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Anxiety

Anyone can experience anxiety. It is common to feel anxious when in a stressful or challenging situation. However, some autistic people may feel anxious in their day-to-day lives due to navigating social and sensory environments that might be difficult or challenging. Research suggests autistic people are more prone to experiencing anxiety and estimates that up to half of all autistic people experience high levels of anxiety on a regular basis. If you or someone you know is struggling with high levels of anxiety, there is support and help available.

What is anxiety?

The NHS describes anxiety as 'a feeling of unease, such as worry or fear that can be mild or severe. It becomes a clinical condition when experienced for a prolonged period of time and when it has a significant impact on a person’s life.'
 

How do I know if I am anxious?

Everyone has feelings of anxiety at some point in their life. You may feel worried and anxious about a change to your daily life, sitting an exam, or a job interview. 

Signs that you might be anxious include: 

  • feeling restless or worried
  • a churning feeling in your stomach
  • a fast, thumping or irregular heartbeat
  • faster breathing
  • sweating or hot flushes
  • nausea (feeling sick)
  • problems sleeping
  • panic attacks.

If your anxiety is constant, hard to control and affecting your everyday life, then you may have Generalised Anxiety Disorder (GAD). Read more about anxiety and GAD on the NHS website. 
 

Why might autistic people experience anxiety?

Even though it is not part of the autism diagnostic criteria, many autistic people experience high levels of anxiety. Research varies but the consensus suggests that it might be common for around 40-50% of autistic people to receive a clinical diagnosis of anxiety. 

A recent National Autistic Society survey found 47% of autistic people fall into the severe anxiety category based on GAD diagnostic criteria.

Difficult social situations and sensory environments can increase stress and increase anxiety for autistic people.

Another significant cause of anxiety is a sense of being misunderstood and/or not accepted by non-autistic people. To ‘fit in’ and not be seen as different, autistic people might mask or camouflage. This can increase anxiety and have a negative effect on their mental health.

Other reasons that autistic people may experience anxiety include:

  • a change to routine, particularly an unexpected change
  • difficulty identifying, understanding and managing emotions (also known as alexithymia).

A recent National Autistic Society survey found 59% of autistic people said anxiety had a high impact on their ability to get on with life.

Experiencing such high levels of anxiety can lead to exhaustion and meltdowns. It may also lead to autistic fatigue and burnout. This can significantly affect a person’s quality of life, such as their physical and mental health, work/school and social life.

If you or someone you know is concerned about feelings of anxiety, then you might want to get further advice and support.

How do I get help and support?

If anxiety is affecting your life, it might be helpful to talk to your family or friends about what is worrying you. If you feel you need further support, then speak to your GP. 

Your GP might suggest counselling, therapy, or medication to help. 
 

Counselling and therapy

You can go for counselling or therapy through your GP or privately. There are many types of therapy, including cognitive behavioural therapy (CBT), that can be effective for some autistic people if adapted appropriately. 

Search our Autism Services Directory for details of counsellors and therapists in your area with experience of working with autistic people. 

Other approaches that might help to reduce stress and anxiety include: 

  • mindfulness training
  • exposure therapy - working with a professional to gradually expose someone to the thing that makes them anxious
  • low arousal techniques - strategies that focus on the reduction of stress
  • sensory integration training – strategies to help with sensory differences

Ideally, all treatments should be delivered by a professional with a good understanding of autism. Most importantly, to be accessible and effective, support should be adapted to a person’s specific needs. Visit our Seeking help with mental health page for more advice.

In England, there is statutory guidance for adults that states autistic people should have support adapted to their needs if they have a mental health difficulty. 
 

Medication

You may be offered medication, such as anti-depressants. Although antidepressants are generally considered useful and safe, there is very little research into whether they help treat anxiety specifically in autistic people. What research there is suggests autistic people may be more likely to experience side effects such as drowsiness, irritability and reduced activity. 

Antidepressants should be carefully considered and closely monitored by a medical professional. 
 

Advice and tips

Below are some general tips and guidance from autistic people and professionals that you might want to try. 

Understand the triggers

Keep a diary to help identify when you are anxious, and what might make it worse.  

Monitor and manage your energy levels

Be aware of your energy levels after social interactions and other events/situations that you may find tiring or difficult.  Recharge by taking time for yourself and doing things you enjoy. 

Make the environment work 

Make adaptations to the environment where possible, for example lower unnatural light if too harsh. 
Try noise-cancelling headphones to reduce sensory overload.  

Self-soothe

Use sensory tools and stimming to reduce anxiety levels, if that works for you.

Relaxation and calming activities 

Try relaxation methods such as meditation, mindfulness, yoga and exercise.  

Visual schedules

Visual schedules to help structure the day and reduce uncertainty within your day.

Use an app

The following app offers personalised support with anxiety.

Molehill Mountain – includes: 

  • a system for tracking mood and identifying triggers
  • evidence-based tips on how to self-manage anxiety levels.
Making sure that I have enough rest time in between my social experiences, to feel calmer.
Purple Ella

Read about autistic people's experience of anxiety:

Links, resources and article sources

Related advice and support

Anxiety and autism in the classroom

More

Depression

More

Diagnosis

More

Managing anxiety in the workplace

More

Reducing anxiety in autistic children and young people

More

Seeking help with mental health

More

Sensory differences

More

Last reviewed: January 2021

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