Maybe you feel on edge most of the time, even on days when nothing obviously bad is happening. Maybe you've been told you "worry too much", when it feels more like your whole body is braced for something.

If you're autistic and anxious, you're far from alone. This article looks at why the two often go together, and some options for what can help.

How common is it?

Research suggests autistic people are more likely to experience anxiety.

Numbers vary between studies, but the pattern is consistent. Being anxious isn't a personal weakness. It often makes sense, given what many autistic people are dealing with every day.

Why autism and anxiety often go together

There isn't one cause, and it's different for everyone. The National Autistic Society describes several common contributors (National Autistic Society).

  • Uncertainty and change. An unexpected change to plans or routine can be hard to adjust to. If you don't know what's coming, your brain may stay on high alert.
  • Sensory load. Noise, lighting, crowds and smells can raise stress. If your environment often feels too much, it's hard to relax. Our guide to why everyday environments can be exhausting goes into this.
  • Social demands. Feeling misunderstood or not accepted by non-autistic people can build anxiety over time.
  • Masking. Hiding autistic traits to fit in can increase anxiety and affect mental health. You can read more in our article on masking.
  • Hard-to-name emotions. Some autistic people find it difficult to identify and understand their emotions, which can make anxiety harder to spot and manage.

Say it's Monday morning. Your manager sends a message: "Can we have a quick chat later?" No time, no topic. For many people, that's a small thing. For you, it might mean hours of running through every possible meaning, while the office noise and the effort of looking "normal" add to the load.

How autistic anxiety can look different

Anxiety doesn't always look like obvious worrying. It might show up in your body, your behaviour, or as a general sense of being on edge.

Things you could try

These are options, not rules. Pick what feels doable.

Getting support

If anxiety is affecting your daily life, you deserve support.

Your GP is a good place to start. They can talk through options and refer you to services. It may help to write down what you want to say beforehand, or mention that you're autistic and how you communicate best.

NHS Talking Therapies offers talking therapies for common problems like anxiety. If you live in England and you're 18 or over (16 or 17 in some areas), you can refer yourself or ask your GP to refer you. Services differ in Scotland, Wales and Northern Ireland, so your GP is a good first step there.

Therapy may need adapting. NICE guidance for autistic adults says therapy for anxiety and other mental health conditions should follow NICE guidance for that condition, but adapted. Suggested adaptations include a more concrete and structured approach, more written and visual information, regular breaks, plain language, and including your interests where possible (NICE CG142).

You can ask a service what adjustments they offer, such as written summaries, a quieter waiting area, or extra time to answer questions.

If you're supporting someone

Try not to dismiss anxiety as overthinking. Small, practical things can make a real difference: giving clear plans and plenty of notice, explaining changes early, and checking how the person prefers to communicate.

References

  1. Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological Medicine, 49(4), 559–572. doi.org/10.1017/S0033291718002283
  2. National Autistic Society. Anxiety. autism.org.uk
  3. NICE (2012, updated 2021). Autism spectrum disorder in adults: diagnosis and management (CG142). nice.org.uk/guidance/cg142
  4. NHS. Find an NHS Talking Therapies service. nhs.uk