Anxiety symptoms and reactions are very common in individuals with autism spectrum disorder (ASD). They can interfere with functioning across home, community and school settings. Scientific studies have found that from 11 to 84 percent of youth with autism suffer from anxiety symptoms – intense fear, trouble concentrating, rapid heartbeat, tension, restlessness or sleeplessness.

Lisa Rogers with Educating Diverse Learners answers a reader’s question about helping her son overcome his daily stressor. 

Q: Dear Lisa,

My son has fears. One thought gives him daily anxiety: that of his pants not staying up. We tried belts that he buckles too tightly. He still fears the pants will fall and the buckle gives extra sensory problems. We tried sweatpants that he ties tightly, still fearful. All day he hikes his pants up. I tried to show him the pants can’t fall down but this doesn’t help. He also insists on wearing underwear two sizes too big. He is 8 and diagnosed as PDD-NOS. Could you direct me to any information to help him? This fear is causing multiple meltdowns daily. I don’t know what to do. Thank you, -Anonymous

A: Dear Mom or Dad,

Multiple meltdowns each day can certainly take its toll on your son and your family. I understand how critical this issue is for you and will do my best to provide helpful information for you to consider.

In order to be most helpful, I do need to ask a few questions first.

  • Is your son able to explain in any way what is causing or contributing to this fear? You mention that this is a current situation and so any insight about the reason for this development will be helpful. As you know, children on the autism spectrum are often rule-driven and literal in their interpretation of language. Perhaps something an adult said with good intentions about the importance of keeping your pants up or a scene from a movie could be a root cause? On the surface this might seem silly, but this can help in better understanding your son and his very real fear.
  • If your son is able to communicate through words or pictures, you might try cartooning as a way to acquire insight. When he is calm and all is well, you can sit together and draw a cartoon where you ask him to describe his thoughts while he is walking with his pants snug and tight around his waist. If not too stressful for him, you could even draw a picture with pants falling down on a stick figure and ask him to describe his ideas/feelings about this.
  • Have you already tried suspenders or even overalls to provide a sense of security beyond a belt or tie? It sounds like there are compounding sensory issues and so these might not be feasible options.

For now, here are a few ideas to consider . . .

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Depression, Aspergers, Help, Resources

It is said that 40 million Americans live with an anxiety disorder, which is more than the occasional worry or fear. We all experience anxiety to some level. Anxiety in children is common when separated from their parents or from familiar surroundings. However there is a type of anxiety that is more severe and may be misdiagnosed. Anxiety left unchecked or treatment may become paralyzing to everyday life.

Below we’ve gathered several lists for you. What does anxiety look like? How can it manifest, when is it critical to consult a doctor and what methods are available to self calm. Here we go….

Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Depression, Aspergers, Help, Resources

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

According to research from the Mayo Clinic, several types of anxiety disorders exist:

  • Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
  • Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
  • Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
  • Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
  • Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
  • Separation anxiety disorder is a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
  • Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
  • Specific phobias are characterized by major anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
  • Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
  • Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don’t meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

Parents should be alerted to the signs so they can intervene early to prevent lifelong complications. The American Academy of Child & Adolescent Psychiatry offers you different types of anxiety in children.

Symptoms of separation anxiety include:

• constant thoughts and intense fears about the safety of parents and caretakers

• refusing to go to school

• frequent stomachaches and other physical complaints

• extreme worries about sleeping away from home

• being overly clingy

• panic or tantrums at times of separation from parents

• trouble sleeping or nightmares

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Anxiousness is one of those emotional states we see in the face; but perhaps most of all we see it in the movements of the body.

(Note: there is purposely no audio with the above video)

When we become anxious we lose some control over our actions. Carrie’s hands are raised, partially coverng her face, as her fingers scratch nervously. Her gaze is unfocused and shifts direction from side to side and then upwards.

Feeling anxious or distressed is shown in the mouth – and here Carrie’s mouth is stretched and then becomes slack and turned down. She’s at a loss as to how to answer a difficult question, as she gives way to negative thoughts.

When someone is in the grips of anxiety they temporarily go into an emotional ‘bubble,’ losing awareness of the person they are having a discussion with.

Signs to note

  • partially covering her face with her hands
  • unfocused gaze
  • shifting direction of gaze from left to right, then up
  • scratching her hand
  • mouth stretched, then drooping down

By John Habershon

A woman with her hand on her head, grimacing. Text reads: 24 surprising physical symptoms of anxiety

24 Surprising Physical Symptoms of Anxiety

Staff Writer at The Mighty

We may think we know what anxiety looks like (shaking hands, shallow breaths) and what it sounds like (“I can’t do this. What if I can’t do it. What if?…What if?…), but what does anxiety feel like? Often, we focus so much on the racing thoughts and emotions that come with anxiety, we forget to recognize how physical anxiety can be. In fact, you can feel physical effects of anxiety without even realizing it’s anxiety that’s causing it.

To learn some of the ways anxiety not only affects your mind — but your body — we asked people in our mental health community to describe what physical symptoms of anxiety they deal with, and what they feel like.

Here’s what they shared with us:

1. “When I get into high anxiety, sometimes out of nowhere, I get GI [gastrointestinal] symptoms. Constantly going to the bathroom. I have cramps and abdominal pain. It’s tough because there is nothing I can do but just try to wait it out.” — Michele P.

2. “Does anyone else find themselves antsy after a big panic attack where you can barely sit still and then for the next couple days, you’re completely mentally/physically exhausted? I feel like everything is just too much and I can’t move.” — Kristen G.

3. “It starts with my heart racing… so fast I can hardly breathe. Then the nausea. It is unrelenting. The nausea makes my anxiety worse which makes my heart race, which makes me more nauseous. It’s all a vicious cycle, and it is so hard to escape.”2 — Rachael J.

4. “In the aftermath of a panic attack, I often feel bone-chillingly cold. It doesn’t matter what time of year it is, and no jacket or blanket helps. I just have to ride it out until it goes away.” — Monica M.
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Attention deficiency can become a barrier for many things to many people. Children diagnosed with Asperger’s Syndrome often times are also diagnosed with Attention-deficit/Hyperactivity disorder and may have a hard time concentrating in class, have a hard time sitting still during dinner, or may lack consistency. Adults diagnosed with ADHD may struggle with organization at work or home.

Silhouette of a beautiful yoga woman at sunset (in surreal colors)

ADHD is defined by the Mayo Clinic as a chronic condition that affects millions of children and often persists into adulthood. ADHD includes a combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Besides proper medication, practicing Yoga can be another support to help ease the mind and relax the body.

Yoga is an ancient art based on a harmonizing system of development for the body, mind, and spirit. Practicing yoga can help in slowing down the mind, relaxing the body, and becoming aware with your immediate present. In other words, for someone whose mind is racing, has a difficult time concentrating, and has extra energy, yoga can be a good support to help in reducing these emotions.

The question is how do I even begin doing yoga? Well, get ready because here are your first 3 steps into beginning your journey to calmness and relaxation!

Beginner’s Steps to Yoga

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Depression, Aspergers, Help, Resources

If you have: lost interest in your usual activities; trouble sleeping, wake up early or sleep all the time; a change in appetite (more or less); withdrawn from people with a down mood (for Aspies it might be sad, irritable or a sense of hopelessness – whatever negative mood or thoughts you recognize), you have what we call major depression.

Depression, Aspergers, Help, Resources

For this, you probably need professional help. Things are not hopeless but being depressed is like looking through dark glasses. While people with Asperger’s are prone to depression because of challenging life experiences, clinical depression is not part of Asperger’s Syndrome and usually responds to treatment. For those struggling with lower level depression, you might still consider therapy to look at ways to make life changes and feel better.

Professional Help

For finding professional help and other resources, Autismsource.org is a gold mine of resources including lists of local therapists in your area.

Online directories:

Psychologists, social workers, psychiatrists, advanced practice registered nurses (APRN), and other specialties all can provide therapy. Individuals should be licensed providers in their states. You can find this information by looking at their websites.

Only psychiatrists, other MDs (medical doctors), and APRNs can provide medication. Medication has been demonstrated to be effective in treating depression. Often a combination of medication and therapy are most useful. The form of therapy most recommended is CBT (cognitive behavioral therapy). MBCT (mindfulness-based cognitive therapy) has been shown to be effective for depression although there isn’t research on it with people on the spectrum. Most therapists specializing in working with those with ASD know how to modify traditional CBT to best work with those on the spectrum.

It can be very challenging, certainly in parts of the US, to find therapists who take insurance.

The prevailing cost of therapy varies widely across the country. Some therapists (usually psychologists) offer sliding scale fees or have some lower fee slots, so it’s worth calling and asking. Clinics generally take insurance but you want to be sure that the therapist is familiar with ASD. The first thing you should do is call the number for patient or customer service on your insurance card and ask for a list of providers (psychologists/psychiatrists/social workers) in your area. This way you can know all the providers near you who are in network with your insurance plan before you call around clinics. In network providers have more affordable rates than out of network providers. It is important to inform yourself about your insurance plan and coverage before you begin the search.

Also, check providers with Medicaid if you have it. Any MD or APRN will know about treating depression with medication. Some therapists who accept Medicaid might be experienced with ASD even if they’re not on a directory for ASD.

Self Care Strategies

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As students with AS and NLD of all ages return to school, there’s two challenges: making the transition from summer to the school routine, and setting up the year to maximize success. Transitions and novelty often are the source of anxiety, so many AS and NLD students are increasingly anxious as that first day back to school approaches.

Anticipatory anxiety can be expressed as headaches, stomach aches, and specific fears of the year ahead: who’s in the classes, will there be bullying, what’s expected by teachers, having to take gym.

How can a parent help (or an older student prepare)?

Deal with anxiety:

  1. Recognize anxiety is a real feeling, but not an accurate prediction of what’s going to happen. Too often parents get caught up in the anxiety themselves.
  2. Meditation has been proven to turn off the “fight flight” response, and the breathing techniques are useful to use when there’s challenges or frustration. It’s a good time to start practicing daily. There’s apps for all ages.
  3. Exercise is another good way of dealing with anxiety. It doesn’t have to be a sport. Walking outside can be calming.
  4. AS and NLD students usually have ideas of what helps with anxiety but sometimes don’t initiate doing those things: reading, music, playing with pets.
  5. Use self talk – realistic self encouragement can be thought through ahead of time: “I can handle this,” “I know I can get help if I need it” are examples.

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