Suzana Herculano-Houzel

Anxiety, constant bane of us autistics


I can tell you what it is. I can’t tell you why we have it. Yet, anxiety is a common feature of people on the autism spectrum.

Anxiety is a physiological and mental state of readiness as the brain expects to have to deal with a problem – even if the problem for now only exists inside one’s own head. The muscles tense up, like they do in an athlete at the ready who is just waiting for the start signal to race as fast as possible to the 100 yard line: that’s the brain getting the body ready to move, just like we wind up the coil of a toy. The mental version of that preparation to act is that the mind also gets tense, hyperattentive, expecting the problem to materialize and ready to jump at it.

Being capable of anxiety is great: tensing up in anticipation, sometimes at the mere thought of the problem you will have to solve tomorrow or next week, is probably just what you needed to get started prepping for the job.

But being constantly anxious without reason, or exceedingly anxious when just a bit of tension would be enough, is exhausting. And constant, uncalled-for, excessive levels of anxiety are common features of those individuals in the autism spectrum. Which, basic logic reminds you, does not at all make anxiety a privilege of those on the spectrum. Everybody can and probably will suffer from anxiety now and then, and some much more than others, depending on a combination of genetic factors, upbringing, traumatic experiences, and cognitive and coping strategies learned along the way. But anxiety is SO common amongst those of us on the autism spectrum that it begs understanding – also because learning where it comes from is the key to mitigating it and living better lives.

I have learned from my own experience that sensory overstimulation can cause enough anxiety in the form of muscle tension that I will get tension headaches in noisy environments, like restaurants, especially if I try to fight the noise and have a conversation. Retreating into one’s own head and admiring the view and the company while remaining quiet is a coping strategy that many, like me, learn by pure chance – then stick to it, because it works beautifully. Remember, a stressor is only stressing to you if you try to control it. And one of the issues with autism is that hypersensitivity is pretty much a defining feature, which makes what is a perfectly tolerable environment for neurotypicals an ordeal to autistics, one that both requires lots of self-control to cope and causes sensory discomfort that our brain interprets as a major stressor that needs running away from. Different autistics have different sensitivities. Uncontrollable loud noises (my own music blasting out of my speakers is awesome!), high luminosity, high visual contrast, stripes, and certain smells are painful to me and literally give me the shivers (no, I don’t know the connection there – yet).

Having to watch oneself in the presence of others is another major source of stress, and thus of anxiety – and one that only worsens over time, as we learn to read the inadvertent, undesired consequences of our words and actions on others, when we just stated the obvious and we only meant well. Realizing that we don’t function like other people and are looked down upon for that leads to trying to fit in, which requires constant cognitive effort of self-supervision, which some call “masking” (I don’t, but that’s a whole other story). Whatever you call it: it’s exhausting – which is why when we find those precious few people who are kind to us, who cherish our quirks, whether or not they share them, we become their fierce, loyal friends. It feels soooooooo relaxing to be allowed to be yourself.

Whether the anxiety of autism is a primary feature or one that emerges naturally from sensory hypersensitivities, from the constant cognitive effort of self-supervision to function in a neurotypical world, or all of the above is something that I believe has yet to be determined. Regardless, the remedy is the same: we learn to stay away from people and situations that are sources of stress – and in more insidious or extreme cases, medication may be the difference between crippling, paralyzing anxiety that leads to nausea and body pain, and being able to live well.

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