People with autism are more likely to be diagnosed with anxiety disorder than their neurotypical peers. There are several reasons contributing to this overlap. However, with timely intervention, anxiety can be treated or managed as autistic individuals learn to regulate their thoughts and feelings.
Let’s learn more about anxiety and how it affects people on the autism spectrum, as well as helpful strategies (both self-managing and those dependent on others) to manage anxiety with autism.
What is Anxiety?
Anxiety is a feeling of heightened alertness. There can often be physical symptoms of anxiety: e.g., the heart beats faster, and the body automatically becomes very tense. This feeling may accompany fear, worrying about the future, or general stress - so the sinking feeling you get before a big interview, or the butterflies in your stomach when you see your crush walk up to you may just be you being anxious.
However, when this state becomes so overwhelming that you cannot function normally, complete day-to-day tasks or fail to get anything done, then it becomes a problem. When anxiety symptoms are overwhelming and persist without any stressors or reasons present, it is considered an anxiety disorder. Note that an anxiety disorder can only be diagnosed by a licensed practitioner.
Types of Anxiety Disorders
Anxiety affects people in different ways, or in different scenarios. People exhibit various ways of coping with anxiety as it is a unique experience. According to the [American Psychiatric Association](https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders#:~:text=There are several types of,anxiety disorder and selective mutism.), anxiety disorders consist of various types, some more debilitating than others. The table below lists some common anxiety disorders with examples.
Why is Anxiety Common in Persons Also Diagnosed with Autism?
Autistic individuals are statistically more prone to developing anxiety disorders. There are many reasons for this overlap. According to a webinar sponsored by the Autism Research Institute, Autism, Anxiety, and the Five Prime Suspects - there are five main reasons that contribute to the prevalence of anxiety in the autistic community.
Sensory Activities
Autistic people may experience sensory activities involving sight, touch, smell, noise, and taste more intensely than others. Facing different and new sensory experiences can overwhelm them easily, and make them very uncomfortable, thus leading to anxiety.
Focusing on Details
Autistic Individuals often have an eye for detail as they canbe acutely aware of their environment. While this attention to detail is a valuable skill to have, it can fuel anxiety when they are expected to adjust to changes in their environment or their routine.
Task Frustration
People with autism may struggle with motor skills, complex cognitive processing, and keeping up with the pace of their peers. All of these can lead to anxiety about completing the task at hand.
Language
It is common for autistic individuals to struggle with speech, verbal communication, or associating words with ideas or thoughts in their head. This may limit their ability to communicate effectively, which can lead to anxiety as they ineffectively convey their feelings, needs, or preferences to others.
Social Situations
There is a lot of pressure to understand the nuances of socially acceptable rules, which when paired with language and communication barriers, can lead to serious anxiety in autistic people. The situation tends to be worse for individuals who are more personally aware .
How to Differentiate between Anxiety and Autism?
The symptoms of both anxiety and autism can manifest in similar ways. This can lead to misdiagnosis or delayed diagnosis, causing an overall delay in helpful intervention.
It is important for parents and caregivers to keep track of changes in behavior and mood, instead of just casually noticing them. They will need these data to help physicians and specialists identify if certain behaviors or habits are a one-off thing in response to the environment, or a symptom of a long-term condition.
The key here is to track what you see, rather than what you think is causing responses. Write down what happens before a troubling behavior (the antecedent), what the behavior is (as descriptively as possible), and what tends to happen afterward - perhaps in response. For example, when facing a crowd, the individual may fall asleep, start to shake their hands, complain of a stomach ache, or even run away. The caregiver may pursue them or leave them alone. This types of scenario would be good to share with your doctor or therapist.
It is easier to differentiate between autism and anxiety when there are data collected over time about changes in behavior. This further helps in arriving at the right diagnosis so the most effective and helpful treatment option can be selected for the autistic individual.
Conclusion
Everyone experiences anxiety at some point in their lives, but autistic individuals may be more prone to developing anxiety disorders. Symptoms of anxiety and autism overlap, and the two are sometimes confused. Close observation and behavior tracking can help physicians in determining a diagnosis, and lead to better targeted interventions. There are several strategies to help with anxiety, but the success of any depends on the individual's stress and skill level, and support from their therapists, caregivers, or parents, among other factors.
Disclaimer: This article does not contain behavior-analytic content.
