21/11/2025
Some Autistic people experience sudden, devastating drops into despair, hopelessness, and panic, with an incredible level of intensity.
While not a formal diagnosis, this experience has come to be known as an anxious depressive attack (ADA), an urgent state of emotional distress that is familiar to many Autistic people.
An ADA “mostly begins with an abrupt surge of intense anxiety followed by uninterrupted intrusive thoughts; lasting ruminations about regret or worry produced by violent anxiety, agitation, and loneliness.”*
Let me try to describe what an ADA feels like.
Out of nowhere, or after one small thing, you may feel a wave of suffocating despair that feels impossible to escape.
You’re not just anxious; you feel completely hopeless.
Some clinicians are now using the term anxious depressive attack (ADA) to describe this kind of episode.
It’s not an official diagnosis, but it names something many Autistic people have experienced: a sudden and intense mental health crash marked by severe hopelessness, emotional pain, and overwhelming anxiety.
An ADA often begins with a deep sense of emotional collapse. From there, intense anxiety sets in.
Thoughts become intrusive and nonstop.
You may feel panicked, numb, or completely detached.
It can be hard to speak, hard to think, and impossible to function.
Outwardly, someone might seem quiet or withdrawn, yet internally, they are in distress.
For Autistic people who already experience heightened sensitivity to stress, social rejection, and emotional overload, these attacks can be especially frequent and intense.
Recent research suggests that anxious depressive attacks may be the link between rejection sensitivity and treatment-resistant depression.
Rejection sensitivity can lead to these attacks, and the attacks themselves can make depression worse.
There is also evidence that some brains are simply wired to feel rejection more intensely.
That’s not a defect or a flaw; it’s simply a neurological difference.
This understanding could lead to treatments that are actually designed for brains like ours.
If you have had an ADA, or watched someone you care about go through one, you know how real and painful it is.
We need more research, better support, and a system that sees what so many of us are actually going through.
I am not a fan of research aimed at eradicating autism.
I am a fan of research that prioritizes the quality of life for Autistic people. We must find ways to help those who suffer these frightening attacks, and it starts by formally identifying the experience.
If you are a research ju**ie like I am, or if you just want to read more about this topic, here’s the link to the research (and the source for my quote):
*🔗 https://onlinelibrary.wiley.com/doi/10.1002/npr2.12399