Depression can affect anyone. Depression can mean people have difficulty with their daily routines. It can impact on relationships and effect overall health, well-being and enjoyment of life. Depression is noted as the most common mental health condition that a person with intellectual disability may experience, however it may be hard to tell if someone is affected. People with an intellectual disability may have difficulty communicating how they are feeling. They may have behaviour difficulties or take medications that can overshadow a mental health issue. In this month’s blog, we will look at some of the signs and symptoms of depression in people with an intellectual disability, what treatments might help, and what you can do to provide support.

Signs and Symptoms

For people with intellectual disability, it might be hard to tell if they are experiencing depression. However, you might notice changes in behaviour that are out of character such as: 

• A change in mood that tends to be more sad or angry. This could also present itself in aggressive outbursts or even self-harming;
• Withdrawing from activities that used to be enjoyable;
• Disinterest in food;
• Difficulty sleeping or a change in sleeping habits or
• Decreased energy, more tired than normal or a noticeable slowness in movement and speech.

It is also important to consider whether there have been any major changes or negative experiences in the persons life recently. Even a minor change in routine could be very significant and result in a depressive episode. 

Available Treatments

There are a number of  different treatments that are known to be useful for people with intellectual disability who have depression. Psychological therapies include cognitive behaviour therapy, counselling and psychotherapy. These therapies may also need to be adapted to meet the specific communication and cognitive needs of the person. Medical treatments can include the use of medications. Medications should always be reviewed and prescribed by either a psychiatrist or GP and used in combination with other supports such as psychological therapies. Lifestyle changes can also be beneficial. Regular exercise, a healthy diet and encouraging the person to engage in more activities that are enjoyable can all help to minimise the effects of depression.

How can you help?

Here are three steps you can follow if you suspect that someone with intellectual disability might be depressed:

Step 1 – Approach the person to talk about your concerns by communicating with them in their preferred communication style and avoid leading questions. Check in with them to make sure they have understood what you have said and you have understood them.  

Step 2 – Listen non-judgmentally with empathy and genuineness. You may need to give the person additional time to think and respond, especially if they have difficulty communicating.

Step 3 – Encourage and support them by discussing options for different types of professional help available, self-help strategies and explore their available family and friendship support networks. Be led by the options that the person thinks might be right for them. They might also want your support to access different services.

Not everyone will present with the signs and symptoms described. If you think the person is in crisis, or is thinking of self-harm, you should always seek support from a mental health professional or emergency services. However, with the right support and treatment, people with depression can go on to lead fulfilling lives. People with intellectual disability can be vulnerable to depression for a range of different reasons. It is important not to assume that just because someone usually presents with some of the symptoms described, that is just how they always are. You can always check in to truly identify if they are OK and if they need some additional supports.

(Reference: Kitchener BA, Jorm AF, Kelly CM, Papas, R, Frieze,M. Intellectual Disability Mental Health First Aid Manual. 2nd ed. Melbourne:Mental Health First Aid Australia, 2010)

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