"Just because I struggle to put how I feel into words it doesnt mean I don't feel things. In fact, the worse I feel, the more I struggle and often default to, 'I'm fine'."

Around a half of autistic people have difficulties understanding and describing their own emotions. This is known as Alexithymia. Alexithymia can make anxiety feel worse for autistic people.

What is Alexithymia?

Alexithymia is a term to describe problems with feeling emotions. In Greek, it loosely translates to “no words for emotion.” It is estimated that 1 in 10 people has alexithymia, but it is much more common in those with depression and in autistic people. 1 in 5 autistic people have alexithymia.

People who have alexithymia may have have trouble identifying, understanding and describing emotions. They may also struggle to show or feel emotions that are seen as socially appropriate, such as happiness on a joyous occasion.

How does Alexithymia affect anxiety?

There are two main reasons why Alexithymia can contribute to anxiety:

  1. Alexithymia can mean that autistic people can struggle to sense physical symptoms of anxiety such as changes in heart rate or a rush of adrenaline. It can mean that these symptoms are confusing and unpredictable and make anxiety feel much worse.
  2. Alexithymia can make it more difficult for autistic individuals to regulate their emotions. People with anxiety are usually able to accept a level of worry at certain times (such as during exams). This acceptance can stop anxiety getting worse. An autistic person with alexithymia may find this harder to regulate. Instead of accepting these feelings, they may push them away, which may make things worse.

How can anxiety be treated in people with Alexithymia?

Alexithymia is one of the reasons why standard anxiety therapies may not be as effective for autistic people.

If an autistic person is seeking treatment for anxiety it is important to understand whether they have alexithymia. If they do, they may need a different approach to therapy. People with alexithymia may benefit from targeted therapies such as training in identifying and communicating feelings, or mindfulness exercises.


Supported by Fujitsu.

Official Sponsor of Autistica’s World Autism Awareness Campaign 2021