High / Low Anxiety?

I don't have a separate diagnosis of anxiety, I think it's just part of my autism diagnosis. It can fluctuate between high and low, so socially I get a bit nervous even going on the school run, but it's daily so I don't show it outwardly, and will even initiate 'small talk' so I don't look weird. But then other times, like at an extended family gathering, it's crippling that I know I should talk to relatives but just can't do it unless they initiate it, when I try my best to be normal. 

Same with going places, making doctors appointments etc. If it's something that's routine or even expected, the anxiety is less, otherwise it can be so high I just can't do it.

It used to be worse when I was younger. People just thought I was shy. 35-40 years ago you just had to get on with things. It was hard.

I think it is mostly a threat response to new and unpredictable environments.

You can't think your way out of it as it is not a thinking problem. Your nervous system is triggered first. This feeds into your thinking, changing the mode and how you behave.

You just have to do things and gradually train your body that things are safe and nothing bad happens. You may need to build up to it it just white knuckle it the first couple of times.

Depending on how calm I am, I can still find it hard to go into some places the first time. It is not consistent though.

I can walk into hotels easily, but not coffee shops. Social settings are hard, business settings, apart from some shops, are easy. E.g. having to walk past a shop 3 or 4 times, or go home and come back, before going in. In COVID for 2-3 years I could not enter anywhere new at all. It was a threat response even though cognitively I knew it was ok, I could not override it. So I was restricted to 4 buildings. I am over that now thank goodness.

I mentioned it in my diagnosis. But I think it is more a consequence of autism for some people, rather than a diagnostic criteria. That's why there are separate anxiety disorders.

Autism in general can make you more susceptible to other things.

I get what you’re saying. There is potential that I could interact with the tougher consumers more often to build up that muscle.

A little more background: I work as an employment specialist for people with disabilities. So the business I work for has a day program for people with disabilities. When I say extreme behaviors, I mean things like (for example) anger outbursts from dementia.

The good news is that’s not really a core function of my job to deal with behaviors (unless it is one of my clients that I am job coaching), as I am not a direct support professional. I just help them out from time to time when I’m not busy. So “the only way out is through” approach probably would work for me, but it’s ultimately optional for me in order to keep employed.

I also agree that a little more training would help. A lot of the behaviors are unpredictable, but you can see the signs that they are coming usually. The only problem with me getting more training is that we have to squeeze that in with the work I am actually supposed to be doing.

profdanger said:

My coworkers always seem to effortlessly know what to do and how to handle extreme situations.

Companies that require you to interact with the public should offer courses on "dealing with difficult customers" that will train you on how to interact.

It it largely scripting so should be fairly easy to learn as an autist and with practice you get more comfortable with using it.

Being able to identify when you are in a situation where you need to use these skills is possibly a bit more tricky but with expereince you learn to spot it.

The start of my career was like this but I kept puting myself in the situations where I would have to deal with this sort of thing until I mastered it - stressful but the fastest way to be able to cope for me.

It is also how I dealt with many other areas that caused me anxiety - I faced them down and proved I could deal with them as I was always taught "the only way out is through" and it worked very well for me. All this was decades before I was diagnosed so I always considered myself to be neurotypical back then.

I think my anxiety is so acute because I didn’t know I was Autistic & everything built up over a v long period of time. As part of my assessment I scored extremely high for anxiety if that helps at all.

I’ve been diagnosed with generalized anxiety disorder. It makes things like driving in unfamiliar places or walking on a crowded city sidewalk almost unbearable. I am medicated for it, which at least makes it much easier to work.

I’d say there’s a lot of overlap for my anxiety and Autism. My social anxiety is pretty high and so I struggle even more than others when faced with complex social dilemmas. Ex. At my workplace we have consumers that can exhibit extreme behaviors, and I seem to never be able to know what to do when someone is having a behavior. My coworkers always seem to effortlessly know what to do and how to handle extreme situations.

My anxiety is pretty high but I do still manage to function. I would say it plays a pretty big part with my autism as much of it is around social interaction and change.

Just to clarify — I wasn’t saying anxiety isn’t considered in assessments. Of course it is, and NICE is clear on that.

What I meant was that anxiety isn’t part of the core diagnostic criteria for autism itself; it’s a very common co-occurring condition and something assessors need to distinguish from (or alongside) autism. That’s an important difference.

Jalapeno said:

Anxiety is not part of the diagnosis as far as I know ?

Just for info, anxiety is considered.

Per the NICE clinical guidelines for adult autism assessments, assessors must “take into account and assess for possible differential diagnoses and coexisting disorders or conditions” - and the specified conditions that they must consider do include anxiety disorders:

NICE - Autism spectrum disorder in adults: diagnosis and management

I have anxiety but like many probably have just taken it as part of being Autistic in an NT world , so haven't bothered to get a diagnosis. 

I had Talking Therapies for social anxiety and the weekly scores changed a little but were in the mid to high range, and I asked my therapist should I get a diagnosis to which she said "what difference would it make?" I couldn't think of a good answer to that

It's not like Autism and ADHD where I felt a diagnosis was needed and beneficial.

Anxiety is not part of the diagnosis as far as I know ? but as Bunny said it's sadly very common because of the world we live in

If it helps, according to the NAS: "Research varies but the consensus suggests that it might be common for around 40-50% of autistic people to receive a clinical diagnosis of anxiety":

NAS - Anxiety > Why might autistic people experience anxiety?