Anxiety is a real difficulty for many adults on the autism spectrum, including those with Asperger syndrome. It can affect a person psychologically and physically. This guide talks about the different ways you can manage anxiety, from keeping a diary, learning relaxation techniques, getting support from others in a similar situation, or using our Brain in Hand app.

Anxiety can happen for a range of reasons and autistic people can vary in their ability to cope with it.

Understanding emotions can be difficult. By helping someone to understand anxiety, you can help them to manage it better. Resources such as those sold by Incentive Plus as well as the Autism Research Centre's CD ROM, Mind reading, can help to support a person to recognise emotions.

Anxiety can affect both the mind and the body, and produce a range of symptoms. The psychological and physical symptoms of anxiety are closely linked and so can lead to a vicious cycle that can be difficult to break. The psychological symptoms of anxiety are:

  • easily losing patience
  • difficulty concentrating
  • thinking constantly about the worst outcome
  • difficulty sleeping
  • depression
  • becoming preoccupied with or obsessive about one subject.

Its physical symptoms include:

  • excessive thirst
  • stomach upsets
  • loose bowel movements
  • frequent urinating (going to the loo)
  • periods of intensely pounding heart
  • periods of having gas
  • muscle aches
  • headaches
  • dizziness
  • pins and needles
  • tremors.

If you do experience any of these symptoms, it is important to also get medical advice to rule out other medical conditions.

Strategies for managing anxiety

Once someone understands anxiety and has identified the things and situations that make them anxious, they can then take steps to cope with the anxiety. If you are supporting an autistic person, try and be aware of what makes them anxious and how best to help them manage certain behaviours.

Keep a diary

To help someone understand anxiety, get them to understand the symptoms they display when they are anxious and to look at the causes of their anxiety. Keeping a diary in which they write about certain situations and how these make them feel may help them to understand their anxiety and manage it better.

Use the diary also to think about the physical changes linked to anxiety. An autistic person might retreat into their particular interest if they are anxious about something - use the diary to monitor this as well. Record:

  • Time and date
  • Situation
  • How I felt
  • How anxious (1 to 10)

Use an app

Our Brain in Hand app is designed to help manage anxiety. It gives easy access to personalised support from your phone, helping you to remember activities, reduce anxiety and feel supported. It come with a telephone mentor service to help you at time when you need extra support. 

Meltdown prevention plan

Create an anxiety plan when someone is feeling positive about things. An anxiety plan is a list of things and situations that cause anxiety as well as solutions and strategies they can use to help them manage their anxiety levels. The plan can be adapted, depending upon how well someone understands anxiety. Here’s an example:

  • Situation – going on the bus
  • Anxiety symptoms - heart beats fast; sweat and feel sick
  • Solution - have stress ball in pocket, squeeze the ball and take deep breaths, listen to music.

Hear Maja Toudal, a person with Asperger syndrome, talk about 'energy accounting' - a tool she created in her daily life to help prevent her going beyond her 'stress threshold'.

Relaxation techniques

Autistic people can sometimes find it very difficult to relax. Some have a particular interest or activity they like to do because it helps them relax. If they use these to relax, it may help to build them into their daily routine. However, this interest or activity can itself be the source of behavioural difficulties at times, especially if they're unable to follow their interest or do the activity at a particular moment.

Some people may need to be left alone for short periods of the day to help them unwind.

Physical activity can also often help to manage anxiety and release tension. Using deep breathing exercises to relax can be helpful as can activities such as yoga and Pilates, which both focus on breathing to relax. Use a visual timetable or write a list to help remind the person when they need to practice relaxation.

Any other activities that are pleasant and calming such as taking a bath, listening to relaxing music, aromatherapy, playing on a computer may also help reduce anxiety. Some people may find lights particularly soothing, especially those of a repetitive nature, such as spinning lights or bubble tubes.

You may need to encourage some adults to take part in these activities so that they can enjoy their benefits. You can do this by explaining when and where they will do the activity and what it will involve. You may have to go along with them at first and do short periods of activity to begin with.

Talking about anxiety

Some people find direct confrontation difficult. They may therefore be unable to say they don’t like certain things or situations, which will raise their anxiety levels. If they identify they are anxious, they could use a card system to let family or friends around them know how they are feeling. At first, you may need to tell them when to use the card and prompt them to use it when they do become anxious.

They could also carry a card around with them to remind themselves of what they need to do if they start getting anxious. You could also give them a stress scale that they can use whenever they find something particularly stressful.

It may help them to buy our Autism Alert card, which is the size of a credit card. They can use the card to let members of the public know that they are autistic.

Getting support from other autistic people

Personal accounts

It may help someone on the autism spectrum to read the personal accounts of other autistic people, and to see how they dealt with certain situations and managed any anxiety they experienced. A number of autistic people have written personal accounts of their experiences:

Glass half empty, glass half full: how Asperger's syndrome has changed my life by Chris Mitchell

Making sense of the unfeasible: my life journey with Asperger syndrome by Mark Fleisher

Thinking in pictures by Temple Grandin

We also produce a quarterly newsletter called the Spectrum. It is written by autistic people and includes personal accounts of having autism.

Online resources

Aspies for Freedom (AFF)

Wrong Planet

Identity First Autistic

The National Autistic People's Organisation

The resources on external websites are provided for your help and information only. They are sites maintained by other groups, organisations and individuals and are provided in good faith. The presence of a website does not necessarily imply that the NAS endorses or supports the originator(s), nor does the absence of a group imply that the NAS does not support it, and cannot be held responsible for the quality of the information provided.

Support groups and specialist help

Going to a support group means meeting other autistic people, which can be helpful in some cases. Different support groups will offer different activities, from going on outings to discussion groups about particular topics. Some autistic people are not able to identify their anxiety or to put in place strategies to manage it on their own. A specialist or a counsellor with experience of autism may be able to help them. Visit our Autism Services Directory for information about local support groups and specialist counsellors.

Further information

Search the NAS library catalogue for relevant books and journal articles.


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Last reviewed: 09 November 2017