How Autism Complicates Anxiety

Having anxiety and autism is a double-sided blade.

Every day, I spend a lot of time and energy trying to act “normal” — trying to remember the proper greetings, eye contact, don’t stim, remember that joke you heard on TV, the unwritten social rules it feels like everyone knows except me. It’s exhausting, but usually I have a pretty good grip on things, and most people don’t know I’m autistic unless I tell them.

But then the anxiety comes, and you reach a point where you have to decide whether you spend all your energy acting “normal,” or not having an anxiety attack. And slowly, your battery depletes into emergency power from trying to do both. So you use what’s left to hold off the anxiety, because for those of you who have never experienced an anxiety attack, I can’t even begin to describe the terror.

All the characteristics of autism I was trying to hide creep out. I start stimming more and repeating phrases. I can’t hold back talking about a favorite thing. I can’t remember how to properly converse; cue the awkward silences when I’m supposed to say something but don’t. My executive functioning skills diminish, eye contact stops, and I can’t force myself anymore; it takes too much effort. My brain processing speed slows; it’s taking longer to understand what people are saying. After a conversation I realize where I went wrong, yet will repeat the same error again and again. I’m failing because I have to keep my anxiety under control.

I’m not ashamed of having autism, I’m ashamed of the way society treats people who are different. I’m ashamed I have to wear a mask in order to not get beat up. I grew up being bullied and picked on for something I was born with, and when I was young I didn’t even have a diagnosis yet. It’s a lesson that sticks with you.

Autism also affects my anxiety/panic attacks. I consider an anxiety attack something that happens when I get more and more anxious and can’t get it under control until I lose it, and a panic attack to come out of nowhere without any warning.

Usually I would say I have the rationality of a 12-year-old, sometimes an adult on a good day, but once I start panicking, that changes to maybe a 5-year-old. I have no logic left; I don’t realize I could fall down the stairs or injury myself. The same with my verbal abilities; I can go nonverbal, or short sentences. Processing speed goes into the negatives. Longer sentences get lost in my head; I can’t compute them. Sensory sensitivities skyrocket; the lights and sounds hurt more than usual. Often the self-injurious stims start. I’m not sure if it’s a need for sensory input, being overwhelmed and confused, frustration, a need to feel something other than panic, a distraction, or my discombobulated way to calm myself down. I don’t know, and unfortunately 5-year-old me isn’t the most communicative.

It’s the weirdest thing. I go from logical, rational, adult-ish to cowering 5-year-old in seconds. It’s like smart, articulate scientist Bruce Banner turning into irrational few-worded Hulk. Anxiety attack me can’t remember the skills, can’t remember that this is only temporary. Anxiety attack me has zero self-soothing strategies; my brain is blank.

It’s humiliating to lose control of yourself. It’s frustrating to try your hardest and still fall flat on your face (sometimes literally when I don’t listen to the people telling me to sit down and my legs give way). I get really angry with myself afterwards. My emotional thesaurus is quite limited, but I feel bad.

All that doesn’t even include the normal anxiety attack symptoms: rapid breathing, fast heart rate, shaking, sweating, rigid, scared, headache, chest tightness, crying, etc. No, they’re just the sprinkles on top of this ice cream sundae.