(I wrote this article for an upcomong newsletter on anxiety and how it related to Autism. For that reason there may be some stuff on here I already mentioned in my older posts. I'll post a copy on here anyway.)
Anxiety is one of those pervasive things that everyone experiences at some time or another, but for many people it can be it can be a major albatross. Anxiety disorders are common among the general population, and especially common for those on the Autistic spectrum. Not to say that every Autistic person has anxiety issues, but many do and there many ways that anxiety can affect those on the spectrum in peculiar ways.
For one thing many Autistic people tend to worry a lot. I think very often people with logical/analytical type minds (which are common though not universal on the spectrum) are prone to a "What if?" mentality. This may even be useful in some lines of work, but it can also be a problem. While many people, especially young people have problems caused by not considering potential consequences to things. I feel many Autistic people can be the other extreme. Others on the spectrum may even have a combination of both extremes.
Sometimes a large portion of what can make it difficult for an Autistic person who seems "high functioning" can be Anxiety related. Of course many people who are either not Autistic or never had anxiety issues of their own may have a hard time understanding it and can oversimplify things in an attempt to help. I myself have experience with both. There are of course many different causes and treatments for anxiety (for those both Autistic or not Autistic) which are best left up to professionals who are familiar with each individual case to handle. Some people can be helped with counseling, while for others the cause is organic and requires medication. I know "medication" is a dirty word for many and I understand things may be over prescribed but for some people it is beneficial. Anxiety/panic attacks are also a common manifestation of Anxiety and are frequently misunderstood and mislabeled. I will get to them later. Anxiety can manifest in many ways and can often masquerade as many people, especially adults are ashamed to admit to it out of fear of appearing weak. Also men may feel a cultural need to cover up anxiety and fear for obvious reasons. Also professionals may feel the need to cover up anxiety and especially panic attacks out of fear of appearing unprofessional or losing credibility and people's respect. Instead one may complain of being under the weather and needing to get some fresh air. Even if one admits to what is really happening there is an assumption that others won't understand even if they intend to be "nice" about it. Also one might not want to upset the other person leading to 2 people panicking and creating a vicious cycle. Once anxiety escalates to this level a polite "It's OK, don't worry..." is not going to cut it. Many times panic attacks can also be organic or a reaction to medications. Reasoning with the person won't always help.
One issue that is common for Autistic people are sensory sensitivities. Many sensory stimuli that are mundane or mildly unpleasant for the average person can be overwhelming or terrifying to an Autistic person. This can be especially an issue with "higher functioning" people on the spectrum as they may be more likely to try to know what they're feeling is not typical and try to conceal their issues. Sensory sensitivities are not the same as phobias but can be easily mistaken for one of them. Sensory issues are not something that someone can be rationalized out of. A person may already know that for example a loud noise or strong odor is not going to harm them but cannot help the way they feel. Telling people not to worry so much and giving "pep talks" on self esteem, self confidence, or using the common pop-psychology methods for dealing with anxiety is just going to miss the point. It always helps to provide perspective and to educate people on the things they are anxious about, especially if there are unfounded fears such as "monsters under the bed". But many times the problem is organic and a different approach is needed. This is where a professional comes in. I'm not sure if sensory sensitivities can be "cured" and we can't always avoid the environments which are painful for us, but we can sort things out to allow for reasonable accommodations and make compromises with the outside world.
As for anxiety or panic "attacks" we have another issue that needs to be addressed for both Autistic people and the general population. Many times these go undiagnosed. Other times people confuse them with Generalized Anxiety or a more common panic reaction to a crisis. Many people have them and don't even know what they are. Many people have more than once made fruitless trips to the emergency room only to be told that nothing is wrong. These can cause someone to feel as if they are going to have a heart attack, a stroke, are getting sick, or are about to pass out... For me I have mistaken them for Asthma attacks. I do not have severe Asthma, but was diagnosed with mild Asthma as a small child. As I got older I have experienced what I thought were Asthma attacks only to look back and realize that they were anxiety related. What seemed like Asthma may have been hyperventilation. Besides, having Asthma is far more socially acceptable than anxiety attacks, especially for a guy. For a person who is non-verbal, anxiety and/or panic is of course going to manifest in less direct ways.
Control of one's environment is another issue common for Autistic individuals. This is not to say that Autistic people are necessarily "controlling" in a domineering or narcissistic sense, nor am I implying that Autistic people must always get their way. What I'm saying is that many on the spectrum get extreme anxiety in environments where they have little control or escape. Many also feel the need to always know what to expect. Many phobias among the general population stem from control issues. An example is that many people afraid of flying are aware of the statistics which state that flying is safer than riding in a car and may even believe the statistics, yet they have no problem driving anywhere. The difference is that the more risky option is one they have more control of while in the less risky option they are at the mercy of a pilot whom they can't see and probably have never even met. There is no easy solution to this, as nobody is going to be able to know everything that is going to happen or be able to completely control their environments, but again people can make reasonable accommodations and if possible provide options to help a person feel less "trapped". Many times those with Claustrophobia or Agoraphobia have similar issues.
Seasonal depression, while not necessarily related to Autism, can also involve anxiety. I myself find that while I am the way I am all year, anxiety tends to spike for me in the Winter months. Researchers cannot seem to agree on exactly what causes this pattern or if it even exists. I do find it helpful for both anxiety and depression to get as much natural light as possible in the Winter. This too however, can have some relation to control. In the Winter the combination of darkness, cold weather and sometimes heavy snow tends keep a person indoors and can add to a perception of confinement. Also people may feel less in control as driving is not always a safe option and neither is opening windows or constantly running in and out of the house. Seasonal depression or anxiety too can have many causes and what I'm mentioning are only thoughts.
No matter what the cause is for someones anxiety, it is definitely something for people to be aware of so that people don't have to live with one hand tied behind their back while having no idea why. In dealing with the Autistic population it is important to understand that their anxiety may have a different dynamic than that of the general population. When possible, it is important that these people are able to identify and freely share what is "really" bothering them without judgment. After that there are many ways to address the issues based on the individual. If there is one thing that I can say from experience does help (though not a cure) is awareness both on the part of the person suffering anxiety and those involved with them. Sometimes after much experience and identifying patterns in our own anxiety, we can tell ourselves that what we are experiencing is just anxiety and not "food poisoning", an allergic reaction, or impending doom. We can also become educated on recognizing signs of more serious problems like a heart attack or diabetic shock... so that we can discern the gravity of a situation more accurately. Having a smart phone and being able to Google things I am anxious about has helped me a lot, though one shouldn't over-do the research or it can have the opposite effect. All these suggestions I am giving are not meant to be a cure. When a problem has an organic cause we can't always help how we feel, but we can learn to manage it to a point.
Anxiety is one of those pervasive things that everyone experiences at some time or another, but for many people it can be it can be a major albatross. Anxiety disorders are common among the general population, and especially common for those on the Autistic spectrum. Not to say that every Autistic person has anxiety issues, but many do and there many ways that anxiety can affect those on the spectrum in peculiar ways.
For one thing many Autistic people tend to worry a lot. I think very often people with logical/analytical type minds (which are common though not universal on the spectrum) are prone to a "What if?" mentality. This may even be useful in some lines of work, but it can also be a problem. While many people, especially young people have problems caused by not considering potential consequences to things. I feel many Autistic people can be the other extreme. Others on the spectrum may even have a combination of both extremes.
Sometimes a large portion of what can make it difficult for an Autistic person who seems "high functioning" can be Anxiety related. Of course many people who are either not Autistic or never had anxiety issues of their own may have a hard time understanding it and can oversimplify things in an attempt to help. I myself have experience with both. There are of course many different causes and treatments for anxiety (for those both Autistic or not Autistic) which are best left up to professionals who are familiar with each individual case to handle. Some people can be helped with counseling, while for others the cause is organic and requires medication. I know "medication" is a dirty word for many and I understand things may be over prescribed but for some people it is beneficial. Anxiety/panic attacks are also a common manifestation of Anxiety and are frequently misunderstood and mislabeled. I will get to them later. Anxiety can manifest in many ways and can often masquerade as many people, especially adults are ashamed to admit to it out of fear of appearing weak. Also men may feel a cultural need to cover up anxiety and fear for obvious reasons. Also professionals may feel the need to cover up anxiety and especially panic attacks out of fear of appearing unprofessional or losing credibility and people's respect. Instead one may complain of being under the weather and needing to get some fresh air. Even if one admits to what is really happening there is an assumption that others won't understand even if they intend to be "nice" about it. Also one might not want to upset the other person leading to 2 people panicking and creating a vicious cycle. Once anxiety escalates to this level a polite "It's OK, don't worry..." is not going to cut it. Many times panic attacks can also be organic or a reaction to medications. Reasoning with the person won't always help.
One issue that is common for Autistic people are sensory sensitivities. Many sensory stimuli that are mundane or mildly unpleasant for the average person can be overwhelming or terrifying to an Autistic person. This can be especially an issue with "higher functioning" people on the spectrum as they may be more likely to try to know what they're feeling is not typical and try to conceal their issues. Sensory sensitivities are not the same as phobias but can be easily mistaken for one of them. Sensory issues are not something that someone can be rationalized out of. A person may already know that for example a loud noise or strong odor is not going to harm them but cannot help the way they feel. Telling people not to worry so much and giving "pep talks" on self esteem, self confidence, or using the common pop-psychology methods for dealing with anxiety is just going to miss the point. It always helps to provide perspective and to educate people on the things they are anxious about, especially if there are unfounded fears such as "monsters under the bed". But many times the problem is organic and a different approach is needed. This is where a professional comes in. I'm not sure if sensory sensitivities can be "cured" and we can't always avoid the environments which are painful for us, but we can sort things out to allow for reasonable accommodations and make compromises with the outside world.
As for anxiety or panic "attacks" we have another issue that needs to be addressed for both Autistic people and the general population. Many times these go undiagnosed. Other times people confuse them with Generalized Anxiety or a more common panic reaction to a crisis. Many people have them and don't even know what they are. Many people have more than once made fruitless trips to the emergency room only to be told that nothing is wrong. These can cause someone to feel as if they are going to have a heart attack, a stroke, are getting sick, or are about to pass out... For me I have mistaken them for Asthma attacks. I do not have severe Asthma, but was diagnosed with mild Asthma as a small child. As I got older I have experienced what I thought were Asthma attacks only to look back and realize that they were anxiety related. What seemed like Asthma may have been hyperventilation. Besides, having Asthma is far more socially acceptable than anxiety attacks, especially for a guy. For a person who is non-verbal, anxiety and/or panic is of course going to manifest in less direct ways.
Control of one's environment is another issue common for Autistic individuals. This is not to say that Autistic people are necessarily "controlling" in a domineering or narcissistic sense, nor am I implying that Autistic people must always get their way. What I'm saying is that many on the spectrum get extreme anxiety in environments where they have little control or escape. Many also feel the need to always know what to expect. Many phobias among the general population stem from control issues. An example is that many people afraid of flying are aware of the statistics which state that flying is safer than riding in a car and may even believe the statistics, yet they have no problem driving anywhere. The difference is that the more risky option is one they have more control of while in the less risky option they are at the mercy of a pilot whom they can't see and probably have never even met. There is no easy solution to this, as nobody is going to be able to know everything that is going to happen or be able to completely control their environments, but again people can make reasonable accommodations and if possible provide options to help a person feel less "trapped". Many times those with Claustrophobia or Agoraphobia have similar issues.
Seasonal depression, while not necessarily related to Autism, can also involve anxiety. I myself find that while I am the way I am all year, anxiety tends to spike for me in the Winter months. Researchers cannot seem to agree on exactly what causes this pattern or if it even exists. I do find it helpful for both anxiety and depression to get as much natural light as possible in the Winter. This too however, can have some relation to control. In the Winter the combination of darkness, cold weather and sometimes heavy snow tends keep a person indoors and can add to a perception of confinement. Also people may feel less in control as driving is not always a safe option and neither is opening windows or constantly running in and out of the house. Seasonal depression or anxiety too can have many causes and what I'm mentioning are only thoughts.
No matter what the cause is for someones anxiety, it is definitely something for people to be aware of so that people don't have to live with one hand tied behind their back while having no idea why. In dealing with the Autistic population it is important to understand that their anxiety may have a different dynamic than that of the general population. When possible, it is important that these people are able to identify and freely share what is "really" bothering them without judgment. After that there are many ways to address the issues based on the individual. If there is one thing that I can say from experience does help (though not a cure) is awareness both on the part of the person suffering anxiety and those involved with them. Sometimes after much experience and identifying patterns in our own anxiety, we can tell ourselves that what we are experiencing is just anxiety and not "food poisoning", an allergic reaction, or impending doom. We can also become educated on recognizing signs of more serious problems like a heart attack or diabetic shock... so that we can discern the gravity of a situation more accurately. Having a smart phone and being able to Google things I am anxious about has helped me a lot, though one shouldn't over-do the research or it can have the opposite effect. All these suggestions I am giving are not meant to be a cure. When a problem has an organic cause we can't always help how we feel, but we can learn to manage it to a point.
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