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The Overlap Between Autism and Anxiety

Autism and anxiety, two commonly diagnosed conditions, share various characteristics and can sometimes co-occur. Understanding the ways in which they overlap can help you better understand and support your child.   

Autism and Anxiety: Common Co-occurring Diagnoses 

Research shows that autism and anxiety frequently co-occur, with up to 40% of individuals diagnosed with autism also experiencing clinically significant levels of anxiety (van Steensel, Bögels, & Perrin, 2011). The diagnostic criteria for anxiety and autism differ, but they have a number of overlapping features. 

A physician assessing a young child for a diagnosis.

Signs of Autism and Anxiety 

Autism is characterized by differences in social communication, interaction, and repetitive behaviors, while anxiety is marked by excessive worry, fear, and physical symptoms like increased heart rate or sweating. Both conditions may involve difficulties with adapting to changes, managing uncertainty, and coping with sensory sensitivities. 

Despite these similarities, there are notable differences in how anxiety manifests in individuals with autism. While those without autism may have a wide range of anxiety triggers, individuals with autism often experience anxiety in relation to their core autism symptoms, such as social situations, changes in routine, or sensory sensitivities (White, Oswald, Ollendick, & Scahill, 2009). 

How Autism and Anxiety Can Interact 

When autism and anxiety co-occur, they can add to the challenges faced by those with either condition alone. For example, the social communication difficulties experienced by people with autism can contribute to increased anxiety in social situations. Conversely, anxiety can make it even more challenging for someone with autism to navigate social interactions, develop coping strategies, or adapt to changes. 

Navigating life with these co-occurring conditions can be complex, generating unique needs and challenges for those with both autism and anxiety. 

Treatments and Therapies for Autism and Anxiety 

Understanding the overlap between autism and anxiety has significant implications for diagnosis and treatment. A personalized approach that considers both conditions is essential to providing the best possible support. Some treatments and therapies that might help include: 

  • Cognitive-behavioral therapy (CBT): CBT is an evidence-based intervention that focuses on modifying thought patterns and teaching coping strategies. Modified CBT, specifically tailored for individuals with autism, has been shown to be effective in reducing anxiety symptoms (Sukhodolsky et al., 2013). 

  • Social skills training: This intervention aims to improve social communication and interaction for those with autism while also addressing anxiety related to social situations. 

  • Medication management: Medications such as selective serotonin reuptake inhibitors (SSRIs) can be prescribed to help manage anxiety symptoms. Working closely with a healthcare professional to find the most appropriate medication and dosage for each person is essential. 

  • Occupational therapy (OT): Occupational therapists work with people to develop the skills needed for daily living, self-care, and academic success. For those with autism and anxiety, OT can address sensory processing issues and help develop coping strategies. 

Recommended therapies for people who have both autism and anxiety will vary based on factors such as age, severity of symptoms, and personal preferences. A qualified healthcare professional can help develop a personalized treatment approach that supports the growth and development of children and adults who have both conditions. 

Citations 

1. van Steensel, F. J., Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14(3), 302-317. doi: 10.1007/s10567-011-0097-0 

2. White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), 216-229. doi: 10.1016/j.cpr.2009.01.003 

3. Sukhodolsky, D. G., Bloch, M. H., Panza, K. E., & Reichow, B. (2013). Cognitive-behavioral therapy for anxiety in children with high-functioning autism: A meta-analysis. Pediatrics, 132(5), e1341-e1350. doi: 10.1542/peds.2013-1193  

Suzanne Goh
Author: Suzanne Goh, MD, BCBA