DEPRESSION, SUICIDE RISK
People with Autism Spectrum Disorders such as
autism and Asperger's
syndrome can be prone to depression,
which may lead to a risk of suicide in some cases. These developmental
disorders have a lasting change in a person’s thinking, how they
react to certain situations, their work and how they relate to others.
People with Asperger's or autism may face increased stress, greater
difficulty with relationships, difficulty managing their own emotions,
and often fewer skills for dealing with these problems. Without
appropriate support they may find themselves feeling isolated and
It is important to realize that because of these and other factors,
autistic teenagers and adults might experience feelings of depression
and may be at greater risk of suicide. For people who think about
ending their lives, suicide may represent an answer to what they
feel is an otherwise unsolvable problem. The choice may appear preferable
to circumstances such as enduring emotional distress or disorder,
which the person may fear more than death.
It is particularly important for family members, friends and those
who care about the person to know the danger signs, know ways of
being helpful and know who you can turn to for advice or referral.
Recognizing the first signs
A suicide attempt is rarely made following a sudden
or impulsive decision. Rather, it is more common for individuals
to shift between the stages on a continuum which range from the
initial thoughts about suicide to committing suicide. The stages
may be bi-directional (i.e. a personal may move forward, return
to an earlier stage or no longer consider suicide as an option):
• Organizing means
• Suicide attempt (intentional or subintentional)
• Commit suicide.
Some may engage in self-harming
behavior which has the potential to lead to death while the
actual goal is not to die. It is important to be alert to cues that
someone may be considering suicide. Things to look out for are:
• Statements like ‘It would have been better if I had died’
• Making threats about committing suicide
• If they become very withdrawn or depressed.
Autism and Asperger's syndrome can affect communication
abilities, which may complicate looking for these cues. If the person
has tried to commit suicide before, you should particularly be aware
of cues and try to assist them to seek professional help. There
are various factors which indicate a higher risk of suicide occurring.
The autistic person may have access to lethal means and the development
of a specific plan. Drug abuse, engaging in extreme behavior and
catastrophic reactions to relatively mild stress can also increase
the risk factor. In some cases a final crisis may act as a precipitating
How you can help
A person who is considering suicide usually needs
to know that others care. Some suggestions on providing support
• Sometimes just being with a person is helpful, even if not talking
• Contact others who may be able to provide support
• Listen to what they are saying about themselves and their life
• Avoid saying things like ‘You should be grateful you are alive’
or ‘You'll get over it’
• Tell them you are always willing to talk and that there are others
who care as well.
• Encourage them to stay in touch with friends or make new ones
• Make sure they are in touch with a local doctor.
When the risk of suicide is high
Crisis intervention can involve a number of strategies.
Immediate support can include telephone counseling, referral to
a psychiatrist, closely monitoring the person or moving the person
to a less stressful environment. Other strategies are:
• Medical/psychiatric treatment (including medication)
• Psychological therapy
• Mental health case management
• Linking into support systems (e.g. family and community organizations).
Specific crisis intervention strategies for suicide risk
The general aim is to lower the level of lethality
or very high risk of suicide by working to: a) increase the individual’s
psychological sense of possible choices and b) to increase his/her
sense of being emotionally supported.
Strategies may include the following:
• Establishing rapport (e.g. ‘I'm listening and I want to support
• Explore the person’s perception of the crisis
• Focus on the immediate past (e.g. a recent significant event or
problem) and immediate future
• Develop options and a plan of action
• Increase the options available to the person
and the number of people available to help
• Arrange removal of the potential means of suicide where possible
• Monitor their emotional state and establish a follow-up plan
• Try to involve appropriate people in the person’s natural support
Encourage the person to develop a plan including
resources and support in the immediate future. Write down the steps
of a personal safety plan to be carried around by the person (e.g.
in their wallet). Also, try to increase the person’s investment
in the future by involving them in small and meaningful activities
(e.g. tasks around the house and garden).
It is recommended that people offering support
to a distressed individual avoid using the following techniques:
• False reassurance e.g. ‘Everything will be fine, don't worry’
• Inappropriate use of facts e.g. ‘You'll recover from your brain
injury within a year’
• Confrontation e.g. ‘It is time for you to accept that you will
never walk again’
• Minimizing a person’s feelings e.g. ‘Come now, it is not that
• Probing or intrusive questioning (e.g. ‘Why do you think your
girlfriend left you?’
A combination of the following techniques can be used to convey
• Active listening (nodding and minimal responses such as ‘okay’,
• Meaningful eye contact and supportive body language
• Reflection of feeling (e.g. ‘You sound really upset’, ‘I can see
that you are frustrated’)
• Reflection of content (e.g. ‘It sounds like you want your family
to give you more space’)
• Paraphrasing and summarizing (e.g. ‘At the moment you are feeling
• Asking permission (e.g. ‘I want to help you - can I come and sit
Support for the parent or carer
Working with, or being close to someone who is
at high risk of committing suicide can be extremely stressful. It
is very important that people receive their own support and take
care of their own emotional well-being. Support for the person working
with the distressed individual may come in the form of debriefing
from other professionals. Relatives and friends may also benefit
from seeking professional help in order to express their feelings
and receive advice.
If you are thinking about suicide
If you are a person with autism or Asperger's
syndrome, and you are considering suicide, you should know that:
You are not alone. Most people think about suicide at one time or
another, and thinking about suicide does not mean that things can’t
Sometimes problems seem unbearable, but there are always things
you or others can do. If you have an Autism Spectrum Disorder,
it might be particularly hard to see your way through some problems.
That is why it is essential that you talk about your problems with
someone who can help.
There are always people willing to help you work out your problems.
Don't be afraid to ask for help. Let family members, friends, your
local doctor or other professionals know how you feel.
See the Family
and Carer issues section of the website for more information.
Click here for the full
range of Asperger's and autism fact sheets at www.autism-help.org
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