a N x i E t Y by Len Benzi
Anxiety is one of those pervasive things that everyone experiences at some time or another, but for many people it can be a major albatross. Anxiety disorders are common among the general population and especially common for those on the autism spectrum. Anxiety can affect those on the spectrum in peculiar ways.
Sometimes a large portion of what can make it difficult for an autistic person who seems "high functioning" can be anxiety related. Of course many people who never have had anxiety issues of their own may have a hard time understanding and can oversimplify things in an attempt to help. There are many different causes and treatments for anxiety (for those both autistic) which are best left up to professionals to handle. Some people can be helped with counseling, while for others the cause is organic and requires medication. I know "medication" is a dirty word for many and I understand things may be over prescribed, but for some people it is beneficial. Anxiety/panic attacks are also a common manifestation of anxiety and are frequently misunderstood and mislabeled.
Anxiety can manifest in many ways and can often masquerade as weakness, as many people, especially adults, are ashamed to admit they have anxiety. Also men may feel a cultural need to cover up anxiety and fear. Professionals may feel the need to cover up anxiety and especially panic attacks out of fear of appearing unprofessional or losing credibility and co-workers' respect. Even if one admits to what is really happening, there is an assumption that others won't understand even if they intend to be "nice" about it. Also one might not want to upset the other person leading to two people panicking and creating a vicious cycle. Once anxiety escalates to this level, a polite "It's OK, don't worry..." is not going to cut it.
One issue that is common for autistic people is sensory sensitivities. Many sensory stimuli that are mundane or mildly unpleasant for the average person can be overwhelming or terrifying to an autistic person. This can be especially an issue with "higher functioning" people on the spectrum as they may be more likely to try to know what they're feeling is not typical and try to conceal their issues. Sensory sensitivities are not the same as phobias but can be easily mistaken for them. Sensory issues are not something that someone can rationalize away. For example, a person may know already that a loud noise or strong odor is not going to harm them but cannot help the way they feel. Telling people not to worry so much and giving "pep talks" on self esteem, self confidence is just going to miss the point. It always helps to provide perspective and to educate people on the things they are anxious about, especially if there are unfounded fears such as "monsters under the bed." But many times the problem is organic and a different approach is needed. This is where a professional comes in. I'm not sure if sensory sensitivities can be "cured" and we can't always avoid the environments which are painful for us, but we can sort things out to allow for reasonable accommodations and make compromises with the outside world.
Many times anxiety or "panic attacks" go undiagnosed. Other times people confuse them with Generalized Anxiety or a more common panic reaction to a crisis. Many people have anxiety attacks and don't even know what they are experiencing; instead thinking they are having a heart attack, a stroke or a fainting episode. Many people have more than once made fruitless trips to the emergency room only to be told that nothing is wrong. I have often mistaken anxiety attacks for asthma attacks. I was diagnosed with mild asthma as a small child and as I got older, I have experienced what I thought were asthma attacks only to look back and realize that they were anxiety related. What seemed like asthma may have been hyperventilation. (And having asthma is far more socially acceptable than anxiety attacks, especially for a guy.)
Control of one's environment is another issue common for autistic individuals. Many on the spectrum get extreme anxiety in environments where they have little control or escape. Many also feel the need to always know what to expect. Many phobias among the general population stem from control issues. An example is that many people afraid of flying are aware of the statistics which state that flying is safer than riding in a car and may even believe the statistics, yet they have no problem driving anywhere. The difference is that the more risky option is one they have more control of while in the less risky option they are at the mercy of a pilot whom they can't see and probably have never even met. There is no easy solution to this, as nobody is going to be able to know everything that is going to happen or be able to completely control their environments, but again people can make reasonable accommodations and if possible provide options to help a person feel less "trapped."
Seasonal depression, while not necessarily related to autism, can also involve anxiety. I myself find that while I am the way I am all year, anxiety tends to spike for me in the winter months. I do find it helpful for both anxiety and depression to get as much natural light as possible in the winter. This too however, can have some relation to control. In the winter the combination of darkness, cold weather and sometimes heavy snow tends keep a person indoors and can add to a perception of confinement. Also people may feel less in control as driving is not always a safe option and neither is opening windows or constantly running in and out of the house.
In dealing with the autistic population, it is important to understand that anxiety may have a different dynamic than that of the general population. When possible, it is important that these people are able to identify and freely share what is "really" bothering them without judgment. After that there are many ways to address the issues based on the individual. What has helped for me significantly is awareness of my anxiety and awareness from people in my life.
And being educated about symptoms and being able to distinguish between a heart attack and anxiety or an allergic reaction or anxiety is helpful as well.