Autistic Anxiety vs. Neurotypical Anxiety:

How to Spot the Differences

As an Autistic-ADHD (AuDHD) adult, I've come to realize that my experiences of anxiety often manifest differently compared to my neurotypical peers. Common anxiety symptoms like catastrophic thinking and rumination are familiar to me, yet there are moments when these terms don’t fully capture my experiences. For instance, my anxiety at large events is less about fear of what might happen and more about an intense dread of sensory overload and the unpredictability such settings entail. This isn't just fear—it’s a sensory overwhelm, making my body react with signals typical of anxiety, but triggered by different stimuli.

In collaboration with Dr. Jonathan Dalton in our masterclass, I have gained clearer insights into distinguishing between typical anxiety and what I now understand as Autistic anxiety. This differentiation has been pivotal in identifying triggers specific to Autistic anxiety, which I am eager to share in this article.

Autistic individuals not only face a higher likelihood of experiencing anxiety, but the nature of our anxiety also includes unique triggers and responses not commonly observed in neurotypical individuals. This divergence in anxiety experiences is substantial, encompassing what can be termed Autistic anxiety and sensory overwhelm.

This article aims to delve deeper into these differences, offering insights into the distinct ways Autistic people experience and respond to anxiety and overwhelm.

What is Neurotypical Anxiety?

We’ve all been there. Your mind is racing, you can’t think about anything but your worry. You can’t focus or concentrate at all. Your body might feel tense and you know later your muscles are going to ache from how tight your body is. But you can’t let it go. Your heart is beating quickly and you might be shaking or just generally feeling shaky. Your stomach might be upset or you might be grinding your teeth. When you experience anxiety most of–us neurodivergent or not–experience at least some of these sensations. This is typical anxiety.

Anxiety is a natural process. It’s our brain's way of telling us that something is unsafe and that we need to avoid that particular stimulus in order to stay alive. It helps us avoid things like snakes and bears that could physically injure or kill us. When we are in the presence of something that is dangerous, our body and mind experience anxiety so that we don’t miss it, ignore it, or get distracted and end up getting hurt or killed. Anxiety is an alarm that succeeds in doing its job to make us pay attention and avoid the object that is triggering it. 

Anxiety, in and of itself, is not inherently bad. It equips us with essential tools for responding to emergencies. Anxiety serves as a potent teacher. A single experience of food poisoning, for example, can effectively signal to our bodies: DANGER! Anxiety is protective. It heightens our mental alertness when we need to be vigilant, boosts our physical energy when we need to flee, and helps us distinguish between signals of danger and safety. Feeling fearful after encountering a rattlesnake under a rock, we are unlikely to turn over rocks carelessly again, just as we would avoid a cave after spotting a bear inside. Anxiety in its protective role has taught us to avoid particular stimuli or experiences that could be harmful.

When is Anxiety a Problem?

So, anxiety is not necessarily a bad thing. However, disordered anxiety—such as that experienced by individuals with an anxiety disorder—can be debilitating. Anxiety becomes disordered when it is disproportionately intense compared to the actual risk involved. To illustrate this, consider an example provided by Dr. Jonathan Dalton involving a fire alarm:

Imagine you put toast in the toaster and then head upstairs to get dressed. While you are away, the fire alarm starts blaring. Since you're not in the kitchen, you can't immediately tell whether it's just your toast burning or if your curtains have caught fire. Until you go downstairs to check, the alarm keeps you alert and prepared for action. This scenario parallels how anxiety functions; it's like a sensitive alarm system that sometimes goes off too loudly for minor issues.

Anxiety can be similar to a faulty alarm that treats every burnt toast like a house fire.. Disordered anxiety signals a full-scale emergency when the reality is much less severe, suggesting you flee the house or tackle a fire that doesn't exist. This kind of anxiety can suggest danger where there is none, leading to unnecessary stress and potentially disruptive behaviors.

Disordered anxiety happens when something is scary but not actually dangerous.

Unfortunately, the way we respond to anxiety can unintentionally reinforce it, particularly through patterns of attention and avoidance. In situations of real danger, focusing on the threat and avoiding it are useful behaviors—they keep us safe. But when these reactions are triggered by harmless situations, they can amplify our anxiety unnecessarily. Over time, this makes the brain treat these benign situations as if they were actual threats.

Understanding the difference between real threats and exaggerated fear responses is vital, not only for understanding the nature of anxiety but also for managing it effectively—whether in neurotypical or Autistic individuals.

What is Autistic Anxiety?

Anxiety has a different flavor for the Autistic person, and sometimes it’s not even anxiety! When something feels vaguely familiar to anxiety, many of us lump it into the “anxiety” bucket because we don’t have other words for it. But from atypical anxiety triggers, to anxiety-like experiences, Autistic anxiety is anything but typical.

Autistic Triggers

Autistic anxiety often involves atypical triggers that align with the challenges of navigating a world primarily designed for neurotypical brains. These triggers are intimately tied to the ways in which Autistic individuals process sensory information, social cues, and changes in their environment. Understanding these triggers is crucial for developing supportive strategies that address the unique needs of Autistic individuals.

• Changes in Routine: Many Autistic people rely on structured routines and predictability to manage daily life. This reliance on routine provides a sense of control and reduces cognitive overload. Unexpected changes—such as a sudden alteration in daily plans or a last-minute cancellation—can provoke intense anxiety. These disruptions challenge the mental scripts that we often use to prepare for and navigate through our day. For example, a surprise school assembly or an unplanned visit to a new location can be significantly distressing and disorienting.

• Cognitive and Sensory Overload: Autistic people often experience heightened or diminished sensitivity to sensory inputs such as sound, light, touch, and smell. Environments that are overly stimulating, such as crowded public spaces, loud environments, or places with bright lighting, can trigger sensory overload. This overload can manifest as anxiety because it overwhelms the individual’s ability to process information and remain functional. For instance, the chaotic environment of a shopping mall during peak hours can trigger intense overwhelm due to the combination of loud noises, bright lights, and the sheer volume of people.

• Social Situations: Social interactions often involve nuances and unspoken rules that can be difficult for us to navigate. The unpredictability of social behavior, the need to interpret body language and tone, and the potential for miscommunication can make social situations particularly challenging. Anxiety in these contexts may arise not just from a fear of social judgment but from the exhausting effort required to continuously decode social cues. A typical party or networking event, where spontaneous interactions occur and social expectations are high, can thus become a major source of anxiety.

Anxiety-Like Experiences and Sensory Overwhelm

In addition to atypical triggers, Autistic people frequently encounter experiences that resemble anxiety but are fundamentally different from anxiety. While anxiety typically revolves around potential future threats—those "what if" scenarios—Autistic experiences are usually triggered by immediate, tangible disruptions to our sensory or environmental balance.

This type of response is less about the fear of potential harm and more about confronting a known reality that is challenging to manage. For example, being in an overly noisy room isn't just uncomfortable; it can trigger an intense response that resembles anxiety but is rooted in an urgent need to escape the sensory overload.

These experiences often necessitate real-time adjustments and specific accommodations that address the nature of the immediate situation, rather than dealing with anticipatory worries about potential future events. Such responses might include finding a quieter space, reducing visual stimuli, or having clear exit strategies in social settings. Here are a few considerations when addressing these anxiety-like experiences.

Understanding Overwhelm vs. Anxiety

When people feel overwhelmed they may refer to this as “anxiety.” However, they are fundamentally different. Overwhelm tends to be present-focused and body-based, whereas worry is often language-based and future-oriented, focusing on unknown possibilities.

Overwhelm, tends to be more immediate and sensation-based. It can overwhelm our minds to the extent that it shuts down communication, making it difficult to articulate our feelings or needs. Autistic overwhelm often happens in response to sensory overload, cognitive overload, or when there is too much routine disruption in our environment.

Dread vs. Anxiety

Dr. Jonathan Dalton discusses the distinction between dread and anxiety. Anxiety typically involves worries about what might happen, such as fretting over how you will be perceived at a social event or what might or might not occur there. In contrast, dread is about the certainty of discomfort, such as knowing an event will be overstimulating and involve extensive small talk.

Anxiety asks "what if" and involves worry about what might happen. Dread on the other hand is stress about what you know will happen.

For example, if a child dreads going to a friend's event because they know it will be overstimulating (not because they are worried about if they will make a good impression) that is dread not anxiety. And of course, both can be present at once!

I have further expanded Dr. Dalton's framework to specifically tease out sensory dread and social dread.

Sensory dread, is specifically when we're dreading a situation or event because we know it involves activities that overstimulate and overwhelm our sensory experience.

Social dread, is specifically when we're dreading a situation that we know will involve social experiences that are undesired (small talk, lots of social-based questions, unpredictable and unplanned socializing).

Sensory Dread and Environmental Factors

Sensory dread, involves dread of going into an environment we know will be sensory overwhelming. Unlike anxiety, which often concerns the fear of hypothetical futures, sensory dread is a response to real and present environmental factors that are overwhelmingly uncomfortable or even painful.

For example, this form of dread might be triggered by the anticipation of entering a noisy, brightly lit environment. The dread is not due to a fear of a potential negative outcome, but because the sensory reality is known to be intolerable. When someone with sensory dread contemplates going to school, work, or the grocery store, they are not reacting to an unfounded fear but to a well-known reality of sensory overload. They are dealing with the certainty of discomfort, not the possibility of danger.

Why Teasing Out the Difference Matters

I'd understand if you're thinking — yeah, but isn't this just semantics? I believe it's helpful to tease these things out because understanding whether we're experiencing overwhelm, dread, or anxiety signals different needs.

Overwhelm and dread often indicate a need for specific accommodations, such as support for executive functioning or sensory challenges. Implementing targeted accommodations, like noise-canceling headphones for sensory sensitivities, breaks during social interactions, or setting clear social expectations, can profoundly alleviate anxiety-like responses. If anxiety is the primary concern, the approach typically involves confronting the issue directly.

Furthermore, while traditional anxiety treatments might involve confronting and rationalizing "what if" scenarios and targeted exposure, managing sensory dread often requires changes to the environment or the individual's exposure to uncomfortable sensory experiences. This approach acknowledges that the distress experienced is not irrational but a rational reaction to overwhelming or distressing sensory input or disruptions to expected patterns of interaction and behavior.

Recognizing and understanding these distinctions is important not only for those who experience Autistic anxiety but also for caregivers, educators, and clinicians. By distinguishing between typical anxiety, overwhelm, and sensory dread, support strategies can be better tailored. This understanding leads to more effective interventions that respect the specific nature of Autistic anxiety and overwhelm.

Autism and Social Anxiety

Social situations can significantly impact us in two primary ways: First, they can amplify the anxiety we already feel from other aspects of our lives, intensifying our pre-existing dread. Second, these social settings can themselves be the direct cause of our anxiety, particularly if the environment demands high levels of social interaction or sensory processing, which we find challenging.

• Navigating Social Dynamics: Anxiety and social hypervigilance are often heightened for those of us who practice masking. Masking involves deliberately altering our natural behaviors—such as facial expressions, tone of voice, language choice, and posture—to conform to the surrounding social norms. This adaptation requires a constant awareness of potential rejection or criticism, forcing us to continually adjust to meet others' expectations.

• The Exhaustion of Masking: The effort required to maintain masking can be draining. It demands continuous vigilance over others' responses and the interpretation of their thoughts and feelings. This state of heightened alertness can make social interactions especially exhausting, mimicking the symptoms of social anxiety due to the hypervigilance to social cues.

• Feedback Loop in Social Interactions: Engaging in social interactions often triggers a feedback loop that can be overwhelming. A perceived social misstep may lead to feelings of disapproval or rejection, prompting us to constantly revise our "social rule book." The energy needed to manage these adjustments adds significantly to the stressful environments we navigate daily.

• Social Dread: Similarly to how we experience sensory dread, I propose that we can also experience social dread. We dread the small talk and social demands that will be imposed upon us, not out of anxiety for the unknown but because we anticipate the drain on our social battery. This social dread might appear and feel similar to social anxiety until we develop specific language for and understanding of it.

Contextualizing Social Anxiety: If we find ourselves feeling anxious only in interactions involving non-Autistic individuals, this response can be considered a proportionate reaction to the complexities of navigating cross-neurotype interactions. However, if this anxiety persists even among other Autistic individuals, it may indicate the presence of social anxiety. Recognizing this distinction is crucial, as it helps us understand the specific triggers and develop more effective coping strategies.

Autistic Anxiety

To summarize, Autistic people experience anxiety similarly to neurotypicals in that we feel the physiological and emotional effects of anxiety. However, we also encounter unique, atypical triggers such as disruptions in routine, unexpected changes, or the general unpredictability when the world goes off script. Additionally, we often experience phenomena that resemble anxiety but are fundamentally different. For example, we may experience what is known as sensory dread or social dread—this isn't a fear of potential negative outcomes but a dread of overwhelming sensory experiences or demanding social interactions that we know will occur.

This form of dread is markedly different from neurotypical anxiety. Typically, neurotypical anxiety is anticipatory, concerned with "what if" scenarios that may never materialize. In contrast, Autistic dread often stems from "what will" scenarios—situations we know will be uncomfortable or distressing based on past experiences. Despite this difference, these experiences are often labeled simply as "anxiety" because they manifest with similar outward symptoms. This mislabeling can obscure the distinct nature of Autistic anxiety and, importantly, the specific supports required to manage it effectively.

Dr. Jonathan Dalton's insights from the masterclass emphasize the nuanced approach needed in treating Autistic anxiety. While avoidance can exacerbate anxiety in neurotypicals by preventing them from confronting their fears, the strategy for Autistic individuals often involves creating carefully managed accommodations to reduce sensory overload and unnecessary stress. It's crucial to differentiate between avoidance behaviors that are maladaptive and those that are protective responses to sensory dread. For Autistic people, certain "avoidances" are actually necessary accommodations—tools that allow us to manage overwhelming environments rather than challenges to overcome.

In practice, this means that interventions for Autistic anxiety shouldn't aim to eliminate avoidance across the board but should be tailored to recognize when avoidance is a coping strategy against genuine sensory and cognitive overload and when it is an anxiety behavior. This requires a both/and approach of accommodating the need while eliminating unhelpful avoidance patterns.

Conclusion

Understanding these nuances is vital not only for those of us experiencing this form of anxiety but also for caregivers, educators, and therapists. Recognizing the unique nature of Autistic anxiety can lead to more effective support strategies and interventions tailored to our specific needs. To learn more about a strength-based view of anxiety and the differences between Neurotypical and Autistic anxiety, you can check out our 90 minute masterclass on the topic here.

References

Dalton, J. (2023) Understanding anxiety: A strength-based perspective. [Presentation]. Neurodivergent Insights Masterclass.