Autism and anxiety

Autism and anxiety are two different labels. But despite being unrelated, many autistic people experience high levels of anxiety. In this article, we will dig deeper into this link.

Connecting autism and anxiety

Anxiety is not part of the criteria for being autistic.

However, many autistic individuals experience high levels of anxiety. A 2021 survey by the National Autistic Society found that 47% of autistic individuals meet the threshold for severe Generalised Anxiety Disorder (GAD).

Similarly, Lever & Geurts (2016) found that over half of autistic adults will receive an anxiety diagnosis over the course of their lifetime.

Although some level of worry is normal, many autistic people find that their levels of anxiety can be overwhelming and place significant limitations on a person's life.

Why might there be a link?

There are several possible reasons autistic individuals may experience higher levels of anxiety.

Some individuals experience a wider range of stressors. For example, sensory issues including lights being too bright or not bright enough, strong smells, or busy, crowded environments.

Cross-neurotype communication (communication between autistic and neurotypical individuals) can be harder and because non-autistic people make up the majority of the population, this can leave the majority of the burden on autistic individuals.

This can be particularly tricky when autistic individuals express emotions differently, which could lead to a lack of emotional attunement from those around them.

Additional stress can be caused by trying to fit in (masking) or trying to hide their neurodivergent status for fear of pre-justice and discrimination.

What can we do about it?

On a societal level, building greater awareness of autism and developing earlier identification and intervention can help avoid anxiety from the start. Better autism assessment processes will help us support autistic individuals.

This would involve examining how we design society in a way that suits neurotypical people and does not suit autistic people. For example, socialising at work, the expectation of small talk and lack of consideration of sensory needs when designing environments.

For autistic individuals struggling with anxiety, there are a range of different supports available including psychotherapy, medication, support groups and self-help strategies.

Because autism is a spectrum of presentations, it is impossible to say which strategies will be effective for each person. However, evidence-based psychotherapies such as cognitive-behavioural therapy (CBT), emotion-focused therapy (EFT) and person-centred therapy are good places to start.

Conclusion

The majority of autistic individuals are likely to experience anxiety. This raises big questions about how we can design society in an autism-friendly way and a needer for better supports for autistic individuals experiencing anxiety.

Thankfully, this journey has already started. Neuroaffirmative practices are becoming more common and better identification processes are already beginning to allow us to make earlier and more effective interventions.

References

Lever, A. G., & Geurts, H. M. (2016). Psychiatric co-occurring symptoms and disorders in young, middle-aged, and older adults with autism spectrum disorder. Journal of autism and developmental disorders, 46, 1916-1930.

Metadata

Published 18 December 2024. Written by Chris Worfolk.