at 2am really.  The best news I have is she appears to be more emotionally stable over the last couple of days and is looking forward to her birthday. So fingers crossed. 

Burnout is intimidating if you are undiagnosed. You don't understand what is happening to you. Once you get over it, it leaves you confused.

It is also hard to see from within as it is a cumulative issue. Even though things are so hard, you think you are lazy, or just making a fuss. I couldn't understand it, till I got diagnosed this year and decades of issues dropped into place.

I think you have described it quite well. 

Hi, In terms of autistic burnout- this link explains it really well https://www.autism.org.uk/advice-and-guidance/professional-practice/autistic-burnout 

I have personally experienced autistic burnout (and had it mistaken for depression) and I think it’s important to distinguish between them. When I am burnt out I loose the ability to do all kinds of things that I used to be able to do and cope with before. Everything feels like it takes an inhumane effort and I am so mentally and physically exhausted that I can’t do or enjoy anything - if I have to push through this often leads me to overworking more as even ‘fun things’ become so hard, so I tend to think I might as well work which just worsens everything. Burnout can look like depression because both can stop people from engaging with interests etc but the reason why may differ- with burnout it’s often due to simply being too exhausted to do anything and once you rest properly the interest comes back. I am only talking of personal experience but when professionals think you are depressed, the advice is often to still try to engage with the things you used to be interested in, or to try new things and find new interests or to socialise more again etc. I tried to do all these things and ultimately it made it worse as it deepened my exhaustion and burnout- it took me a very long time to understand that. I hated resting so even when I thought I was ‘resting’ I wasn’t really. I do know now though that if I am more rested then the desire to do things comes back and I can find new interests etc. I think what people don’t realise is that autistic burnout builds up over years and years- all those little things in every day life that are exhausting, the masking, living in a world not built for us, it just all adds up over time and can slowly chip away at you. For me knowing that I am autistic really helped me as I was able to understand myself better and I could start to see some of the stress factors more clearly and recognise some of the patterns. I was then able to remove some of them. 

I don’t think autistic burnout is very well defined at present- there are only very few studies on it so far (and a lot of the information comes from people’s experiences), so the above is just my personal experience. 

Regardless of whether your daughter is depressed or burntout or both, knowing whether she is autistic could really help in the long term

Hi, Autistic individuals may actually be more likely to experience depression, though if your daughter is autistic, it may not be depression but could also be autistic burnout which can present similarly. It is actually very common for autistic people to be diagnosed with other mental health conditions before someone recognises they are autistic (it happened to me- I was told I had depression, anxiety etc before being diagnosed at 25).

I am sorry you are experiencing difficulties in finding someone to assess your daughter. Are you considering going privately? I was diagnosed via Sara Heath and had a good experience:https://shropshireautonomy.co.uk/pre-diagnostic-support/  This is one of the more affordable routes towards a private diagnosis. Sara cannot diagnose anyone herself but she conducts an in depth pre-diagnostic assessment and writes a detailed report- if she believes you may be autistic you can then arrange an appointment with a consultant psychiatrist she works with who will conduct his own assessment and can give a formal diagnosis, which is recognised by the NHS (The psychiatrist has experience diagnosing for NHS). I was moving countries a lot at the time and really struggled and I needed answers but was unlikely to ever make it to the end of a waiting list before moving again- this route to diagnosis was ideal for me as it could all be done online. If this is a route you might consider, I would suggest you email or phone Sara for some more information- she is very approachable and nice- it was actually a very good experience for me to talk to her as I felt understood for the first time in a long time. I don’t know if this helps, but this was just my personal experience. 

Post diagnostic support in the UK for adults isn’t great (in fact depending on area there isn’t any) but at least for me getting a diagnosis still made a huge difference as I could understand myself better. Since your daughter is still at school, it could also help get her more support and it will also help her later on if she wants to go to university or if she needs any adjustments in the work place. In terms of support you could also then consider looking for a counsellor that has experience working with autistic individuals- my university funded some sessions for me with someone who is autistic himself and it has been much more helpful than other types of counselling.  

You also mention that your daughter is not in a good place at the moment- do you know what might be contributing to that? 

I hope your daughter feels better soon and that you can get some answers- having that information really helps even if it takes time to figure it out. 

Thanks Kevmck

hopefully an honest assessment re ASD and depression will be imminent as an appointment now on Tuesday. 
we will take the professional advice on next steps as well but agree depression is the more immediate concern.  Just hope our daughter is engaged in whatever is recommended

Thanks for all of this information bunny.  A lot to digest at a glance. Will look and hope to absorb over the weekend. 

Thanks again Stuart 

very brave of you to be so open and I do appreciate it 

we do have an appointment with a psychiatrist next Tuesday who will apparently advise on mental state. Depression likelihood and medication if appropriate. 

burnout also seems viable. But she’s a teenager so sleep diet and exercise (any healthy life choices really) are heavily compromised. 
I think my wife and I realise this will be a long and fairly daunting journey. We just hope and pray our daughter gets on board as well

but wishing the best of luck to you too. 
david

By the way, an assessment won't fix anything. If ASD is positive, you may have access to some support till 18, or while in education. It is the adaptations that will help, which you could do anyway.

For depression, which can be a side effect of burnout or overload, there is your GP or a psychiatrist. But I would try fix the burnout and source of stress and overload, ensure adequate sleep, hydration, a good diet (with supplements if needed) and light exercise first. I'd try to avoid medication as it may not work, but it is for someone qualified to judge.

Sleep is the biggest thing.

As i recently had my assessment through my work Bupa. 

I needed to get a referral from my doctor before they would approve my assessment. I think that if you can convince whoever you're getting a referral from that you need a depression assessment as well. Then through a private route they should accommodate you. 

I just got referred for an ASD assessment because I had already worked out that's what I needed. When I got my report back they said that i could have depression as I do have some tell tale signs. Despite that I don't think that I am depressed i'm just dealing with a lot. 

Anyway I digress,  if the people who are doing the assessment are doing their job properly then they should let you know if they think that your daughter has depression. As it might be a more immediate issue than any ASD diagnosis. 

The text editor may have added a space, it is one word "joinpsychology.co.uk", itbis Jo in Psychology compressed.

I don't have time to type much. There is an ebook you can but at "embrace-autism.com" . I bought it.

"Autistic burnout is a syndrome conceptualised as resulting from chronic life stress and a mismatch of expectations and abilities without adequate supports. It is characterized by pervasive, long term (typically 3+ months) exhaustion, loss of function, and reduced tolerance to stimulus."

You have executive function issues and bandwidth to do things drops. Additional stress becomes unmanageable. People want to be close but you gave to be alone, a lot. Socialising is very hard. 

I have had it at least 3 times. It takes 6 or more months to recover. You are fragile for a while. Your thinking is dysregulated and you may fixate on things or get things out of perspective.

If you have past trauma, you can enjoy looping on it. It makes you think of ending it all, which I came close to. It is not just being a bit down.

You nervous system is overloaded and you start hypervigilence and seeing threats. Criticism is very hard to take, you shut down, become irritable. Some you are aware of, sone you are not.

You are just in survival mode. Drink offers some temporary relief, for me, but makes it worse overall.

While you are tired, if fight or flight is too active you can't sleep. You kidneys also may not slow at night so you get up for the toilet 3 or 4 times, I thought I had diabetes. A blood test showed various hormones awry, including chronic stress markers.

I also ended up with eye problems, CSR, last time.

Not being diagnosed it is disastrous for relationships and it seriously adversely affected my life. Something I have had some trouble coming to terms with 

I don't think it is well known. Certainly GPs will have no idea.

Hi David and welcome to the community.

It's well known that depression can often co-occur with autism. As the NAS explains, "it affects up to half of all autistic people at some point in their life":

NAS - Depression

Depression, along with certain other mental health conditions, should automatically be considered by any assessor as part of an autism assessment (whether for under 18s or for adults) as part of the method of differential diagnosis:

NICE - Differential diagnoses

This is also explained here, in an NAS article that you might find helpful - along with the other articles in the diagnosis hub:

NAS - What happens during an autism assessment

The NICE guidelines for autism in under 18s also specify that, after an autism assessment, a child may be allocated a key worker to manage and co-ordinate ongoing care and support covering areas including mental health, psychiatry, and psychology.

NICE - Autism in children: Scenario: How should I manage a child or young person with confirmed autism?

If you live in England, then you might like to consider requesting an assessment via Right to Choose (RTC), which enables access to certain, approved private providers who typically have much shorter waiting lists than the NHS, but with the assessment still funded by the NHS. This option is explained here

NAS - How to request an autism assessment

There's a list of RTC providers for autism at the bottom of this page, for example:

NHS Sussex - NHS Right to Choose: for Autism and ADHD Assessment

I notice that you also asked, below, about burnout. You might find these NAS resources helpful:

NAS - Autistic fatigue and burnout

NAS Professional Practice - Understanding autistic burnout

Hello Stuart

thank you for the information. This is a bit of a minefield for us all as new to it but bullying and exams have both been prevalent in the last 2 years

if you’re able to without impacting your own mental health could you describe burnout symptoms briefly please?

re psychology today. That link appears to go to a generic domain. Was there a specific person that helped you yhat we could get in touch with please?

once again thank you for responding

David

A lot of the private places seem to be adult focused, although no-one seems to define this. It maybe taken as 16-18.

Note the autistic burnout may appear to be depression from the outside. Both can co-occur simultaneously and in my opinion (and experience) sorting out the burnout is the most important.

A prolonged period of stress, such as exams or bullying, could do it. 

If I am allowed to mention someone private, you could try join psychology.co.uk who specialises in female presentation. She saw me when I was burnt out, dysregulated and emotional and managed ok (although I am not female or young). I did it in-person but I believe online is also possible. It is all to NICE guidelines so would be accepted by a GP.

You can email and then have a brief call, up to 15 minutes, to decide if she can help you. It is for adults, but as mentioned this is not defined.

(I have no commercial relationship or sponsorship, so this just a personal suggestion.)