Severe anxiety in 5 year old - wondering about medication

Hi all, I have a nearly 6 year old son who was diagnosed with ASD a year ago, although it was suspected before that. His speech was very delayed as was his social skills.

He’s always been quite an anxious child, but he’s always been able to enjoy himself - until this summer. He will have what seems panic attacks when we go out and arrive somewhere (he’ll be fine and happy to actually go before that), and his reason is usually ‘it’ll be late’ (It could be morning, he’ll still say it’s going to be late). He always becomes upset if his grandmother stays ‘too long’ (although what exactly is too long changes all the time) and it’s like a switch flicks in his head and he gets very upset and panicked until she leaves. He gets very distressed if someone on TV is the ‘same’ as in real life - e.g if he’s eating and there’s food on tv, if someone has no shoes on and he also has no shoes on.

It’s very upsetting for us to see because it’s such a big change in him - he used to enjoy soft plays and going to the beach, but even if we do somehow manage to get him out of the car he will, unpredictably, start panicking and scream to come back. We’ve tried to identify any sensory stimuli that could be triggering these but there isn’t any from what we can tell.

He’s doing well in school with a 1 to 1 worker, but whenever we arrive he will get a panicked look in his face and tell us he’s scared - despite the fact he doesn’t seem to know what he’s scared about. Once he’s in school he’ll be absolutely great all day, but constantly want to know the time. He also has a 2 year old brother who is very confused as to why his brother doesn’t want to go to parks with him etc to play anymore and he of course doesn’t understand :(

We've spoken to a psychologist and got some tips such as making sure he is 100% aware of what will be happening in his day and when he'll be home but unfortunately its not helping.

I am wondering whether medication could help - I'm aware that SSRI's can help anxiety in children. I feel a bit…wrong in asking about this to his psychologist though, almost as if we’re trying to stop him being ‘him’ - but right now he’s just not the happy boy he should be and just seems to live his life with constant anxiety :( does anyone have any advice?


  • These are incredibly complex emotions he’s experiencing. He’ll know a little better how to express what was going on when he’s 40. For now he’s 6. 

    it might be important to measure his experiences not by “happiness” but by matters of intensity, curiosity and adventure. Happiness is a nebulous tool for most Autists, there’s little weight in it. it’s fleeting and a thing for consumer moments: a new Nespresso machine, an hour in Waterstones all to myself. Time at the movies with a friend.  

    I’m not a GP or a trained psychoanalyst, but medication seems like something one takes when everything else fails and there is crippling pain. He sounds like a normal boy with a fantastic autistic brain very capable of becoming his unique self. He also seems like he has limits to socialising and limits to nonsensical situations. Nonsensical to him. It’s you’re job to help work out how he’s making sense of the world and then help realign perspective / expectations if need be. 

    I’m going to take a leap here but I was obsessed with infinite space by age 3. Not the passage of time but the fluidity of existence. 

    And to me it sounds like he has a fascinating desire to understand Time. I think this is quite incredible: is he interested in dissecting and working with watches? Can you find anything and everything to do with the time/space continuum and see if he’s interested in it? What about early physics? I would reach out to anyone in academia and find all resources for children to be able to engage with the essence of Time. Maybe buy a metronome or find apps with clocks on them.

    I would help him become involved in understanding the passage of 5 minutes and 10, and work in increments. If he’s interested sit at the train station and engage with the coming and going of trains. Stay for an exact pre-designed set amount of time and see how many arrive on time. Teach him the 24 hour clock, buy him his own clock. Eventually he will be able to anticipate matters of time better. This way when grandma is coming over, give him a set time for her visit. Allow him a set time to retreat. But he should know that certain family members, like grandparents, are allowed to stay until after he falls asleep. 

    in cases going forward you may be able to ask him for time. Have him use a stop watch and understand how long it takes you to do dishes or take out the rubbish or drive to school. This may help him feel like he has a source to safe guard or keep track of. You could make a chart for him too. Also maybe make a monthly chart of when the sun sets. Note that time lapse (slow or fast) may cause anxiety as it is warping a seemingly solidified element.

    I think there is something connected here with the fantasy/reality situation as well. But this is another matter. It may be useful for him to engage with theatre and puppet shows or other forms of performing arts to understand what is needed so TV becomes less of a different dimension of reality and more about the art of presentation. The passage of time in TV is warped quite often - it is not part of our “reality”. 

    While he’s 6, it could be a loss to everyone to sedate a mind which is perhaps attempting to work out deeper elements of physics, the mechanics of existence and dimensions of reality. The only solution is to engage all the more so he can begin to understand and have a sense of commandeering his world. 

    Unfortunately the younger sibling will have to eventually find his own friends and allow his older brother his own space. Siblings tend to do their own thing by a certain age anyway, these will just start younger and that may bypass extra stress, who knows! 

  • Hello ,

    Thank you for sharing this with the community. I'm sorry to hear that you have been having some trouble with your son's anxiety. You may like to discuss medication with a GP/medical professional. However, please do take a look at the following information from the NAS around anxiety in children with Autism with some strategies:

    I hope this helps,


  • Six is far too young an age to take medication. How about Chamomile tea? (might relax him naturally)

    Time would interest kids. One of my brother's first words was 'Clock'. He was obsessed with clocks as a child; he lost that interest growing up, but that's natural.

    My brother was never interested in what I was interested in; as well. Again, that's perfectly natural.

    Easy does it.