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Acute Anxiety in Adults with Asperger’s and High-Functioning Autism

Many individuals find it very difficult to deal with anxiety if they have Asperger’s (AS) or High-Functioning Autism (HFA). Coping with acute anxiety uses many different cognitive functions, for example:
  • formulating a coping strategy
  • identifying causes
  • maintaining control of emotions 
  • recognizing the symptoms

Having AS or HFA can make it difficult to balance all these processes to manage acute anxiety.

Here are some tips for managing acute anxiety for adults on the autism spectrum:

1. Apply slow breathing techniques. Proper breathing habits are essential for good mental and physical health. Focus on your breathing pattern. Identify whether you breathe mainly through the chest or through the stomach. Short, shallow and rapid breaths from the upper chest should be avoided. Breathe deeply and slowly through the nose. You should feel greater movement in the stomach than the chest as you inhale and exhale. Practice breathing exercises every day. Learn to apply slow breathing as needed (e.g., when feeling anxious or angry).

2. Become aware of the major sources, or triggers, of acute anxiety in your life. First, keep an awareness diary for a few weeks that notes the date, time, event, severity, symptoms, and coping strategies you used to ease the situation. Second, categorize different acute anxiety situations as follows: unimportant, uncontrollable, important, or controllable. This can help you to stand back from your situation in order to view it more clearly and objectively.

3. Adopt a small set of coping skills, and then test them to see if they actually work. Identify what changes you can make to control the situation and reduce acute anxiety levels (e.g., using positive self-talk to develop an up-beat outlook toward a job interview, and then practicing this technique to gauge its effectiveness).

4. Gain some acceptance skills. This is acknowledging the acute anxiety and being realistic about its effects (e.g., what aspects are controllable/uncontrollable or important/unimportant).

5. Make use of visualization techniques. Use imagination (e.g., pleasant daydreams or memories) to move yourself into a relaxed state. Here’s how:
  • Get comfortable, and scan the body for tension.
  • Begin to relax the uptight muscles.
  • Then pick a favorite peaceful place which is real or imagined.
  • Next, focus the imagination using all five senses.
  • Lastly, use affirmations (e.g., repeating “I am letting go of tension and feeling peaceful”). 

Practice using visualization three times a day for about five minutes. This is usually easiest in the morning and at night in bed. Eventually, with practice you can use visualization in everyday situations when feeling anxious.

6. Use some action skills. This is actively making changes to counteract or reduce the level of acute anxiety. Follow through with an anxiety management plan and monitor acute anxiety levels (e.g., after a job interview, find a relaxing and enjoyable activity to wind down).

7. Utilize progressive muscle relaxation. This is where you learn to identify muscle groups and the difference between tension and relaxation in the muscles. Focus on four main muscle groups:
  • chest, stomach and lower back
  • hands, forearms and biceps
  • head, face, throat and shoulders
  • thighs, buttocks, calves and feet

Tense muscles for 5-7 seconds and relax for 10-15 seconds.

8. Work on your awareness skills. This is getting a clearer understanding of the situation and how it affects you (e.g., finding out what a job interview involves and what is required).

9. Start doing Yoga. Stress and anxiety are everywhere. If they're getting the best of you, you might want to hit the mat and give yoga a try. Yoga is a mind-body practice that combines stretching exercises, controlled breathing and relaxation. Yoga can help reduce stress, lower blood pressure and improve heart function – and anyone can do it! Yoga is considered a mind-body type of complementary and alternative medicine practice that brings together physical and mental disciplines to achieve peacefulness of body and mind, helping you relax and manage stress and anxiety.

Yoga has many styles, forms and intensities. Hatha yoga, in particular, may be a good choice for stress management. Hatha is one of the most common styles of yoga, and beginners may like its slower pace and easier movements. But most individuals can benefit from any style of yoga — it's all about your personal preferences.

The core components of hatha yoga and most general yoga classes are:
  • Breathing: Controlling your breathing is an important part of yoga. In yoga, breath signifies your vital energy. Yoga teaches that controlling your breathing can help you control your body and quiet your mind.
  • Poses: Yoga poses, also called postures, are a series of movements designed to increase strength and flexibility. Poses range from lying on the floor while completely relaxed to difficult postures that may have you stretching your physical limits.

The potential health benefits of yoga include:
  • Improved fitness: Practicing yoga can lead to improved balance, flexibility, range of motion and strength. And this means you're less likely to injure yourself in other physical endeavors or in your daily activities.
  • Management of chronic conditions: Yoga can help reduce risk factors for chronic diseases, such as heart disease and high blood pressure. Yoga might also help alleviate chronic conditions, such as depression, pain, anxiety and insomnia.
  • Stress reduction: A number of studies have shown that yoga can help reduce stress and anxiety. It can also enhance your mood and overall sense of well-being.

10. The effectiveness of whatever strategies are used to manage acute anxiety will be improved if after each strategy is used, it is evaluated. This can be done by (a) noticing the physical, mental and behavioral signs of acute anxiety, (b) selecting a coping strategy for reducing acute anxiety, (c) evaluating whether or not the strategy worked by reassessing the level of severity, and (d) maintaining the use of the strategy. If there has been no change or an increase in acute anxiety levels, try using other strategies.

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