Anxiety disorders are mental health problems that are common in autistic adults and children. Anxiety can have a profoundly negative impact on daily life and can affect how someone copes at school, work or during day-to-day activities.
We urgently need to know more about anxiety and autism so autistic people who are struggling can get the right support sooner. That's why one of our 2030 Goals is proven treatments for anxiety in autistic people.
Key facts about anxiety and autism
- Everyone feels anxiety from time to time, but when these feelings impact daily life and become overwhelming, it is considered an anxiety disorder.
- Anxiety disorders are common in autistic people compared to non-autistic people. Contributing factors for autistic people could include sensory differences,communication differences, intolerance to uncertainty, and disruptive changes to routine.
- There are lots of treatment and support options available to help people manage feelings of anxiety. If you are autistic, support tailored specifically for autistic people will be the most effective for you. Learn more in our Anxiety and Autism Hub.
I hope research can help autistic people find better coping strategies for things like anxiety and depression. I have a lot of problems with anxiety, and I think that there should be more out there to help us cope with everyday life.
Jackie, a late diagnosed autistic adult
About anxiety disorders
Anxiety is an emotion that everyone experiences sometimes. It is a feeling of worry or fear about future situations, and what could go wrong. For example, someone may feel anxious before an exam, starting a job or meeting new people.
For some people, feelings of anxiety can creep into everyday situations, become overwhelming and impact their ability to live their day-to-day lives. This is when someone is likely to have an anxiety disorder. Anxiety disorders are more common in autistic adults and children than non-autistic people.
Each person’s anxiety has a different set of triggers, and everyone has a different approach to managing their symptoms. Common types of anxiety disorders include:
- Generalised anxiety disorder, where someone may worry a lot about a wide range of situations or issues.
- Social anxiety, a fear of social situations.
- Agoraphobia, a fear of open spaces and crowds.
- Panic disorder, where someone experiences panic attacks. This is when someone experiences brief but intense and overwhelming feelings of fear unrelated to their situation.
- Phobias, where someone has a specific fear, such as spiders (arachnophobia), heights (acrophobia), or closed spaces (claustrophobia).
Physical symptoms of anxiety include:
- A racing heart rate
- Feeling short of breath
- Feeling agitated and distressed
- Feeling shaky
- Sweating and feeling sick
- Chest pain
Anxiety and autism
Anxiety disorders are more common in autistic adults and children than non-autistic people. Over half of autistic adults will have a diagnosable anxiety disorder in their lifetime, with many more experiencing intense feelings of anxiety that affect their daily lives.¹
Currently, there are very few services offering anxiety treatments specific to autistic people. That is why proven treatments for anxiety for autistic peopleis one of our 2030 Goals.
Everyone experiences anxiety differently, but some stressors may contribute towards anxiety in autistic people including:
- Lack of predictability orsudden, unexpected changes in routine. Find out about our research about coping with uncertainty.
- Sensory differences. Certain environments are more stressful for some autistic people than for non-autistic people. This could include bright lights, strong smells or multiple sound sources.
- Communication differences between autistic people and non-autistic people may fuel social anxiety. This can be amplified by autistic people feeling they need to ‘mask’ their autism.
- Difficulty in understanding your own emotions, known as alexithymia.
- Anxiety about specific distressing situations, such as crowds.
When an autistic person is feeling anxious, they may react in the following ways:
- Seeking lots of reassurance
- Avoiding situations, like refusing to go to school
- Meltdowns, which are automatic reactions to distressing situations.How to support someone having a meltdown
- Overthinking things and ‘getting stuck’
- Repetitive movements like rocking, stimming or flapping
- Hyperfixating on routines or play
- Running away
- Self-harm
What you can do about anxiety if you are autistic
There are lots of things that you can do to help manage anxiety if you are autistic. However, there isn’t one thing that will help everyone. It’s important to take the time to find what works for you to help you feel calmer so you can be better prepared for the next time you feel overwhelmed.
We've listed several options below for options for autistic people struggling with anxiety. As there's plentyto cover, we have divided this section into self-management options, and support from others.
What you can do about anxiety - self managing anxiety for autistic people
Jump to: Visit our anxiety and autism hub Use ourMolehill Mountain app Self soothing Thinking about your environment Taking time to relax to manage your energy levels Keep a diary Give mindfulness a go
Visit our anxiety and autism hub
We have a dedicated anxiety and autism hub, which is full of helpful research-backed information for positive coping strategies for anxiety for autistic people.
Use ourMolehill Mountain app
Molehill Mountain is an app specially designed to help autistic people understand their anxiety. You can use Molehill Mountain to explore the causes and symptoms of your anxiety.
The app lets you track your worries and the situations that trigger your anxiety, get evidence-based daily tips to understand more about anxiety, and learn techniques to try.
Self soothing
There may be self-soothing methods that can help manage feelings of anxiety. For example, stimming, rocking, or creating calming sensory environments may help you relax if you are anxious.
Creating a sensory box is a good option for self-soothing. Fill a box with sensory toys and other items that bring you joy. The next time you feel dysregulated, you can access an assortment of items that might help you feel better.
Some autistic people find engaging in their specific interestscan help them relax by focusing on something they enjoy rather than their stressors. Be mindful to keep a healthy balance between your interests and other responsibilities.
Thinking about your environment
If you have sensory issues that can make certain public environments stressful, there may be items you can use to minimise that stress. For example, carrying noise-cancelling headphones, sunglasses, or wearing comfortable clothes.
Too many public spaces are overwhelming for neurodivergent people who have hypersensitive sensory issues. Find out about our 2030 Goal of making public spaces more accessible for neurodivergent people.
Taking time to relax to manage your energy levels
If you find social situations or some public spaces exhausting and anxiety-inducing, taking time to relax and do something you enjoy afterwards can help you manage your energy levels
Keep a diary
Some people find that keeping a diary helps them understand and manage their anxiety better. Writing about situations and how they make them feel helps identify the causes and symptoms of their anxiety. Finding a daily routine can make the world a more predictable place and reduce anxiety.
Give mindfulness a go
Practising mindfulness can help you feel more present, feel more relaxed, and alleviate feelings of anxiety.
Often, when we talk about mindfulness our first thought is mindfulness meditation, such as focusing on your breathing or paying attention to various parts of your body and their physical sensations. In fact, mindfulness is about focusing on the present, whatever you are doing.
Mindfulness isn’t always suitable for everyone. If it leaves you feeling more stressed and anxious than before you started, it might not be for you.
What you can do about anxiety - support from others
Jump to: See your doctor Talking therapy CBT Support groups
See your doctor
Your doctor can offer options to help you manage your anxiety. For example, finding a medication.
Some autistic people may be more (or less) sensitive to medication. If you feel comfortable, speak to your doctor to discuss your options
.Autistic people tell us that going to the doctor can be stressful because they feel that health professionals do not understand their needs. Tools like health passports may help your doctor learn about you and your needs.
The law states that reasonable adjustments must be made in health and social care. You can tell your doctor what reasonable adjustments you need. They can use the reasonable adjustments digital flag, so you don’t need to explain every time you use an NHS service.
Talking therapy
Talking to a therapist can help you find ways to cope with anxiety-inducing situations and identify techniques to help you relax or support you in your relationships.
If you choose to have private therapy, find a therapist who can adapt their approach to meet your specific needs. You may want to consider people who have autism-specific knowledge or are neurodivergent themselves.
CBT
If you struggle with anxiety and live in the UK, you are likely to be offered Cognitive Behavioural Therapy (CBT) on the NHS. Cognitive Behavioural Therapy is a type of therapy where you break down your problems into different thoughts, behaviours and actions and explore if they are helpful to you or not. CBT can be a useful tool, but it is not suitable for everyone – for example if someone has complex or severe mental health challenges.
Most of the evidence base for CBT is not specific to autistic people. Some research suggests that CBT tailored specifically to autistic people can be helpful. However, we still need to learn more about the effectiveness of CBT to improve autistic people’s mental health.⁴
Support groups
Some autistic people find that sharing their experiences with other autistic people helps them feel less anxious. Talking to people about your thoughts and feelings might be challenging, but it couldhelp you feel better. Contact a support group if you can’t speak to a family member or friend.
You can visit the National Autistic Society's Directory of Servicesto find a support group or mental health service near you.
