Molehill Mountain
An app to help autistic people understand and self-manage anxiety.
What is Autism?
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.
Over half of autistic adults will be diagnosed with an anxiety disorder in their lifetime, with many more experience symptoms of anxiety that affect how they live their lives¹
About 8 in 10 autistic adults will experience mental health challenges in their lifetime¹
Anxiety disorders affect over 40% of autistic children compared with just 3% of non autistic children²
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
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:
Physical symptoms of anxiety include:
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 people is one of our 2030 Goals.
Everyone experiences anxiety differently, but some stressors may contribute towards anxiety in autistic people including:
When an autistic person is feeling anxious, they may react in the following ways:
What helps you manage anxiety? Share a tip with the community in The Tips Hub
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 plenty to cover, we have divided this section into self-management options, and support from others.
Below are some ideas to help you self manage anxiety and find something that works for you.
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.
Visit our anxiety and autism hubMolehill Mountain is a free app designed with and for autistic people to help autistic people to help them self manage 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.
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 interests can 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.
If you have sensory sensitivities 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.T
Too many public spaces are overwhelming for neurodivergent people who have sensory differences. That's why one of our Goals is to make spaces more accessible for neurodivergent people.
Learn about our accessible public spaces GoalIf 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.
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.
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. It doesn't have to include sitting still. You could mindfully do the washing up, or go for a mindful walk.
However, 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.
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 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.
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
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 could help you feel better. Contact a support group if you can’t speak to a family member or friend.
Thank you to Dr Emma Nielsen for collaborating on this article.
[1] Lever, A. and Geurts, H. (2016) Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder.
[2] Simonoff, E. et al., (2008) Psychiatric disorders in children with ASD: prevalence, comorbidity and associated factors in a population-derived sample.
[3] Manning et al., (2023) Sensory-inclusive spaces for autistic people: We need to build the evidence base.
[4] Linden, A. et al., (2022) Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials.
An app to help autistic people understand and self-manage anxiety.
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