Navigating the Connection between Anxiety and Autism Spectrum Disorder
Anxiety and Autism Spectrum Disorder (ASD) are two prominent issues that have seen an alarming increase in prevalence over the last few years. Anxiety ranks among the most prevalent mental health disorders in the United States. According to the National Institute of Mental Health, approximately 325 of adolescents have encountered an anxiety disorder, and around 19% of adults have experienced one in the past year. Rates tend to be higher in females than males.
Moreover, an estimated 31.1% of adults will face an anxiety disorder at some point in their lives. In parallel, the Centers for Disease Control reports a surge in Autism Spectrum Disorder (ASD) rates over the past two decades. In 2002, Autism was thought to affect 1 in 150 children, but by 2018 that number had jumped to 1 in 44 children fitting the criteria for an ASD diagnosis.
So, when and how do these two disorders intersect, and what should parents expect in cases of comorbidity? To better grasp this connection, we must first understand the nature of each condition.
What is Anxiety?
Anxiety, as defined by the Diagnostic and Statistical Manual (DSM-5), entails “excessive worry and apprehensive expectations, occurring more days than not for at least 6 months, about a number of events or activities, such as work or school performance. “While occasional anxiety is normal, an anxiety disorder diagnosis is made when anxious thoughts impede daily activities like school work and relationships. Anxiety disorder comes in various forms, from Generalized Anxiety Disorder to Post Traumatic Stress Disorder, Social Anxiety Disorder, and Panic Disorder. More often, anxiety disorders co-occur with other conditions like ADHD, depression, and eating disorders. Individuals with ASD often report higher rates of anxiety, with half of autistic adults meeting the criteria for an anxiety disorder. Steensel et. AI (2011) found that 40% of autistic children experience comorbid anxiety disorders.What is Autism Spectrum Disorder?:
ASD is a broad diagnosis, as outlined by the DSM-5, encompassing a wide spectrum of children displaying persistent deficits in social communication, social interaction, and repetitive patterns of behavior, interests, or activities. ASD can present with or without intellectual Impairment and may involve Various Medical, genetic, or environmental factors. The severity of ASD varies from “requiring support” (Level 1) to “Requiring very substantial support” (Level 3).Understanding what co-morbidity is?
Why do individuals who meet ASD criteria are most likely to also meet criteria for an anxiety disorder? Our world is primarily designed for neurotypical individuals, which can lead to stress and anxiety for those who are neurodivergent. While this question is still being researched clinical observations have revealed several phenomena:- Individuals with ASD often exhibit inflexibility or rigidities. When they cannot adhere to their need for rigidity, anxiety is a natural response.
- Many individuals with ASD have distinct sensory experiences, such as heightened sensitivity to sounds. The anticipation of possible sensory discomfort can lead to anxiety.
- Social situations may not come intuitively to individuals with ASD. They often sense that they are not meeting social expectations without understanding what they should be doing differently, causing anxiety.
- Communication difficulties can also contribute to anxiety. The uncertainty of having one’s needs met or understood is a valid source of anxiety.
- Some individuals with ASD engage in “masking,” consistently suppressing their natural behaviors to gain social acceptance, which creates stress and anxiety.
