autism & anxiety (includes grounding the body exercise) (sessions #13)

I feel like I have anxiety all day, every day, all of the time. And some of the worst places I feel it is when it seems like there's no reason to feel it. And it turns out that obviously anxiety is a common dynamic many of us struggle with, but it is particularly difficult and common among autistic people. How common? Anxiety disorders are the most common mental disorder in the U.S., affecting about 18% of the general population. This cites that research has shown that the incidence of anxiety in people with autism may be significantly higher than that. And one review found with research on anxiety and autism, that almost 40% of autistic children and 50% of autistic adults experience some sort of anxiety disorder. Adolescents and school-aged children with autism have the highest prevalence of clinical, 40%, and subclinical anxiety, 26%, compared to other age groups with autism. So what else is common? We look at specific phobias are the most common form of an anxiety disorder among those with autism and OCD, obsessive compulsive disorder, and social anxiety disorder are also frequently co-occurring alongside autism. Just a quick reminder, what does anxiety feel like? It can feel like this angsty restlessness, or like just bad things are going to happen. Like you're kind of holding your breath all of the time. It can feel like restlessness, increased heart rate, difficulty focusing and concentrating, feeling tight in your muscles. I will say this next symptom of irritability is extremely common, just like quick to trigger, quick to anger, and often one of the most common ones, more so even than other symptoms, especially among men, I will say, but in general, just being irritable or easily frustrated, annoyed, having appetite issues, tummy issues, and certainly things like sleep disturbance, difficulty falling asleep, staying asleep, racing thoughts. Many of those things can occur with autism and anxiety, but specifically in anxiety as it occurs just generally. But we know to have all of those thoughts and something like rumination, it turns out some research is showing, especially among women, is very common for autistic women. So there's, according to this recent, I'm going to share, there's a book called Understanding and Treating Anxiety in Autism, a multidisciplinary perspective. I will link the webinar down below, but it talks about clearly these dynamics. And it says that there are five prime suspects and reasons why anxiety can be particularly challenging for autistic people. The first one is attention to detail. People with autism tend to be more detail focused. While this can be, it says, a valuable skill, it can also make changes in routine and transitions. Anything that's forcing you to shift your anxiety and maybe hyper-focusing on details in general can trigger other thoughts and feelings, but essentially this piece of autism that is often very common, not among everyone, but often very common. Number two, the high propensity for sensory sensitivities. And so when you are noticing things like sight and smell and sound and touch and taste, you can easily be overstimulated and overwhelmed and essentially overloaded, which can trigger anxiety, especially if there's no escape, there's no way to stop it. You know, you're stuck in a situation or environment. You can't rescue yourself from something like a smell in your office or a building. I used to have this office in Newport and my office had an ocean view, but it was right near the bathroom. Cocoa is destroying the water bowl. And the bathroom smell triggered me so much and I couldn't help it. Like it opened the door and it wasn't necessarily always bad, but it was just the old bathroom smell. And when you can't escape that, I would feel like stressed. My clients coming down the hallway and they'd be like half the time, I don't even know what you're talking about. I don't even smell that. But just my point is here, not being able to change that. It was quite difficult. It makes a lot of sense why I stayed home after the pandemic in terms of work for many reasons. It was so overstimulating, getting ready, getting in the car, driving to work, the traffic, and then just being in a building all day with people. Not great for those of us who need a lot of controlled environment and downtime. The third reason is social situations. This is very common, obviously. I've talked about hovering over ourselves before, during, and after social situations, but also things like social cues and small talk and the environment that a lot of the social rules and things we're supposed to do, which might require masking and suppressing stimming desires and needs, that all of that can create a lot of anxiety for people on the spectrum. The next one is language, that some individuals with autism process language differently, and anxiety can increase it when it's difficult for them to express their needs in the appropriate, socially expected ways. There's a whole way of interpreting the self in the world and processing that can be quite different for those with autism. That inherent difference can create a deep sense of anxiety. Lastly, what they call task frustration. People with symptoms with autism often have issues with motor skills and executive functioning or abstract thinking that may trigger anxiety and feel like anxiety when working on a challenging task. Just like how you approach something, the way that your brain works, the way you systematize or engage in something or solve a problem might be different. There could be stressors associated with that that can also increase anxiety. Lastly, of course, things like genetic propensities toward anxiety in our nervous system. It seems like so many autistic people really do live often in a state of fight or flight. They have a more sensitive nervous system to everything. I've been talking about this HSP dynamic, where if you're taking in everything all of the time, it is much more likely that you will be overloaded and overstimulated. Obviously, something else like the social pressures of living in a world that demands you to be a certain way can naturally increase anxiety, like I was saying. Especially if the way that you like to be versus the way the world expects you to be or demands you to be, for you to be socially accepted, that rub in between those two can create a lot of anxiety. When you're feeling anxious and you're autistic, you might find yourself stimming more. You might find yourself avoiding sensory triggers or seeking them out. Remember, with autism, you can have both sensory avoidance and sensory seeking behaviors. You might have issues with your food and your tummy and not wanting to eat or feeling like you're afraid or stressed out or just moody in some way. Wanting to avoid things and isolate, as I've talked about, in a healthy way, this idea of bedrotting, girlrotting, isolating, whatever you want to call it. If you're not doing it in a full-blown depressive shutdown, there can be a space where controlling your environment, giving yourself an easy sensory day, focusing on things you love and nurturing yourself can be very helpful whether you are traumatized with a highly active nervous system and or autistic. Avoid it, whatever it is. There's a place for that. This is one of the things you can think about in terms of helping your nervous system, but most of us can't go through every day like that. Like I've said, a day at home isolating, engaging in some form of cocooning or whatever you want to call it, nesting, can be very healing, but a lifetime living that way is often a more significant experience of depression and important. So what can you do? Obviously, monitoring and accommodating the stressors, perhaps removing yourself from certain environments, setting up a sensory-friendly environment in your home, the way that you approach tasks at work, maybe using things like earplugs, I can't say it enough, noise cancelling, headphones, earplugs, all of that can be helpful if you can manage those things. If your child is really sensitive to the way that the table sounds when everyone eats, my daughter has been eating by herself in large part for about five years now. It just reached a point where her rage with her misophonia was so unpleasant for all of us, let alone her, that I had to let go of this idea that we could have these family meals I fantasized about my whole life, especially when she had lots of siblings who were triggering her. It was much worse in those years. I have some of that too, but not to the same degree. Mine, as I've said, is more around smells, but it can definitely create anxiety and rage, like I said. Learning to build new skills, problem-solving techniques, mindfulness techniques, guided visualizations can be helpful. Like I said, advocating for accommodations at school or work or home to reduce those triggers that create anxiety. Certainly, therapy, trauma therapies, help with mindfulness-based strategies, nervous system techniques, somatic techniques, all of those aimed at helping soothe and quiet and calm the nervous system. For many people, medication, if that's right for you, can be helpful. Not necessarily an easy-fix medication, I know, but for many people, that can also be helpful. It really is important to understand if you have something like anxiety that is triggered by the environment, by just the way your brain works, that try not to fight it and to try to lean into ways to help yourself and don't see it as, like I said, it would be easy to scream and yell and make my daughter sit there. Trust me, that wouldn't have worked anyway. It made things worse. There are some things you might have to let go of in your family, in your child, in yourself, and make peace with that can be very helpful to help manage and reduce your anxiety. So, that's it for today. There's so much more around anxiety and autism I would love to share more of, but it is really important to start to give yourself a break and understand and embrace who you are while also working on ways to manage and develop and cultivate, if possible, tools and skills to help. I'll be posting a little bit further down the road, like I said, some more mindfulness-based tools. I might start to post some things. I'm sort of not posting as much right now on TikTok and Instagram, which I need to be doing because I'm here every day. So, I might make those more tool-based. I haven't decided yet, so that you're getting something different on each platform. But no matter what it is, please create space and healing and self-compassion and mindfulness around what you need. All right. Thanks for being here. Have a beautiful and lovely day, and I'll see you tomorrow. Bye-bye. Grounding through the body. Grounding through the body is a basic tool. Use it often so you can make it a healthy habit. You can somatically arrive in the body with your awareness regardless of if you feel disconnected, tired, activated, or triggered. Learning how to ground is a basic health and wellness practice that will allow you to sustain your work and life. It also gives you a regular check-in with yourself on how you're doing. You can use this grounding technique anytime, at home or work, or whenever you want to de-stress from your day. The purpose is to reconnect you with the joy of being within your body, in your work, in your senses, increasing your sense of well-being, and having a calmer mind and heart throughout the day. To begin, first check in with yourself, and then ground through the body. This can be done standing, sitting, or lying down. Modify so it feels right for you. Number one. Notice and check in with yourself. Are you tired? Irritated? Disconnected from your sense of joy or flow? Triggered emotionally? Feeling sensory overload? Rehashing old stories in your life? Not really feeling anything in your body, or just generally resistant? Notice whatever applies from the list, then take a breath and say, It's okay. It's a rough day. This will pass. I now need to come back to my body. Take whatever posture feels comfortable for you. Since you have named your current feeling or body sense, take a breath and acknowledge where you are at. Tune your attention to go inside. You can have your eyes open or closed. Quickly scan what your body feels right now. If you are sensing something like irritation, see if you can identify where in your body you feel that. Do you notice it in your chest, your tummy, your neck, your forehead? Anywhere. Once you identify it, place your hand on that body area. Take a breath and exhale slowly, imagining melting the experience of your agitation with each breath. Feel your feet on the ground. If you are lying down, bend your knees and place your feet on the ground. This is preferable to stretching out your legs. Gently push into your feet as if you are doing a slow walk on the spot. Imagine you are pushing away the floor beneath you. There is a little exertion with this. Now imagine that your feet are planted barefoot in the grass or on the ground. Keep walking, keep pushing, and continue exhaling actively. Do this motion for two to three minutes. Then stop, pause, and notice your body. Sense and see with your inner imagination the ground underneath you that is supporting you right now. Tune in to that fact. It's not just imagination, it's also quite literal. Is there any change? How is your body feeling now? Ask yourself or repeat these statements. I feel right now. I feel in my body. I am letting go of. I am grounding into.