{"id":994,"date":"2019-04-15T19:19:26","date_gmt":"2019-04-15T19:19:26","guid":{"rendered":"https:\/\/www.autismconnect.com\/blogs\/?p=994"},"modified":"2019-04-15T20:07:45","modified_gmt":"2019-04-15T20:07:45","slug":"anxiety-in-autism-why-and-how-it-is-different-from-regular-anxiety","status":"publish","type":"post","link":"https:\/\/www.autismconnect.com\/blogs\/anxiety-in-autism-why-and-how-it-is-different-from-regular-anxiety\/","title":{"rendered":"ANXIETY IN AUTISM: WHY AND HOW IT IS DIFFERENT FROM \u2018REGULAR ANXIETY\u2019"},"content":{"rendered":"

WHAT IS ANXIETY?<\/strong><\/h2>\n

Anxiety is a physiological reaction, which we all have experienced. Anything and a lot of things can make us anxious, to varying extents. One can say anxiety is like the body\u2019s smoke alarm. During a fire, the preparatory smoke rings the bell and alert us before a bigger fire sets in. So we prepare ourselves for \u2018fight\u2019 or \u2018flight\u2019 based on the severity of the situation and our coping as well.<\/p>\n

Anxiety presents with various signs and symptoms, which could be psychological, like poor concentration, excessive worry, fears and phobias; autonomic or bodily reactions, like increased sweating, deranged blood pressure, urinary urgency; physical, which could be restlessness, muscle tension or behavioral like irritability, anger, social withdrawal or avoidance.<\/p>\n

ANXIETY IN AUTISM:<\/strong><\/h2>\n

Like all the physiological systems, this alarm system also works and functions differently in different individuals; and based on that, the bell might ring differently, in different volume and different tune. It might sound different to different observing individuals as well. So what\u2019s different in autism? Autism, scientifically being neuro developmentally \u2018different\u2019, the \u2018neuronal discharge\u2019 and hence, the behavioural outcome, turns \u2018different\u2019 and looks even\u00a0 more \u2018different\u2019 to the \u2018usual\u2019 eyes and perception. The expression of anxiety, or the occasional outburst, is an explanation of it, including the coping and acceptance to it.<\/p>\n

Ultimately, children with autism, probably best described as different (but NEVER as ill or sick child) the very natural anxiety \u2018turns\u2019 or \u2018looks\u2019 pathological even for professionals with sufficient knowledge and experience about it. Like all the systems of the body, the \u2018anxiety system\u2019 can definitely turn sick for anyone, which, might need treatment and over treatment shows adequate response, too. We need to be very mindful and particular about the fact that any different expression of anxiety need not be pathological always, neither does it always need treatment. In a much simpler example, you might like red and I might like blue, from dress to car colour, which definitely doesn’t make the other\u2019s choice as ill or sick, and doesn\u2019t need to be changed.<\/p>\n

THE ATYPICAL ANXIETY IN AUTISM:<\/strong><\/h2>\n

How could the anxiety be different in people with autism than in people without autism? It\u2019s mostly the expression, extent, and also the unpredictability. Though the underlying reasons remain the very same, as mentioned earlier. Autistic individuals may perceive the threat differently, and express it differently too.<\/p>\n

The situation turns tough when this difficulty interferes with communication and expressing oneself. The anxiety reaction might stay suppressed for long, without any hint to others, leading to sudden altered outbursts, without much control. The high association of other neurodevelopmental challenges also further add to the problem by improper understanding of the situation, altered judgment about the perceived threat or outcome of it, leading to more expressive or different responses. The altered sensory system and its responses are also quite responsible for the different expression of the anxiety in people with autism.<\/p>\n

Autism, is very rightly conceptualised as a spectrum, in current mental health nomenclature. It is understandable as the visible outcome of its various manifestations are broad, and the anxiety reactions are no exception. As children with autism grow up, they face different kinds\u00a0of challenges as the anxiety situations change, and the response patterns also change accordingly.<\/p>\n

The society\u2019s expectation and way of responding to this has turned quite fixed and stereotyped with every person, as they turn older, further piling up stress and the resultant anxiety levels.<\/p>\n

PREDICTORS OF ANXIETY:<\/strong><\/h2>\n

Various researches have shown greater autism spectrum symptoms, anxious cognitive style, difficulty in language expression and compromised IQ. These could be predictors of anxiety reactions in autistic individuals, with more chances of atypical anxiety presentations, which could be increased fidgeting, self injurious behaviour, sudden anger spells or even hitting the perceived threat, further complicating the situation. Among various anxiety disorders, social anxiety in Autism has persistency been seen to be more common, present in every third autistic
\nindividual, which might need professional\u00a0intervention.<\/p>\n

WHAT CAN BE DONE?<\/strong><\/h2>\n

There is no lack of assessment scales established or novel treatment\/therapy approaches focussing anxiety as a whole, or anxiety in autism individuals. The predictability of assessment tools or the usefulness of therapies has shown promising results in multiple populations and variable situations as well.<\/p>\n

Without going into intricate details of each of them, we should know and remember there are available medicines and various therapies as well, which works excellently if prescribed or applied properly, without being overprescribed, or trying too many novel therapies which haven\u2019t received enough scientific evidence yet.<\/p>\n

Autism specific cognitive behavioural therapy, applying social stories and trying for cognitive restructuring, behavioural and cognitive modification to teach increased\u00a0predictability, visual scheduling can be very useful for autistic children. Where, the parental understanding and role in anxiety management along with differential reinforcement for alternate behaviour are specifically needed for younger children.<\/p>\n

To conclude, anxiety is universal and very much present in people with autism, probably with an increased prevalence than otherwise detected. Because of the different communication patterns or highly associated other neurodevelopmental problems, the very naturally expressed anxiety reactions could look as \u2018pathological\u2019 to a na\u00efve eye, especially when we focus on the expression over the reason or context.<\/p>\n

However, one shouldn\u2019t forget everyone\u2019s anxiety has a reason, and any form of excessive anxiety in Autism could be managed with proper understanding of the reason of anxiety, and if needed with suitable professional care and intervention.<\/p>\n

Dr. TANAY MAITI
\nMBBS, DPM, DNB Psych<\/p>\n

PSYCHIATRIST,
\nAIIMS BHUBANESWAR<\/p>\n

 <\/p>\n

Note: Many more Professional Therapists like Dr Tanay Maiti are listed on our Website Directory.<\/a><\/strong><\/p>\n

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