Can Autism Cause Depression Misdiagnosis?

PostedNovember 12, 2025

UpdatedNovember 12, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Yes, confusion between autism vs depression is surprisingly common. Many autistic individuals show behaviours such as social withdrawal, low energy, or flat facial expressions: signs that often resemble depression. When these traits are not properly understood in context, the result is a high misdiagnosis risk, especially in cases where autism has gone undiagnosed for years.

One key issue is that mood symptoms like irritability or lack of motivation may be present in both conditions, but for very different reasons. In autism, these reactions often stem from sensory overload, disrupted routines, or difficulties in expressing emotion, not from sadness or hopelessness. Treating someone for depression without recognising autism can lead to limited progress and increased frustration.

Traits That May Be Misread as Depression

Here are some examples of how autistic behaviours can be mistaken for depressive symptoms:

Social Withdrawal

Autistic individuals may avoid social interaction due to discomfort or miscommunication, not a desire to isolate or a loss of interest.

Flat Affect or Limited Emotional Expression

This can look like emotional flatness, but it often reflects differences in communication rather than emotional state.

Irritability or Shutdowns

These may occur when routines are interrupted, or sensory input becomes overwhelming not necessarily because of a low mood.

Recognising the difference between autism vs depression ensures more accurate diagnosis and access to targeted, supportive care.

Visit providers like Autism Detect for personal consultations.

For a deeper dive into the science, diagnosis, and full treatment landscape,read our complete guide to misdiagnosis and differential diagnosis.

Beatrice Holloway, MSc

Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.