Anxiety and Autism

Anxiety is a normal emotion and is a natural part of life. We all have anxiety from time to time whether it is sitting for an exam, going to the dentist, or meeting new people, Anxiety feels different for everyone. Anxiety is part of our survival instinct. In prehistoric times we had to fight off animals and run away from dangers. Although we don’t have to do that anymore we still have situations in our lives which set off that survival instinct and generate anxiety. The amygdala, a part of the brain, acts as a warning system to alert us to potentially dangerous situations and it instructs our bodies to act in certain ways so we can get to safety.

There are three reactions that the brain sends to your body, you can automatically go into either:

Fight: facing any perceived threat aggressively.
Flight: running away from the danger.
Freeze: unable to move or act against a threat.

There are no more prehistoric animals around for us to fight anymore, but we can still be in dangerous environments and we need to survive.

Anxiety only becomes a problem when it gets out of control. When you are constantly in a heightened state it can become a disorder, it starts to affect your ability to cope, or your ability to go through your normal activities of daily living, this can happen for many reasons we call this an Anxiety disorder.

Why are Autistic Children and Young People more prone to have Anxiety and Anxiety Disorders?

Autistic people may find social interactions difficult because they socialise differently to non-autistic people. There are lots of unwritten rules for them to remember which can be very confusing for them. Misunderstanding social queues and norms can often lead to situations becoming difficult. Autistic individuals also experience feelings and emotions differently at times. When anxious in a social interaction the feelings are somewhat amplified and overwhelming.

There are some key areas that may cause anxiety for autistic individuals:

Communication

Albert Mehrabian, a researcher of body language, first broke down the components of a face-to-face conversation. He found that communication is 55% nonverbal, 38% vocal and 7% words only. There are many unwritten social cues that neurodivergent people do not pick up on such as the following:

Facial expressions: being able to read whether a person is happy, angry or upset .
Eye contact: maintaining eye contact with the person they are talking can be difficult for many but it can seem rude if you do not do this.
Active listening: listening carefully so that you understand what the other person is saying and responding when appropriate.
Posture: reading whether someone is tense or relaxed.
Tone of voice: does the tone of someone’s voice match their facial expression and posture?
Conversation: how to start, maintain and end a conversation. They may find it difficult to keep up with ongoing conversation or engaging in “small talk”.
Sarcasm, irony, banter, idioms and jokes: Autistic people can find it hard to pick up on subtle nuances as many people on the spectrum are literal thinkers. They may find it difficult to detect if someone is being sarcastic and may take sarcasm for a complement when really they are being unkind. Idioms are confusing for them and they need further explanation on the meaning behind the phrase.

Sensory

Autistic individuals can present different responses to sensory stimuli in all of the 8 sensory systems. If these sensory behaviours are not understood, they can impact on a person’s ability to cope with many everyday situations and may even appear as behaviours that challenges or distressed behaviours. Autistic people may be over or under sensitive to sensory input and sensory overload can result in anxiety. We need to understand how making small adjustments and changes can support the autistic person to decrease their anxiety levels. Read our blog post on Sensory Processing Disorders.

Black & White Thinking

Many people on the autistic spectrum are prone to thinking in a “Black and White” way. It is either right or wrong, good or bad. There is no grey area for them to problem solve which can lead them to catastrophize, especially if they are having a change in routine or are trying a new experience. They will jump to the worst case scenario that something bad is going to happen, this constant thought process is destructive because they are in a heightened state of worry and anxiety.

Social Imagination

Social imagination is about being able to imagine and process things that we were not expecting or are outside our experience. Many autistic people can find it difficult to work out how others are feeling or to see things from someone else’s point of view.

Autistic people may find it difficult to imagine the consequences of their actions or words, or of how these could affect others. People may not understand what is expected of them in new situations, or how to respond to social situations, when the rules aren’t clear, all of which can lead to anxiety and misunderstanding. A difference in imagination can also mean that autistic people prefer to follow set routines and have repetitive behaviours, these may help people to feel secure, as some autistic people may become upset or agitated if their routine is disrupted.

Tips for parents of children with anxiety

Don’t dismiss your child’s anxiety, acknowledge that it is natural to have anxiety and that the feeling will go with time. Validate their feelings “I can see that you are anxious because of…” be empathetic while still encouraging them to face their fears.
Don’t avoid or cancel things because your child is anxious, this is a short term fix, and in the longer term will only reinforce your child’s anxiety in the long term. Instead think about how you can adapt or shorten the activity or event so that they feel safe.
Try not to show your own anxiety when around your child. Anxiety tends to run in families. Children of anxious parents are 5-7 times more likely to develop anxiety disorders than those of non-anxious parents, your anxiety may be picked up by your child. If their parent feels unsafe or senses danger they will too.
Do talk to your child, talk through their fears and anxieties. Ask them what would happen if their worst fear came true? This can reduce their anxiety.

Anxiety Techniques

Most people are able to manage reducing their anxiety by using their own toolbox. It is important with all of these techniques to remember that everybody is individual – what works for one, may not work for another. Here are just a few of the many anxiety techniques you can use:

Breathing

Square Breathing: Square breathing involves breathing in, holding the breath, exhaling and holding it again — all for four counts a piece. Repeat the cycle for several minutes. This anxiety relief exercise promotes relaxation and leads to clearer thoughts, helping to reset emotional peaks.

4-7-8 breathing method: If you can, close your eyes. Breathe in through your nose to the count of four. Hold the breath to the count of seven. Exhale through your mouth to the count of eight.

Grounding

The 3 3 3 rule:

Name three things you see.
Name three sounds you hear.
Move three parts of your body — your ankle, fingers, or arm

Mindfulness

Becoming more aware of the present moment means noticing the sights, smells, sounds and tastes that you experience as well as the thoughts and feelings that occur from one moment to the next. Several practices can help create a new awareness of body sensations, thoughts and feelings.

Try encouraging your child to focus on a particular smell they love, for example, going into the garden and smelling the lavender plants, touching it and just focusing on that for a minute. Give you child an ice lolly, get them to smell it, feel the cold sensation in their mouth, name the flavours as they it melts. These activities can all be done mindfully.

Counting

Counting can be a technique to assist in your focusing away from your anxiety. If you find yourself in a stressful situation focusing on slowing your breathing and counting back from one thousand in multiples of seven could be a technique to practice. If you have a younger child counting up in 2s, 5’s or 10’s could also work. Also choosing and counting things that you see that begin with a certain letter or are all a certain colour.

If none of these techniques don’t seem to work for your child there are lots more available here on Childline’s Calm zone.

If you are concerned that your child’s anxiety is impacting on their ability to cope with their daily life please contact your GP or the Emotional Wellbeing Hub. However if their Mental Health has deteriorated please call 111, option 2 NHS Mental Health Crisis Line (24/7 helpline for anyone of any age.)