What is it?
Anxiety is your body’s natural response to stress and in certain situations is normal and can even be helpful to some extent. At Triple A’s and One Stop Shop Aberdeen, we refer to three kinds of anxiety:
- Normal/situational anxiety: this covers times when it is understandable (and maybe even helpful) to be anxious. For instance, feeling ‘butterflies in your stomach’ when you sit an exam or feeling a little stressed about a job interview. This sort of anxiety can feel unpleasant, but it can also spur you on to prepare/plan for situations and can make you concentrate harder on certain tasks.
- An anxiety disorder: if you are constantly anxious or feel it is really impacting on your daily life, you may have a diagnosable anxiety disorder. This is especially likely if the things you are anxious about are unlikely to actually happen.
- Autistic anxiety: there is a certain amount of extra anxiety autistic people experience on a day-to-day basis and this is often about things that will actually happen day-to-day. Due to communicating with people who have a fundamentally different communication style, our executive functioning problems and our sensory differences, we tend to have a higher ‘base rate’ level of anxiety compared to non-autistic people. In practice, this means many autistic people experience anxiety about things such as: small talk at the school gate, trips to the supermarket/shopping centre, having to make phone calls etc. At ‘normal’ levels this anxiety can be difficult to deal with, but still allows the individual to lead a fulfilling life.
The psychological symptoms of an anxiety disorder can include: feeling worried/restless/tense, struggling to concentrate, mind racing or going blank, indecision, having vivid dreams, and an impending sense of doom.
The physical symptoms can include: dizziness, heart palpitations, breathing rapidly, struggling to sleep, sweating, trembling, tingling, numbness, and gastrointestinal problems (stomach issues).
(For PTSD, specifically, please see this page. )
Anxiety can occur on its own, but it is also often accompanied by depression. If you think you might have an anxiety disorder, you might want to check out our section on depression, too.
Why might autistic people have anxiety?
Anyone can experience anxiety, but autistic people do seem to be more prone.
There are a lot of reasons why anxiety is such a huge problem for so many autistic people. There is a high chance we have experienced social interactions gone wrong, for instance, so may be anxious about it happening again before social events.
There are also a lot of sensory elements that can add to anxiety in autistic people. Being in situations where the lights are too bright, or the background noise is too loud can be extremely challenging and cause anxiety. Worrying about whether we might experience sensory overload can even be a source of anxiety.
Masking (and fear of not being accepted), struggling to identify and regulate your emotions, difficulty with transitions, and changes to routine are also all reasons autistic people can experience such high anxiety levels.
What can I do if I think I have anxiety?
If you do think you may have an anxiety disorder, the best first step is to see your GP (or another health care professional if you are already under their care – like a midwife or psychiatrist).
Your GP should assess you and talk through your treatment options, which may involve medication, some sort of therapy, or a combination of the two.
If you feel unable to tell your GP or another health care professional, try to tell someone else you trust as a first step.
What can I do myself?
Alongside the advice given by your GP (or if you want to do something to help while waiting to see a GP or while building up the courage to tell somebody) there are some things you can try yourself to help.
If you are unsure about the source of your anxiety it can help to keep a diary of the times you feel anxious. Note down the day/time you feel anxious, what you feel (a general sense of worry/obsessing over an upcoming event/racing heartrate/fast breathing) and what else you had going on that day. Look back over it when you feel calm and see if you can identify a pattern. There are some apps that allow you to track various things like mood and anxiety, which may be useful.
Try to manage your sensory needs as best you can. Finding yourself in constant sensory overload or constantly seeking out sensory input can be very anxiety-inducing. You can:
- Make sure your environment is comfortable for you in terms of the temperature, how bright the lights are, noise levels, comfortable seating etc. You may require addition supports to achieve this like headphones and/or ear defenders or sun glasses.
- Make sure you have seen to any interoceptive needs you might not notice like hunger, thirst, going to the toilet.
- Make sure you are wearing comfortable clothing and have to hand any stim toys you might want to access.
You can try to build routine and structure into your day-to-day life to give yourself some stability and predictability. For some autistic people a very flexible routine may be less likely to cause anxiety. It is also essential to schedule/allow yourself downtime, especially after events that are likely to be stressful or intense.
Avoiding or decreasing your caffeine and/or alcohol consumption can also help with anxiety and anxiety symptoms, although if you tend to consume very high levels this might need to be done slowly and/or with the supervision of a doctor.
If you are feeling particularly anxious and/or have an anxiety disorder, you may experience panic attacks. Having a one-off panic attack is relatively common and about 1 in 10 people get them now and then.
While the specifics of each panic attack can vary from person to person, they generally involve some of the following symptoms:
- Sense of impending doom (perhaps even convinced you are dying)
- Heartrate feels faster/harder
- Dizziness or feeling unsteady
- Hyperventilating/feeling like you can’t catch your breath/feeling like you’re being smothered
- Sweating/feeling hot or cold
- Chest pain
- Nausea/sudden urge to go to the toilet
- Feeling disconnected from surroundings
Panic attacks can look a lot like several medical emergencies such as heart attacks or anaphylactic shock (and even sometimes like menopause). If you are in any doubt, it’s always best to seek medical attention (including dialling 999 if you think the situation is an emergency). Many people call ambulances thinking they are having a heart attack, only to find it was a panic attack – even medical professionals can confuse the two at first glance – so there is no shame in this.
Once you have had a panic attack, it is often easier to identify it as such the next time.
If you find you are having panic attacks, there are some strategies that might help you deal with them.
- Focus on breathing slowly and make your ‘out breaths’ (exhalation) longer than your ‘in breaths’ (inhalation).
- Tell yourself you are having a panic attack and will be okay.
- Try some grounding techniques like: identifying a certain number of things you can see, hear, touch, smell and taste; or submerge your hands in water and focus on the feeling; or do some stretches; or recite a poem or song lyrics.
- When you are feeling calm it might be helpful to write yourself a letter explaining you are safe to read when you are having a panic attack. Alternatively, you could ask someone you trust to record a message on your phone or write a note for you to listen to or read when you feel a panic attack starting.