Helping autistic individuals with anxiety

Helping an autistic person who struggles with anxiety requires a personalised and compassionate approach that takes into account the unique ways autism can influence and be influenced by anxiety. It's often a matter of addressing the root causes, which can be different from those in neurotypical individuals, and providing tailored strategies for coping.

Here's how I would approach helping an autistic person with anxiety:

1. Understanding the Triggers and the "Why"

First, it's essential to understand what is causing the anxiety. The triggers for autistic people are often linked to core features of autism, and they may not be what you would expect. Common triggers include:

 * Sensory Overload: Heightened sensitivities to sounds, lights, smells, or textures can be extremely overwhelming and lead to anxiety. A crowded, noisy place like a shopping mall can be a source of intense distress.

 * Changes to Routine and Uncertainty: Many autistic people find comfort and safety in routine and predictability. Unexpected changes, even minor ones, can be very destabilizing and anxiety-provoking.

 * Social Demands: Navigating social situations can be a significant source of anxiety due to difficulties with social cues, communication, and the pressure of "masking" (hiding autistic traits to fit in).

 * Difficulty with Emotional Regulation: Some autistic individuals may struggle to identify and understand their own emotions, a condition known as alexithymia. This can make feelings of anxiety confusing and difficult to manage.

2. Creating a Supportive Environment

Making practical changes to the environment can be a very effective first step.

 * Sensory-Friendly Spaces: This could involve using noise-canceling headphones, dimming harsh lights, providing a quiet space to retreat to, or using weighted blankets.

 * Predictability and Visuals: Use visual schedules or checklists to provide a clear structure for the day. This helps reduce uncertainty and gives the person a sense of control.

 * Prepare for Change: When a change is unavoidable, prepare the person in advance. Explain what is happening, why it's happening, and what they can expect. Social stories, which are short, simple narratives about a specific situation, can also be a helpful tool.

3. Teaching and Reinforcing Coping Skills

Anxiety management is a skill that can be learned. The key is to find what works for the individual and practice it regularly, even when they are calm.

 * Sensory Tools and Stimming: Encouraging the use of sensory tools (like fidget toys) and stimming (self-stimulatory behaviors like rocking or hand-flapping) can be effective ways to self-soothe and regulate emotions.

 * Relaxation Techniques: Simple techniques like deep breathing exercises, progressive muscle relaxation, or mindfulness can be adapted to be more concrete and visual. For example, using a pinwheel to practice blowing or counting breaths.

 * Physical Activity: Regular exercise, yoga, or even simple movement like jumping on a trampoline can help release tension and reduce anxiety.

4. Seeking Professional Support

When anxiety is severe or persistent, professional help is crucial.

 * Therapy: Therapies like Cognitive Behavioral Therapy (CBT) can be effective, but they often need to be adapted for autistic individuals. This may involve using visual aids, concrete language, and focusing on specific behaviors rather than abstract thoughts. Therapists who specialise in autism-competent care are recommended.

 * Medication: A doctor may recommend medication, such as Selective serotonin reuptake inhibitors (SSRIs), to help manage anxiety symptoms. It's important to work with a healthcare professional who understands the unique needs and potential sensitivities of autistic individuals.

 * Occupational Therapy: An occupational therapist can help with sensory integration and provide strategies to manage sensory differences that contribute to anxiety.

5. Communication and Empathy

Finally, a foundational element of support is a compassionate and empathetic approach.

 * Simple and Clear Communication: During moments of high anxiety, provide simple, clear, and direct instructions. Avoid complex language or abstract concepts.

 * Validate Their Feelings: Acknowledge that their anxiety is real and valid. Phrases like "I can see you are feeling overwhelmed, what can we do to help?" can be more effective than "Don't worry about it."

 * Patience: Anxiety can be a deeply distressing experience. Be patient and understanding, and remember that some coping strategies may take time to be effective.

By combining these strategies—understanding the specific triggers, creating a supportive environment, teaching tailored coping skills, and seeking professional help when needed—it's possible to significantly improve the quality of life for an autistic person struggling with anxiety.