Autism and Anxiety

Anxiety is a feeling that everyone experiences at points in their life.

It is common to feel anxious when faced with a threat.

However, when this anxiety gets out of control and starts to impact on an individual’s day-to-day functioning, it may be diagnosed as an anxiety disorder.

What is anxiety?

Anxiety is a feeling of worry, fear or dread. It is part of the ‘fight, flight or freeze’ response, a response which has evolved to protect ourselves from danger. When we sense a threat, hormones like cortisol and adrenaline are released, which increase certain processes in our body.

For example, our heart-rate increases, so blood can get to the muscles quicker to move. We feel more alert, so we are more aware of risks in our surroundings.

The problem is that this response can happen even when we aren’t in danger. This can lead to symptoms of anxiety that feel uncomfortable or distressing and get in the way of life.

Some symptoms of anxiety:

  • Increased heartbeat
  • Shaking
  • Hyperventilating or breathlessness
  • Feeling light-headed or dizzy
  • Not being able to relax
  • Loss of appetite
  • Difficulty sleeping
  • Inability to concentrate
  • Worrying
  • Obsessive thoughts
  • Being unable to enjoy things
  • Difficulty taking care of yourself
  • Avoiding situations which increase anxiety

Anxiety is sadly very common amongst autistic children and adults, with a recent survey from the National Autistic Society suggesting that 94% autistic adults experience anxiety, with around half experiencing severe levels of anxiety.

Although anxiety can be triggered by similar things to non-autistic people, such as worries about the future, anxiety in autism is also affected by a wide range of things. It can be particularly debilitating, especially since autistic people may already find social environments overwhelming, and the sensory feeling of anxiety may be particularly uncomfortable. Anxiety may be triggered by:

  • Changes in routine
  • Social situations where expectations are unclear
  • Unfamiliar surroundings
  • New people
  • Loud noises
  • Difficult sensory environments
  • Sudden change of plan
  • Crowds
  • Misinterpreting social cues or body language
  • Needing to talk on the phone

A lot of the things which an autistic brain finds hard to process and manage are things which can happen every-day, like sudden change and difficult sensory environments. Each time these situations are faced, an autistic person may experience spikes in anxiety and feel unsettled. This can lead to burnout, meltdowns, panic attacks, and exhaustion. The individual may be desperate to engage with particular events, but feel unable to do so, leading to feelings of low self-worth and depressive symptoms.

It’s also important to recognise that this anxiety may stem from trauma from previous social interactions or environments where the individual as made to feel inadequate, for example due to misinterpreting a social cue or not understanding a joke. Anxiety may have developed to try to protect themselves from this again, to try to keep them safe. Autistic people are often subject to bullying, and sadly even assault, so anxiety can act as a defence mechanism.

Sometimes it can just feel like the world isn’t compatible with an autistic brain and it can feel extremely frustrating for an autistic person to not be able to manage to navigate situations like other people seem to without ending up in a meltdown.
So, what can help?

  • The environment being made more sensory-friendly
  • Sensory accommodations like ear-defenders or earplugs, fidget toys, comfier clothing and weighted blankets
  • Learning to identify triggers – for example by keeping a diary
  • Building in time to engage with special interests in order to recharge
  • Using visuals to structure your day so you know what is expected
  • Other people giving you advanced warning of change where possible
  • Alternative forms of communication like e-mails
  • Engaging with the neurodivergent community for extra tips and advice
  • Being supported by a therapist or counsellor who understands autism
  • Sometimes medication can help (obviously discussed and monitored by a specialist)
  • Being able to talk things over with a trusted person

It can be hard to disentangle anxiety and autism, when it is so difficult to navigate day to day life as an autistic person. It’s important to recognise the challenges and support each other when people are struggling.