Autism and Anxiety

By sandra.caplesc…, 19 August, 2022
Sad girl staring in the distance

In this day and age, anyone experiences anxiety. It’s a common reaction when feeling stressed. Each day we face situations that can cause us anxiety: sitting in a traffic jam, not understanding a joke, or even arriving late to work. These are not life-threatening situations; some individuals can see the whole picture and calm themselves down. Life goes on.

But for a person with autism spectrum disorder, everyday situations can cause great anxiety.

While other people can cope with daily frustration, stress, and anxiety, individuals with ASD cannot get over them due to navigating social and sensory environments. Research even suggests that autistic people are more prone to experiencing social anxiety. Half of all autistic individuals experience high levels of anxiety regularly.

Anxiety in children is a common mental health issue and can significantly impact their lives. This article discusses the link between autism and anxiety.

What Is Anxiety?

Anxiety is described as a “feeling of unease, such as worry or fear that can be mild or severe.” The NHS says that anxiety becomes a critical condition when someone experiences it for a prolonged period of time and significantly impacts someone’s quality of life.

There is a normal amount of anxiety one feels, but anxiety disorder can become a significant impediment in life. Many individuals with anxiety have unreasonable fears or perceptions that stray from reality. Even if the source of anxiety is not realistic, the anxiety is very real and can lead to panic attacks, emotional meltdowns, or self-injury.

There are multiple forms of anxiety in children:

  • Phobias
  • Separation anxiety disorder
  • Social anxiety disorder
  • Panic disorder
  • Generalized anxiety disorder

What’s important is to recognize the difference between a person on the spectrum and one who simply enjoys solitude. It takes patience and time to get to know an autistic person and separate personality quirks and signs of anxiety.

Autism and Anxiety

A recent National Autistic Society survey found that 47% of autistic individuals have severe anxiety. Despite promising advances in research, the understanding and treatment of anxiety in people with autism are somewhat limited. Understanding the factors triggering anxiety in people with ASD and how autistic kids experience, think, and speak about anxiety, will inform the development of autism-specific interventions.

Autistic people experience stress and anxiety when faced with social situations and stimulating sensory environments. Another cause for anxiety is the sense of being misunderstood and not accepted by neurotypical peers. To fit in, autistic people can mask or camouflage—which can significantly increase anxiety.

Read: Understanding Autism in Girls.

Autism spectrum disorder is characterized by social and communication issues and repetitive behaviors. No two people will experience the same behaviors. That’s why some people have high-functioning autism, while others need assistance their whole life. Early intervention is key to starting treatment and managing symptoms better.

Anxiety is not a core feature of autism, but anxiety disorders are a comorbid condition found in adults with ASD. Experiencing high levels of anxiety can lead to meltdowns and exhaustion, as well as fatigue and burnout.

Anxiety Symptoms

Recognizing and treating anxiety in people with autism is important—and can significantly impact core aspects of autism, such as social withdrawal and repetitive behaviors. It complicates the life of autistic people, especially when it comes to navigating the social world. Generally, it interferes with job performance, placement, and independent living.

A better understanding of treating anxiety disorders and recognizing the signs can improve the quality of life for many children and adults with autism.

As a general rule, autistic children show their anxiety by stimming, engaging in obsessive and ritualistic behavior, and a resistance to changes in routine. In addition, children with autism can’t recognize anxious thoughts and feelings, so they don’t know they are anxious.

You might notice an increase in certain behaviors, such as:

  • Have trouble sleeping
  • Have emotional outbursts (meltdowns)
  • Stim by flapping or rocking
  • Insists on routine
  • Rely on obsessions and rituals
  • Hurt themselves by head-banging or scratching the skin

Physical Symptoms

Symptoms of physical anxiety include:

  • Feeling shaky
  • Sweating
  • Feeling sick
  • Racing heart rate
  • Short of breath

Behavioral Symptoms

Some of the behavioral symptoms of anxiety in people with autism include:

  • Self-harm
  • Running away
  • Seeking reassurance
  • Meltdowns or tantrums
  • Avoiding situations
  • Overthinking
  • Obsessive routines

Anxiety Triggers

People experience anxiety differently. However, there are some common triggers for autistic people, such as:

  • Changes in routine or the environment
  • Unfamiliar social situations
  • Sensory sensitivities, such as bright lights, loud sounds, strong smells, or food textures
  • Anticipating specific situations
  • Time of transition, such as starting a new school year
  • Specific fears, such as sleeping on their own
  • Pressures, demands, or expectations

The first step in reducing your kid’s anxiety is to help them manage it by finding out what makes them anxious in the first place. Autistic children have trouble understanding and managing emotions, so you might need to work with your child to discover the source of anxiety.

Tips for Managing Anxiety

Anxiety is a natural part of our lives. Everyone will experience anxiety at one point or another. Fortunately, there are some steps you can take to ease your child’s worries and encourage them to manage their anxiety levels by themselves.

Once you figure out the things that make your child anxious, you can work towards helping them manage their emotions. Here are some things you can do.

Find a New Way to Communicate

Most autistic children think visually, so maybe visual support and social stories will work well with your child. You can use these tools to help your little one prepare for situations that cause anxiety. For example, social stories walk a child through the plan—from the beginning to the end of the event—and offer a sense of predictability that gives the child control over their anxiety.

You can use video modeling, social stories, or other visual tasks to communicate to your child what is planned—and what they should expect. Some children want to be warned about a change or an event in advance; you know your child better than anyone. Use their strengths to your advantage.

Use Relaxation and Calming Techniques

You can use some ways to calm your child when anxious, such as:

  • Reading a favorite book
  • Taking deep breaths
  • Counting slowly to 10
  • Doing jumps on a trampoline
  • Going to a quiet place in the house

You can guide your child to try these relaxation techniques when feeling anxious. You can also try self-soothing strategies such as meditation, visualization techniques, or deep breathing.

Incorporate Deep Touch Pressure

Deep touch pressure helps a child calm down when overwhelmed. Deep touch pressure stimulation is a firm, but gentle pressure applied to the problem and relaxes the nervous system.

By incorporating deep touch pressure into your child’s life, you can ensure your child will stay calm due to the release of serotonin and dopamine. Your child can wear weighted wearables, compression garments, weighted lap pads, or weighted blankets.

Create a Safe Space

A safe space is somewhere a child can go when feeling overwhelmed. It’s a place where the autistic child can go to calm down and regroup. In a sensory space, the child has limited exposure to sensory input—this can be helpful when anxiety levels rise. This is why it’s essential to know your child’s signs of distress, which can be nonverbal indicators.

Continue Reading: How to Create a Calming Sensory Bedroom.

Explore Different Therapies

Support therapies such as cognitive behavioral therapy, exposure therapy, and even pharmacological interventions can reduce anxiety symptoms in autism.

Talking to a therapist can help children with autism cope with challenging situations. They can also offer techniques that can help children relax. Cognitive behavioral therapy (CBT) is very effective for anxiety disorders in adults and children with ASD. CBT changes how an individual interprets a situation by reducing negative feelings or unhealthy responses.

It involves:

  • Interventions with parents
  • Learning to differentiate between helpful and unhelpful anxiety
  • Progressive exposure to feared stimuli
  • Learning to identify anxious thoughts
  • Practicing reciprocity skills
  • Visual prompts to help cope with abstract thinking

When it comes to medication alone, it’s unlikely to mitigate symptoms of anxiety. Usually, anti-depressants, anti-anxiety medications, and beta-blockers are used to treat anxiety. Still, few studies say whether these drugs are genuinely effective for people with autism. Always speak with your GP or pediatrician about this option, as some medications have side effects, and children with autism might be sensitive to low doses.

Have Fidget Toys at Hand

Fidget toys are designed to spin, have clickable buttons, or pop out—and their primary purpose is to keep hands busy. Depending on your child's fidgeting needs, they come in various colors, sizes, styles, and movement options.

The purpose of the fidget toys is to allow children with autism to engage in repetitive behaviors that help focus the mind and ease anxiety. Fidget toys come in multiple forms (stress balls, putty, anything squishy), and they are soothing, calming—and enjoyable. Here are some options for you: Best Fidget Toys for Autism.

Try the Molehill Mountain App

There are apps available that offer personalized support for people with anxiety. The most popular app is Molehill Mountain, which tracks mood and worries and identifies triggers. It helps people with autism understand their anxiety. The app also offers evidence-based daily tips to help you understand anxiety better.

Brain in hand is another app with a diary, notes, and reminders of daily tasks and offers individual coping strategies. In addition, it has access to support from the National Autistic Society.

Practice Situations

Children can feel more at ease if they practice for stressful situations. It can help your child understand these challenging situations and feel more prepared for them. For example, going to the hairdresser is usually a stressful experience for autistic children because they interact with strangers or don't like strangers touching their hair. You can plan and go to the hairdresser when it's quiet or calm. Go through the steps of cutting hair with your child—or let your child watch someone else get their hair cut.

You can also roleplay these tense situations and practice together. Take turns playing different roles. Remember to keep the scenarios short and simple. Always encourage and praise your child when they do something right.

Try Mindfulness

Mindfulness is a technique that can help people with anxiety. Its purpose is to retrain the way you think and focus more attention on the present moment. Moreover, mindfulness is about listening and accepting your thoughts and feelings.

Keep a Diary

Uncertainty is difficult for people with autism. Keeping a diary helps autistic people understand their anxiety, what triggers it, and how to manage it. Writing about their experiences can help them identify the causes and symptoms of anxiety. A suggestion would be to find a predictable daily routine.

Find a Support Group

Some people with autism find sharing their experiences with other autistic people helps them feel more prepared to face the world and less anxious. Sometimes, it's difficult to tell people how you're feeling. That's why talking to someone can make you feel better. You can always contact a support group if your child doesn't want to talk to a family member or friend.

Monitor Energy Levels

Sometimes, social situations can deplete us of our energy. People with autism might feel the same way, especially if they have difficulty blending in or understanding other people's feelings. They might get tired quickly. Always ensure your child is taking time for themselves and doing things they enjoy.