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Coping with Anxiety when You're Autistic

Updated: May 17, 2023

There’s a high co-occurrence of anxiety in the Autistic population. It can show up in the body as a racing heartbeat, stomach upset, sweating, heat, and an intense energy like you might explode out of your skin at any moment. Mentally, it can look like rapid thoughts, negative thought loops, rumination on mistakes, assumptions of judgment from others, and fixation on potential future situations. Emotional responses of fear, overwhelm, helplessness, acute rejection, anger, and dread are common. Anxiety often begins in childhood and persists over time, though this is not always the case.

Differentiating Anxiety from Autistic Experience

While anxiety is common in Autistics, it can often serve as a catch-all for other aspects of the Autistic lived experience. Consider how sensory overwhelm, meltdowns and shutdowns are similar and different from anxiety:

Sensory overwhelm: This is a common reaction to exposure to unpleasant sensory input. Because certain types of lighting, sounds, smells, tastes and textures can be physically uncomfortable for Autistic people, reactions to taking in too much stimulation can mirror the experience of anxiety. And, naturally, being in an uncomfortable environment creates pain and aversion. This can trigger the nervous system’s fight or flight response, the same mechanism behind anxiety attacks and trauma responses.

Meltdowns: Autistic meltdowns refer to the external behaviors of being overwhelmed. This can be linked to sensory overwhelm, social demands that exceed your tolerance level, or changes to routines that offer a sense of consistency. A person having a meltdown may yell, act out physically, or engage in self harming stims (hitting, scratching, biting oneself, etc). From a neurotypical perspective, this may be miscategorized as a “temper tantrum.” However, from a Neurodiversity affirming perspective, it is a desperate bid to self-regulate and get your needs met.

Shutdowns: On the flip side, when Autistic people are consistently facing demands that outweigh our resources and tolerance level, we can withdraw and shut down in response to stress. Rather than the fight-flight response, shutdowns are more like a freeze response – the nervous system is activated, but speech, movement, and thought become difficult. Sometimes, a person can fawn (people-please) for others before shutting down. Like a meltdown, a shutdown is an attempt to meet your needs and recharge your internal resources. It can look like difficulty speaking, seeking environments with low sensory input, canceling or avoiding external demands (even those that would normally be enjoyable), and difficulty with activities of daily living like grooming and eating.

Sometimes a meltdown can swing into a shutdown. Many people in marginalized groups are taught at a young age that expressing their distress is not allowed (and at times dangerous), and thus adopt shutdowns as a coping strategy. While it’s more "socially acceptable," it’s also liable to turn into burnout over time if the unmet needs continue to outpace external demands. You can learn more about meltdowns and shutdowns here.

Coping with Strengths and Supports

I know I haven’t painted a very optimistic picture. But there are strategies to meet your sensory needs, make accommodations, and take actions that encourage rest and replenishment.

Getting familiar with your sensory needs is a great first step. Identifying what kinds of input are difficult for you, the environments where these inputs exist, and finding accommodations can help lessen the toll it takes on you.

While some sensory information is uncomfortable, there may be other types of sensory input that are soothing. This could be fidgeting with a favorite item or texture, smelling a favorite scent, feeling the weight and warmth of a weighted blanket or cuddling with a pet, or using physical stims to discharge energy and self-soothe. With this information, you can bracket uncomfortable situations with comforting sensory experiences before, during, and after.

In fact, you can use your sensory sensitivity to engage sensory euphoria, which is basically the opposite of overwhelm – it’s a sensory experience that’s intensely enjoyable. For me, it’s the smell of fresh herbs or tea, the shine and vibrant color of paint on canvas, or a loud wall of death metal that blasts all the agitation out of my body. I know that last one is an acquired taste, but my point is that it can look however it needs to, so long as it meets your needs, isn’t harmful, and provides relief.

Engaging with a special interest is another anxiety management technique for Autistic folks. The way we become engrossed with topics that are important to us is something we can use to our advantage, on purpose, to ground ourselves and restore our energy. The intense focus activated by special interests can be a reprieve from the demands of the external world, and fill us with feelings of competence, curiosity, excitement, and joy.

Let’s look at an example: the grocery store, an unavoidable chore, is overstimulating because of the crowds, various sources of noise, bright lighting, and abundance of choices. You opt to go to the store early or late in the day to avoid the biggest crowds. Before you go, you pair square breathing with your favorite stims. You pack ear plugs to limit the sounds you take in, create a list of items to prevent decision paralysis or forgetting essentials, and wear a hat or tinted glasses to limit bright lights and reflections. During the trip, you fidget with a comfort item and practice square breathing as needed. Once you return home, you comfort yourself with your favorite snack, TV show, music, low lighting, and/or movement to discharge the energy of the trip. This can vary greatly depending on your sensory profile, aversions, and interests.

It can be uniquely challenging to manage anxiety as an Autistic person. The cruel twist is that, for Neurodivergent people, anxiety management is even more important to protect and maintain our inner resources. As a Neurodiversity affirming therapist, I’m committed to working with your brain/nervous system and how it operates. If you’re interested in working with me, we can create coping strategies and sensory supports that meet your specific needs, explore ways to unmask, discover your sensory profile, reclaim stims that work for you, and explore internalized ableism that holds you back. I work with adults online, with a particular sensitivity for late or self-diagnosed women and marginalized folks. If you’re interested in connecting, shoot me a message for a free 20 minute consultation.

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