Can the causes of autism also cause depression or anxiety?

I have been following the reaction to the Spectrum 10K project by monitoring the #Spectrum10K and #StopSpectrum10K hashtags (Spectrum 10K is a project aiming to gather the DNA of 10,000 autistic individuals). I have often seen the claim that the depression and anxiety which many autistic individuals experience cannot be caused by autism. Therefore, if we want to reduce the level of depression and anxiety in autistic people there is no point studying the causes of autism. In this blog post I will analyse this claim.

It is commonly claimed that many autistic individuals have such high levels of depression and anxiety because our society does not accept them or accommodate them. Some people can be hostile to other people who are different and this rejection can have a negative impact upon those people who are different. Also, society is set up to accommodate some people whereas other people whom it is not set up for face many barriers in daily living. These claims seem correct. The question is whether the cause of autism could cause depression or anxiety in addition to the depression and anxiety caused by societal response. I will now outline two possible reasons for thinking the causes of autism can cause depression or anxiety.

In relation to non-autistic individuals, depression and anxiety can result from many factors. Some people get depressed or anxious because how their life is going. To say they get depressed or anxious due to their genes would be a mistake. However, other people get depressed or anxious even though there life appears to be going well. There is no detectable environmental trigger of the depression or anxiety. In these cases it is plausible to say that causes internal to the individual are causing the depression and anxiety. So this is an example of depression and anxiety occurring for reasons other than how their lives are going. Could the same sometimes happen in autistic individuals? Now, it could be claimed that if this is happening in autistic individuals then this is due to the causes of depression or anxiety and not the causes of autism. However, do we actually know this? Is it possible that some causes of autism play a causal role in the characteristics associated with autism and can separately also play a causal role in producing depression and anxiety? I do not think this can be ruled out. The sheer complexity of genetics is immense, with any particular gene potentially acting very differently depending upon which other genes are present and what environmental interactions occur. We have only a very limited understanding of this. So it is possible that the causes of autism actually do also result in depression or anxiety which arise irrespective of an individuals life situation. To be clear, I am not saying this is the case, rather, I am saying we do not know enough to rule out this being the case.

Another reason to question the claim that autism cannot cause depression and anxiety is the possibility that what we call depression and anxiety in autistic people is different to depression and anxiety in non-autistic people. When an autistic person reports that they are depressed, and when an non-autistic person reports that they are depressed we take them as to both be experiencing the same thing, namely depression. However, it is possible that actually the phenomenological experience (how it actually feels) of autistic individuals when they report depression is different to the phenomenological experience of non-autistic people when they report depression. This phenomenological experience could arise because what autistic individuals and non-autistic individuals report as depression actually stems from different causes. This would give reason to think that actually what is being reported as depression is actually different in both cases. All this could also be the case for anxiety. If what we call depression or anxiety in autistic people arises from the causes of autism then the causes of autism actually can cause depression or anxiety in autistic people. Now, is there any evidence for this claim? The problem is that phenomenology is very difficult to do and it is very rarely actually done today, so this is not the sort of thing which we have much evidence upon (although I have often felt that my experience of depression seems different to phenomenology I have read relating to non-autistic individuals). Additionally, it raises a whole bunch of metaphysical and conceptual issues about what make two things instances of the same thing (I have published a couple of papers which partly discuss this sort of issue in psychiatry, but ultimately philosophers have discussed these issues for literally multiple millennia in areas other than psychiatry). Seeing depression and anxiety as the same, or not the same, in autistic and non-autistic people seems to be compatible with the evidence and with credible metaphysical and conceptual approaches. Again, I am not suggesting it is the case that depression and anxiety are different in autistic and non-autistic individuals, rather, I am showing that it could be a possibility.

In this blog post I am doing philosophy, aiming to show alternative possibilities rather than showing a particular interpretation is true. I aim to show that we cannot simply dismiss or discount the claim that autism can cause depression or anxiety. As such, I think this is not grounds, in itself, to object to biological research on autism. Of course, I have not addressed many of the other potential problems with biological research on autism in general and Spectrum 10K in particular which may give good reason to reject Spectrum 10K (I have discussed some scientific problems with Spectrum 10K in another blog post).

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