Communication and social difficulties and repetitive behaviors often characterize autism spectrum disorder (ASD). There’s a saying that if you’ve met one autistic person, you’ve met one autistic person. However, no one person on the spectrum is the same as another.
While anxiety is not considered a feature of ASD, many autistic people suffer from it. Thus, you can say that anxiety is a common comorbid condition of ASD. Research suggests that autistic people are more prone to anxiety, diagnosed in more than 20% of adults with autism compared to 8.7% of neurotypical adults. Some anxiety symptoms include obsessive thinking, difficulty concentrating, or difficulty sleeping.
ASD and anxiety might look similar to the untrained eye. Still, experts say that a better understanding of the relationship between autism and anxiety can improve the quality of life of many autistic people.
In this article, discover more about the relationship between autism and anxiety and the difference between social anxiety and autism.
What Is Anxiety?
Anxiety is often described as a “feeling of unease, such as worry or fear, that can be severe or mild.” Anxiety becomes a serious condition when someone experiences it for a prolonged period and can significantly impact someone’s quality of life.
Anxiety can become a severe impediment in life. Even if the source of anxiety is unrealistic, anxiety is a serious problem that can lead to self-injury, emotional meltdowns, and panic attacks.
There are multiple forms of anxiety in children:
- Specific Phobia: Phobias are intense, irrational fears of something that pose little or no danger. This type of anxiety can arise early in people with ASD because of over-responsiveness to sensory stimulation.
- Obsessive Compulsive Disorder: OCD is a common comorbid condition in ASD. It’s characterized by unwanted and intrusive thoughts and other compulsive behaviors. Compulsions are often a coping mechanism for relieving anxiety.
- Social Anxiety: Social communication impairment is an intense fear of being negatively evaluated in a social situation. In turn, this leads to avoidance of said social situations. As a result, the person limits their social opportunities to practice social skills and might provoke negative reactions from others.
- Separation Anxiety: Social anxiety might evoke overprotective responses from parents and caregivers that might strengthen avoidance behavior in children. Separation anxiety arises when the child has to separate from attachment figures.
The Difference Between Social Anxiety and Autism
Autism spectrum disorder and social anxiety disorder (SAD) are two conditions that seem similar because the symptoms appear to be the same. It isn’t easy to distinguish between the two, yet there are similarities and differences you should pay attention to.
One of the reasons why social anxiety and autism are confused is because of similar symptoms. These symptoms might include the following:
- Intense nervousness
- Limited social communication
- Lack of eye contact
- Difficulty in adapting to changes
People with ASD struggle with maintaining eye contact or body posture, reading social cues, and conversing. While not all people with ASD are the same, some prefer limited social communication. As a result, they might appear quiet or withdrawn.
Socially anxious individuals are likely not to speak so much, talk quietly, or have a less confident posture.
Avoiding Social Situations
ASD and socially anxious individuals want to spend time alone rather than be in social situations, although the reasons are different. They might avoid social interactions and actively avoid people. These individuals are happier when isolated from peers. The overlapping similarities might make it difficult to distinguish between ASD and SAD.
Have a Hard Time Building Friendships
Both individuals with SAD or ASD have trouble building and maintaining relationships. It might be difficult to form relationships due to wanting to spend time alone and avoid social situations.
The most significant difference between autism and social anxiety is that social anxiety is a mental health condition, while autism is a neurodevelopmental condition.
While both people with SAD and ASD prefer to avoid social situations, they do it for different reasons.
People with ASD often experience sensory stimulation in social situations and, as a result, might be less inclined to seek out social interaction. In addition, they struggle with figuring out what others are feeling or thinking. This is often stressful for an autistic person because social mistakes might equal a bad experience in the autistic person’s mind.
Those with SAD don’t experience sensory issues but choose to withdraw from social situations for fear of being judged.
There’s also a big difference in social skills, such as:
- People with ASD don’t know how to respond to many social situations. They don’t have the required social skills to engage in conversation. For example, they can speak too loudly or stand too close to someone, which might make them seem rude without intention. They also fidget because this is how they get comfortable in social situations.
- People with SAD have the necessary skills but are afraid to use them in social situations. Social anxiety might often cause people to stutter, blush, or not know what to say. They might seem to have poor social skills, but they’re just anxious. As the person becomes more familiar with the situation, they’ll be able to engage in the conversation.
People with autism also have symptoms different from people with social anxiety:
- Have sensory issues
- Have atypical development
- Often engage in repetitive or unusual movements and noises
- Have specific and almost obsessive interests
- Can’t understand humor or sarcasm
- Have meltdowns when overwhelmed
The diagnostic criteria for both disorders are different. For example, people with ASD engage in repetitive behaviors, while SAD people fear judgment in social situations.
One important thing to notice is the age of onset for both conditions. SAD usually develops at any age. While genetics can influence it, SAD is triggered by stressful life events or trauma.
Autism has been present since birth, and it’s a lifelong condition that cannot be cured. You can manage symptoms through therapy, whereas social anxiety can be effectively treated.
Research suggests that autistic people try to logically figure out the meaning behind facial expressions rather than experiencing a normal emotional reaction that neurotypical people feel.
This happens primarily because of the amygdala, which activates when reading facial expressions—and is present in people with SAD. It shows that the two disorders are very different from each other.
Do All People with ASD Have Anxiety?
People with autism can have social anxiety. Around 30% of autistic children have a diagnosis of social phobia. One of the reasons this happens is that people with ASD struggle with social situations and are at risk of being bullied. The result of the trauma and worry that this will happen again can develop into anxiety.
Continue Reading: Protecting Your Autistic Child from Bullying.
Can Autism Be Misdiagnosed?
Due to the similarities, autism can be misdiagnosed as SAD. This often happens to women and girls who can “mask” autism symptoms and are often misdiagnosed. Many females learn to camouflage symptoms due to fear of peer bullying. Females learn to hide their symptoms by mirroring social behavior and forcing eye contact.
Furthermore, autism is generally seen as a male disorder—more boys are diagnosed with ASD than girls.
How to Tell Between Autism and SAD
The best way to differentiate the two is through a formal diagnosis from a professional. The diagnosis of autism is a lengthy process and involves observing the individual or interviewing parents, caregivers, teachers, etc.
ASD is better diagnosed in childhood or as early as possible. Adults with autism rarely receive a formal evaluation, and it’s challenging to receive an autism diagnosis.
Anxiety in Children and Adolescents with Autism Spectrum
Autistic children can feel the same worries and fears as neurotypical people. However, some autistic people worry about things typically developing peers don't. Some of these things might include:
- Unfamiliar or unpredictable social situations
- Small disruptions to routines
- New sensations their bodies feel
- Social situations that are hard to read (what people are thinking or feeling)
- Their own feelings and thoughts
Symptoms of Anxiety
Anxiety can look like common symptoms of autism spectrum disorder: resistance to a change in routine, stimming, obsessive behaviors, etc. Furthermore, since autistic children might have trouble recognizing their own feelings and thoughts, they might not be able to tell you they’re anxious.
Here are some physical symptoms you can keep an eye for:
- Stim by rocking, flapping hands, or spinning
- Insists on routine even more than usual
- Avoid or withdraw from overwhelming social situations
- Have trouble sleeping
- Rely more on rituals and obsessions
- Have meltdowns or emotional outbursts
- Do things that hurt themselves
Calming Strategies for Anxiety
Unfortunately, anxiety is a natural part of life. Everyone will experience it at some point, and while there isn’t much you can do, there are a few calming strategies to help ease your child’s worries and encourage them to manage their anxiety.
- These strategies might include:
- Taking deep breaths
- Doing jumps on a trampoline
- Running around the yard or a park
- Looking at their collection of favorite items
- Going to a quiet sensory room
- Closing their eyes for a few moments and counting
Or you can use fidget toys to manage your child’s anxiety. Fidget toys are designed to keep your hands busy and are often self-regulating toys. They come in various colors, sizes, styles, and movement options, depending on your child’s needs.
Fidget toys engage in repetitive actions that focus the mind. They are soothing, calming, and enjoyable—and come in different forms. Many adults with autism and anxiety use them to calm down while at work, for example.
Here are some fidget toys you can use: