We have all felt it before. Anxiety. The big A. It can feel terrible. Keep you up at night. Make your stomach hurt. I know from my own bouts of anxiety that it can impact my daily life. For me, watching the news on television brings on such anxiety that it can impact my health and my sleep. Easy fix, right? Just don’t watch the news. But you are still exposed to news and life goes on. We learn to deal with the things outside our control and control those things that we can. It helps to lessen the impact and help to keep the big A at bay. But what if you are on the spectrum? Does anxiety look different for someone with different neurology? Let’s dive in and take a look.

To be clear, anxiety is not a part of the autism spectrum disorder (ASD) diagnosis criteria. However, according to the National Autistic Society, 40% to 50% of people on the spectrum receive a clinical diagnosis of anxiety. It is a common co-occurring condition. A recent survey conducted by the group indicated that 47% of autistic people fall into the severe anxiety category based on the generalized anxiety disorder diagnostic criteria.

There are numerous things that foster anxiety for autistic individuals. Difficult social situations can certainly bring on anxiety. Even writing this I am reminded of a situation where we vacationed with my sweet girl and her parents last summer. We all went to check into the resort and had booked our adjoining rooms only to find out the rooms were not connected as the front desk indicated. You see, we really needed the adjoining rooms so my granddaughter had a place to pace. It’s one of her stims and it really helps feel more grounded. We didn’t want her leaving and having to go outside to find the rest of our family, and she often paces at night. So we head out to our rooms only to find that they are not adjoining. To anyone else, this would have been a minor setback. You call the front desk and get it taken care of. To my sweet girl, it was a major setback. In her state of heightened anxiety, the trip was ruined and we should just go home right now. Once anxiety takes over, getting back on track can be very difficult for her.

There are several common factors that can trigger anxiety. Feeling misunderstood or not accepted can be a huge source of anxiety for individuals on the spectrum. In an effort to “fit in,” autistic individuals may resort to masking and that is also anxiety producing. Masking, as well as heightened anxiety, can lead to mental health issues. Another common issue is a change in routine. This can often create anxiety. Unexpected changes are often a source of upset. As neurotypicals, we might find it easier to roll with the flow, (although, if I am honest I don’t) but that is not always the case when you are autistic. Schedules, routines and expected outcomes are all significant factors in how autistic individuals handle anxiety. In retrospect, I can now see that my granddaughter felt misunderstood (her needs were not being met) and we definitely had a change in routine (we were at a resort, not home). Both of these factors created a heightened sense of anxiety.

I don’t always know how to help my sweet girl when I see her anxiety flare up. What I do know is she struggles with it and I can support her by being empathetic and reducing demands on her until she feels more grounded. I certainly feel her struggle, as I struggle with anxiety myself. I just think she feels it with more intensity, and as her Nana, that can be hard to internalize.

As a family, we will continue to support our sweet girl. We know that living with anxiety can be hard but we will continue to help her with coping strategies. When we foster awareness, acceptance and inclusiveness, we can create a more supportive and empathetic society where everyone has the opportunity to thrive, anxiety and all.