Signs and symptoms

Anxiety and autism

Anxiety is a mental health problem that is common in autistic adults and children. Anxiety can have a big impact on daily life, for example coping at school or at work.

Each person’s anxiety has a different set of triggers and everyone has a different approach to manage symptoms. Common types of anxiety in autism include:

  • generalised anxiety disorder
  • fear of social situations (social anxiety)
  • fear of open spaces and crowds (agoraphobia)
  • other specific fears (phobias)

Common symptoms of anxiety in autism

Jump to: Physical symptoms Behavioural symptoms Triggers

Physical symptoms

Anxiety is a problem when feelings of worry and panic become persistent, overwhelming and beyond a person’s control. 

Symptoms of anxiety include

  • a racing heart rate
  • feeling short of breath
  • feeling agitated and distressed
  • feeling shaky
  • sweating and feeling sick

Behavioural symptoms

When a person feels anxious they may react in the following ways to help themselves feel more in control 

  • seeking lots of reassurance
  • avoiding situations and objects – like refusing to go to school
  • meltdowns, outbursts and tantrums
  • overthinking things and ‘getting stuck’
  • a strong preference for routine and sameness
  • repetitive behaviour like rocking, stimming or flapping
  • obsessive routines or play
  • running away
  • self-harm

Triggers

Everyone experiences anxiety differently but there are some common triggers for autistic people

  • uncertainty and change
  • sensory triggers, for example noise or smell
  • social situations
  • expectations, pressures and demands
  • anticipating specific situations (like school or work)
  • specific fears like crowds, dogs or needles

I feel that anxiety and depression I have suffered over the years is the result of my autistic mind having to cope with a neurotypical world

Jon, autistic adult

My son’s anxiety prevents him from sleeping, makes homework sometimes impossible and undermines his self-esteem and confidence. It pervades his whole life

Sophie, mum

What you can do about anxiety

Jump to: See your doctor Talking therapy Try the Molehill Mountain app  Medication Try mindfulness Keep a diary Support groups Find out more

See your doctor

Autistic people tell us that going to the doctor can be stressful because they feel that health professionals do not understand their needs. But seeing your doctor when you’re experiencing symptoms of anxiety is an important step towards looking after yourself.

Talking therapy

Talking to a therapist can help you find ways to cope with difficult situations, identify techniques to help you relax or support you in your relationships. Clinical trials have shown that cognitive behaviour therapy (CBT) is effective for anxiety disorders in children and young people with autism. Self-help programmes based on CBT can also be effective to help parents and carers or autistic people reduce anxiety.

Try the Molehill Mountain app 

Molehill Mountain is an app specially designed to help autistic people understand 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 about techniques to try. Find out more about the app and how to download it from the App Store. 

Medication

Some people take medication to manage their anxiety and your doctor can discuss options with you. Make sure you always tell the doctor or therapist about your autism because it may affect the treatment you are prescribed and how your doctor communicates with you.

Try mindfulness

A technique that can help those with anxiety is ‘mindfulness’. Mindfulness aims to retrain the way you think to help you pay attention to the present moment. It’s about listening to and accepting your thoughts and feelings.

Keep a diary

Research shows that uncertainty can be difficult for autistic people. Some people find that keeping a diary helps them understand their anxiety and manage it 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.

Support groups

Many autistic people find that sharing their experiences with other autistic people helps them feel less anxious. It might be difficult to tell people how you are feeling, but talking to someone can really help you to feel better. If you can’t talk to a family member or a friend, contact a support group.

Find out more

Read our leaflet on mental health and autism or download this guide to anxiety in autism from City, University of London.