autism and anxiety
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Managing symptoms in adults with ASD and related autism and anxiety

Experts do not consider anxiety a core characteristic of adult autism spectrum disorder, but the most common comorbid disability of autism is a generalised anxiety disorder. Diagnosing and treating anxiety accurately is essential because it strongly affects critical aspects of ASD, such as repetitive behaviours and social issues. Let’s look at the connection between autism and anxiety.

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What is the connection between autism and anxiety?

Typical characteristics of an autism disorder can be identified by, amongst other things, difficulty in socialising and communicating as well as noticeable repetitive behaviour.

Doctors often diagnose severe forms of ASD in the first two years of a child’s life, with high functioning patients diagnosed much later, often years later well into adulthood.

Adults with high functioning autism have minor challenges, sometimes mistaken for symptoms of ADHD (or ADD), and others may experience more severe symptoms such as impaired spoken language. It’s entirely possible for adults with autism to have no problems or only minor considerations.

No two individuals with ASD will have the same behavioural characteristics.

Although anxiety isn’t considered a key feature of autism, the most common comorbid disorder in autism-born adults is a generalised anxiety disorder. More than 20 percent of adults with ASD have been diagnosed with anxiety disorders, compared to only 8.7 percent of adults with neurotypical conditions.

The difficulty with sleeping, obsessive thinking, and difficulty concentrating may also involve psychosocial anxiety symptoms. Physical symptoms may range from stomach upset to heart palpitations or swelling.

The importance of getting a diagnosis

Anxiety in people with ASD must be recognised and treated since it can significantly impact essential components of autism, such as repetitive behaviours and social disengagement. Fear is a big part of the problem, and it affects a person on the autistic spectrum’s life, especially when it comes to navigating the social environment.

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Managing autism and anxiety with medication

Since anxiety is a particular disorder, healthcare professionals can treat it differently from some of the other domains of ASD. The most common forms of treatment often involve antidepressants, anti-anxiety medications, and beta-blockers. Mental health doctors have only published a few studies to show whether these drugs are equally effective in adults with ASD, so results are inconclusive.

Studies into medication as treatment suggest the prescription of Fluoxetine improves repetitive behaviours in adults and children with ASD. A controlled study has demonstrated that Citalopram works no differently than placebos to reduce repetitive behaviours. Some patients were adversely affected by hyperactivity, impulsiveness, and insomnia after taking Fluoxetine and Citalopram.

ASD patients may be sensitive to low doses of medication, which medical professionals should keep in mind. These adults have considerable changes in treatment reactions and adverse drug reactions.

Managing autism and anxiety with therapy

Using medicines alone is unlikely to alleviate the symptoms of concern when treating ASD in adults. Other interventions are necessary and will include training in skills, changes in the environment, behavioural techniques, and sensory inputs.

Cognitive therapy of conduct (CBT) works particularly well in high functioning individuals with proper verbal skills. CBT treats anxiety disorders and OCD in youth with ASD effectively. The therapy aims to alter how a person interprets a situation to reduce negative feelings and unhealthy responses.

This therapy helps patients do the following;

  • Learning to distinguish between helpful and helpless anxieties
  • Learning to identify worry and improve management
  • Gradual exposure to feared stimuli with reciprocal skills by parents to improve a patient’s relationship with others
  • Visual incentives to help the patient face abstract thinking difficulties
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How to recognise autism and anxiety in adults

Recognising the presence of Anxiety in ASD patients is challenging as symptoms overlap and symptoms change. Instead of expressing anxiety through disruption, minimally verbal patients may, for example, not be able to vocalise their inner state. Other patients may fluently speak but fight to understand their own emotions and to talk about them.

Here are a few ways in which anxiety disorders in patients differ according to their surroundings.

Specific phobias

A specific phobia will appear as an intense, irrational fear of something that poses little danger, may surface in the course of ASD due to an overt response to certain sensory stimulations, e.g., a loud environment.

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Obsessive-Compulsive Disorder (OCD) is frequently comorbid with ASD. This disorder revolves around unwanted and intrusive thinking and consequent compulsive behaviour. It is essential to identify comorbid OCDs in these patients as compulsions are performed as a coping mechanic to relieve anxiety while involving repetitive behaviour typical of ASD.

Social anxiety

Social anxiety can develop due to social communication impairment, mainly when a patient functions well and is aware of their social incompetence. Social anxiety is acute anxiety or fear of being judged in a social or performance-related situation, resulting in avoiding gatherings and other social events, thus restricting the patients’ ability to apply social skills.

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Separation anxiety

Separation anxiety may stem from a social impairment, which can inspire overprotective parent reactions that can, in turn, strengthen the behaviour of avoidance. Separation anxiety may then arise if the patient is separated from the attachments.


The effective combination of therapy and medication and some coping techniques will help patients with ASD. Help is available, and it’s important to remember that mental health professionals deal with many people struggling with the same issues and know the best form of treatment.


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