which came first the chicken or the egg?

I don't want to appear smart or anything but I think it is fair to say that anxiety comes from where it hurts! If your greatest pain comes from being rejected by people you like then the things that make you anxious will have some link back to that.

Like True Colours most of my anxiety comes from what I feel about myself or situations that bring those feelings to the surface. All the other factors of physical pain, waiting, cost etc are almost trivial compared to the emotional pain I inflict on myself. (Sorry True Colours if I have misread your meaning).

The other deep emotion is loneliness (other people use different terms). Again I can probably trace quite a lot of anxiety back to this but the links are much less clear.

For me it is less about nature and nurture and more about the running battle between "ilogical brain whizzing" and "common sence".

Regarding the hospital visit, can you build in some "fixed points" where you can rest when you have reached a certain stage. Can you plan to travel there a little early and then plan in a cup of coffee sit down before you sign in. You have then broken the day into ywo more managable chunks with a chance to reset in between. Works for me at times but I understand we're all different.

Dunk 

longman said:

About five years ago during the pre med for an operation, I put down on the form "Mild asperger's syndrome". I've recounted this before, some time back.

On the day of the operation I was asked several times about which inhaler I used, and when the anaesthetist came to see me he was most pressing about the details of my asthma.

I said I didn't have asthma, so he produced the form. Someone had score out "asperger's syndrome" and written "asthma" above it.

Someone who presumably decided - can't be aspergers, silly patient must have got it confused with asthma.......

That is truly appalling Longman.  In the medical field, such stupid actions could have serious consequences.  Clearly in the medical field, many people haven't heard of Asperger's either... So is this a new title "Asthma Syndrome".  Duh!

About five years ago during the pre med for an operation, I put down on the form "Mild asperger's syndrome". I've recounted this before, some time back.

On the day of the operation I was asked several times about which inhaler I used, and when the anaesthetist came to see me he was most pressing about the details of my asthma.

I said I didn't have asthma, so he produced the form. Someone had score out "asperger's syndrome" and written "asthma" above it.

Someone who presumably decided - can't be aspergers, silly patient must have got it confused with asthma.......

@True_Colors At one time I would have said yes, tell them about your AS, but since having read today two separate stories about how two people's serious conditions were missed by multiple professionals because they fobbed off these AS ladies with "it's anxiety" and prescribed anti-depressants instead, I would say don't tell them.  Professionals are so autism unaware still and will have professional bias that can prevent them investigating properly.

I've expressed these theories before on other threads, so please bear with me if you've heard me waffle on about them before.

I think some elements of anxiety arise because we don't pick up feedback from others. We therefore need to analyse situations in order to try to work out what happened. That leads to a propensity to explore all possible outcomes or implications of a situation, which leads in turn to a propensity to worry through many situations and all their negative outcomes, and even to lose sight of reality (would these outcomes really happen?).

My understanding of the NT world is that they play games, sparring with each other, to find out each other's standpoints. That involves using and reading body language, intonation, inflexion, shrugs, looks etc. There's a lot of teasing, white lies, provocation and attempts to undermine that are all part of these games.

The point of this is that NTs quickly work out whether they made a mistake or offended someone, or whether someone's adverse reaction was real or feigned for effect, whether they are being teased or lied to. They still experience misunderstandings. But the other important point is that they usually forget what transpired within minutes. They don't dwell on it. These communication issues occur so frequently that they are commonplace and readily forgotten.

If you are on the spectrum you don't get much social interaction practice, and where it occurs you don't pick up much of the sparring, and don't get a chance to find out whether someone's having fun at your expense, lying to you, or genuinely annoyed or offended.

So the only way you can resolve what you think might have happened is to go over events and analyse. The propensity to analyse frequently fuels a growing propensity to worry. Far from forgetting little incidents they go on in your head for months, years, lifetimes.

So to approach it as "chicken and egg" social skills are a major contributing factor to a higher propensity to worry and get anxious.

Routines and consistent practices provide secure reference points in a world otherwise lacking.

Providing other focal points might help. But I think we need to go further than most to reduce the analysis process. Try to remind yourself that many imagined outcomes are very unlikely. Try to use break words/phrases to interrupt worry cycles, or use brief physical discomfort - the rubber band flick on the inside of the wrist, or finger flick on an ear lobe is often sufficient. Carry a notebook and write down current worry subjects - set down on paper they can be left to a more appropriate analysis time. Write a list of priority worries and try to address those that are more easily resolved.

Find instances where you can ask someone who was present at a event of concern to clarify what happened - someone you can trust not to capitalise on it or tease (not easy). Ask someone to intercede for you. Write an apology note to someone you think you may have offended - over caution might look odd, but it might also help you reduce worry. Ask someone you can trust to give you regular reassurance. OK finding someone you can trust is not easy.

Like True Colors I'm always travelling to places way too early. Any journey I have to write out a plan, with alternatives, and carry it with me - might not actually take it out and look at it, but I keep it with me.

I don't mention the Asperger's....well hardly ever. Mine is at the abler/milder end, whatever that means, so I don't think it lets me down that much, but I am very conscious about where it can let me down. As I've said before I do a lot of observing situations, and confronting uncomfortable environments. I do it so I know when I'm likely to get into difficulties and when it is OK to live dangerously. And I keep trying to increase my exposure to uncomfortable situations. Otherwise I'm prone to retreat.

I do find people's understanding of autism is limited and driven by stereotypes. Also a lot of people say I cannot be. 

But that is the danger for those better able to pass themselves off as NTs. You then get bad reactions because people think I'm messing them about, being deceitful, being rude or cheeky etc., because I don't have control of my responses and I misread situations. An then there's that menace called eye contact - I manage most of the time, but there's always someone who gets up tight about it.

Hi - "nature and nurture" is a common phrase for how a person develops.  The personality we get via our genes and then our experiences and how they affect us.  I'm not autistic so will not venture as to how autism fits into that equation for each invididual. 

I would definitely mention you have Asperger's. I always do myself if I have a doctor's appointment, and I explain how it affects me, such as my need for concrete information and facts, and to avoid abstract metaphorical language.

I hope your appointment goes well

Yes, I have extreme anxiety, some of it is related to what other people might be thinking, but I also have anxieties of an OCD nature that are more deeply embedded within me.