Many autistic adults experience anxiety. This guide talks about the ways you can manage anxiety, including relaxation techniques and therapy.
 

What is anxiety? 

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. 

Everyone has feelings of anxiety at some point in their life. For example, you may feel worried about sitting an exam or going for a job interview. During times like these, feeling anxious is normal. 

But, as an autistic person, you may find it hard to control your worries. You may feel anxious a lot of the time and it can affect your daily life.
 

What are the signs of anxiety? 

Signs of anxiety include: 

• sweating 
• sleep issues 
• panic attacks 
• hyperventilating 
• negative thoughts 
• catastrophising 
• self-harm. 

These are signs that the anxiety has become a significant and debilitating issue in your life. Recognising this early can help you get the right support, therapy and (sometimes) medication. 
 

What causes anxiety? 

Autistic people may experience anxiety for a range of reasons such as: 

• differences in sensory processing for example, being over or under-sensitive to noises, lights and smells 
• finding it hard to predict or adapt to certain sensory situations 
• difficulties with communication and social interactions 
• having alexithymia (difficulties identifying and describing your own and other people's emotions) - it is more difficult to regulate emotions if you cannot identify what you are feeling 
• worrying about uncertainty and change or transitions, which comes with a fear of the unknown. You may like predictability and routines, and experience high levels of anxiety if things change 
• trying to ‘fit in’ or attempt to appear ‘normal’ by changing your behaviour and internalising any stress/anxiety you feel in certain situations 
• performance anxiety – particularly at school or in the workplace. 

 
Ways to deal with anxiety

Understand the triggers 

Keep a diary to help identify when you are anxious, and the symptoms and triggers. 

Monitor and manage your energy levels 

Be aware of your energy levels after social interactions and other events/situations that you may find tiring or difficult. Recharge by taking some time out to enjoy your interests, hobbies or nature. 

Adapt your environment 

As far as possible, adapt your surroundings to minimise sensory overload. Wear noise cancelling headphones on the train for example. 

Reduce uncertainty 

Structure your day with a schedule to minimise stress. Plan for any changes to your routine. 

Self-soothe 

Use sensory tools and stimming to reduce anxiety levels, if that works for you. 

Relaxation and calming activities 

Try relaxation methods and meditation, yoga and exercise. 

Use an app 

These apps offer personalised support with anxiety:  

• Brain in Hand – a diary, notes and reminders of daily tasks, individual coping strategies, system to monitor anxiety levels and access to support from the National Autistic Society. 

• Molehill Mountain – tracks mood, identifies triggers and gives evidence-based tips on how to self-manage anxiety levels. 

Counselling and therapy 

If you would like to access counselling or therapy, you can do this via your GP or privately. There are many types of counselling and therapy, including cognitive behavioural therapy (CBT) that has been shown to be effective for some autistic people. All talking therapies should be adapted to be effective for autistic people. 

You can also visit our mental health support page for more information about seeking help.

You can also try using mindfulness at home through an app. 

Medication 

There is limited research into the use of medications to treat anxiety in autistic people. Researchers suggest all medications, such as anti-anxiety and anti-depressant medications, should be prescribed cautiously and closely monitored. 

At work 

Ask your line manager to: 

• minimise your uncertainty by planning for change – for example, giving you details of a new member of staff starting, and a step-by-step process plan if tasks are changing.  
• check your visual indicator of your anxiety levels. The Wales Trade Union Congress gives an example of an autistic employee using a visual wallchart to communicate his anxiety levels to a manager. 
• feedback on what you are doing well, as you may be anxious about your performance. 
   

Additional support 

You may find it helpful to access local support groups. Start by contacting your local branch. 
 

Useful links and resources 

Personal accounts and anxiety tips 

• Purple Ella, 2016 and 2017 
• Needham, 2019 
• Musing of an Aspie, 2013 
• Neurodivergent Rebel, 2020 
• Lorraine MacAlister, 2017 Autism and catastrophising