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Asperger's and That Damn Anxiety Problem

"Why is it that people with Asperger syndrome seem to have more than their fair share of anxiety? I have suffered with this damn thing my entire life – as far back as I can remember. And it doesn’t get any better with age by the way. Suggestions!?"

People with Asperger’s (high-functioning autism) are particularly vulnerable to anxiety. This vulnerability is a basic trait of the disorder due to (a) the breakdown in circuitry related to extinguishing fear responses, (b) social skills deficits, and (c) specific neurotransmitter system defects.

Reasons for anxiety include the following:
  • Lack of displayed empathy (another Asperger’s trait) significantly limits skills for self-directed social problem solving.
  • Limitations in generalizing from one situation to another contributes to repeating the same social errors.
  • Social skills deficits related to Asperger’s make it difficult for “Aspies” to develop coping techniques for calming themselves and containing difficult emotions. 
  • Their inability to grasp social cues and their highly rigid style act together to create repeated social mistakes (e.g., saying the wrong thing at the wrong time). 
  • In the workplace, it is not uncommon for the Aspie to be bullied and teased by his coworkers, yet he can’t mount effective socially adaptive responses, which often results in both anxiety and learned helplessness.

Several medications have been tried for treatment of anxiety. SRIs, buspirone, and alpha-adrenergic agonist medications (e.g., clonidine or guanfacine) have been tried. The best evidence to date supports use of selective serotonin reuptake inhibitors. One relatively new drug that seems to be having remarkable success in alleviating anxiety is Fetzima.

As a side note, people on the autism spectrum may be more vulnerable to side effects – and may exhibit unusual side effects. For example, disinhibition (i.e., a temporary loss of inhibition) is particularly prominent and can be seen with any of the serotonin reuptake inhibitors. Also, excessive doses may produce “amotivational syndrome” (i.e., a psychological condition associated with diminished inspiration to participate in social situations and activities).

Self-help strategies to reduce anxiety include the following:
  • avoid “what if” thinking (e.g., ‘What if I fail?’ … ‘What if I get sick?’)
  • avoid black-and-white (all-or-nothing) thinking 
  • avoid talking in absolutes (i.e., using words such as always, never, should, must, no one and everyone)
  • develop a daily log to plan out your days (include healthy activities)
  • develop a sense of self-trust (i.e., the ability to believe that you can handle what life throws at you)
  • don’t be a “people-pleaser” (e.g., when do you say ‘yes’ to someone when you really want to say ‘no’)
  • practice yoga
  • realize and accept that you can’t control life, you can only control yourself
  • realize that you’re responsible for your happiness and your life
  • reduce your perfectionistic tendencies
  • stop relying on others for approval

Lastly, but most importantly, distinguish fact from fiction. Fear is being afraid of something, and you know exactly what it is that you’re afraid of (e.g., heights). Anxiety is being afraid of something, but you’re NOT sure what it is. Anxiety is fiction. It’s an anticipation of things going wrong in the future. But since the future doesn’t exist (except as a mental construct), then anxiety about a future event is fiction.

Living With Aspergers: Help for Couples



COMMENTS:

Anonymous said… All part of autism? Get used to it and fight it best you can! This is where the tiredness and long sleeps are relevant!
Anonymous said… as long as autistics are perceived and treated as diseased toys, they`re going to have a much higher rate of mental health issues. as long as autistics try to live like people who aren`t autistic, they`re going to have a higher rate of mental health issues. it`s really pretty simple. the solutions are more complex, however.
Anonymous said… Easier said than done. The adult Asperger want to achieve some balance and sometimes accumulative PTSD feeds into the situation, too, with triggers that appear out of left field. Overwhelming.
Anonymous said… I can only speak for myself, but my anxiety is "out there" so fast, I can never "control" it; it's too dam quick, damage done, and I'm already in wtf-mode before realizing I'm palpitating and acting like an idiot. Which makes me more anxious! I don't know how to forewarn myself to try to stop it; it just happens
Anonymous said… I love how when I went to a doctor all they wanted to do was treat the anxiety and when I asked "what about the other symptoms like innattention and sensory issues and social issues" they just ignored even trying to get me a diagnoses suggesting that anti anxiety meds would be "the cure" instead of what it really did - make me suicidal
Anonymous said… It is a hard question to answer,, but the best thing is to try and find an outlet.. to not let the anxiety spiral and take hold.
Anonymous said… Ive warned all of people around me to get away when i get angry because i really cant stop my rage 
Anonymous said… Meditation helps
Anonymous said… right it's like a nightmare coming true times 100.
Anonymous said… Why do we have anxiety? Because from birth we have been being told we aren't normal. Don't do that, dont say that, look here, go there, sound like this, look like that. When you have to think about everything just to comprehend what's going on around you, and then add in being the best actor/actress everyone has seen, because otherwise you make them uncomfortable, go figure we have anxiety!
•    Anonymous said… as long as autistics are perceived and treated as diseased toys, they`re going to have a much higher rate of mental health issues. as long as autistics try to live like people who aren`t autistic, they`re going to have a higher rate of mental health issues. it`s really pretty simple. the solutions are more complex, however.
•    Anonymous said… Have any of y'all tried Cognitive Behavioral Therapy? I'm looking into it for my 22 years old son. His meltdowns are so violent and I'm terrified he's going to end up in jail one day. Any thoughts?
•    Anonymous said… it might help, if the therapist is experienced and knowledgeable enough about autistics. but his meltdowns at this point are probably ptsd. that`s very hard to recover from. i have a similar issue myself. what he needs to learn are appropriate personal and social boundaries for himself, and how to live like an autistic. cbt might help with boundaries. it won`t help much with living like an autistic.
•    Anonymous said… My anxiety is off the hook! My doc put me on some med that I will need to purge off of but it isn't helping me stop biting my nails and having bad dreams...is anyone here having the same symptoms?
•    Anonymous said… The push for uniformity of human beings in our world is most disturbing. The simple frustration of growing up with people always trying to change your fundamental personality and the stress of trying to fit in ... and failing ...

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