Understanding the Distinction Between Social Anxiousness Dysfunction and Autism
Guest contribution by Emily Ansell Elfer, BA Hons, Dip.
Many people on the autism spectrum are known to have symptoms of anxiety, particularly those related to social situations and communication. In fact, previous research has shown a significant overlap between symptoms of social anxiety disorder (SAD) and autism spectrum disorder (ASD). A large proportion of people with ASD also meet the criteria for SAD. Similarly, studies suggest that people diagnosed with SAD have increased levels of autistic traits.
What is Social Anxiety Disorder?
Social anxiety disorder (SAD) is a psychiatric disorder characterized by intense fear of being checked and neglected by others and excessive avoidance of social interaction.
Dr. Rachel Bédard, PhD, a licensed psychologist, further explains, “Social anxiety is viewed as an excessive level of fear or fear of social situations, including speaking in class, speaking in front of an audience, or attending social gatherings. Fears include making social mistakes, making mistakes, embarrassing themselves or others, etc. People with social fear tend to either suffer from the event (“white knuckle life”) or find a friend / a family / member / peer to lean on. ”
Dr. Bedard says that people with social anxiety really suffer and the level of anxiety is quite high. There are a variety of treatment options available to support people with SAD, including drugs to reduce anxiety and counseling interventions.
“I tend to rely on cognitive behavioral therapy (CBT), which involves seeing how a person talks to himself about life / circumstances / failures of success and how the person behaves in the world,” she adds. “We’re creating mini-experiments to challenge beliefs that the fear is justified, and creating a way to collect the data that shows the person can handle social events. A sense of humor is helpful in this type of therapy. “
What is Autism Spectrum Disorder?
What exactly is an autism spectrum disorder and how does it play out in the context of social skills?
These are Dr. Bedard’s top tips for defining autism spectrum disorders, although she emphasizes that ASD is complex and no definitive statements can be made about the autism experience:
- We know that people with ASD have been searching the environment for different data since childhood, encoding the data differently and drawing different conclusions than people without ASD.
- We know those on the spectrum tend to have high levels of loyalty, attachment, and strong emotions. They generally want to have friends, but aren’t always sure how to accomplish this goal.
- Diagnostically, ASD is associated with sensory differences, difficulties in the social sphere and difficulties in friendship. In practice, these differences vary depending on the person, level of support and personal stress / anxiety level.
People on the autism spectrum often have high levels of anxiety, including social anxiety, but this is only part of autism and ASD can present itself in different ways in different people – hence it is called the autism spectrum.
Treatment and therapies for ASA can include:
- Treating co-occurring conditions such as anxiety, depression, and ADHD. These treatments can include medications.
- Treating sensory problems through occupational therapy
- Talk therapy to relieve stress, develop new strategies, referrals to other professionals
- Educational support
- Access to a speech therapist
- One of the most important interventions is empathy and support from others and the desire of others to actually understand what is going on in the person with ASD and identify ways to their version of success
Similarities Between ASD and Social Anxiety Disorder
From the above, it is clear that social anxiety can often play a role in the life of someone with the autism spectrum.
Another psychologist specializing in autism, Dr. Debra Moore, PhD commented, “More than 30 studies of autistic children under the age of 18 found that nearly 40% had at least one related anxiety disorder. Almost 30% of them qualified for a diagnosis of social phobia and 16.6% met the criteria for social anxiety disorder. ”
The symptomatic overlap between ASD and SAD is found mainly in areas of social interaction and social skills, while restricted and repetitive behaviors and atypical social cognitions can only occur with ASD. Learning disabilities and language impairments are widespread in a large proportion of children and adolescents with ASD, but are typically not observed with ASD. Finally, social anxiety is more likely in older, highly functional children and adolescents with ASD, suggesting that increased awareness of social difficulties may be a factor.
Recognize fear in people on the spectrum and offer support
Dr. Bedard has commented that she’s yet to meet a person on the autism spectrum who isn’t experiencing high levels of anxiety.
“We believe that people with ASD are physiologically stressed and overwhelmed every day. Recognizing fear as a biological manifestation of ASD is often helpful (rather than a person’s deficiency or flaw), ”she says.
“It is imperative that people who treat, live with and love people with ASD recognize anxiety and, in particular, recognize the ‘tips’ that their person is showing.”
Dr. Moore adds, “Anxiety can be caused / triggered by genetics, the environment (bullying, sensory attacks, communication problems, etc.), or it can be secondary to other disorders (depression or autism related disorders). Changes in behavior are an important sign of fear. ”
Behavioral changes can include pulling back, repeating questions or topics, asking for confirmation, saying no frequently, shaking, fidgeting, sweating, crying, rocking, self-harm, and much more.
Treatment can include many of the following elements:
- A daily routine
- Daily stress relief interventions, including exercise, deep breathing, adequate sleep, good nutrition, adequate social contact, time for yourself, time for meaningful activity
- Identify anxiety triggers and create a plan (preferably in writing) to manage stress and anxiety
- humor
- Comradeship, even with animals
- CBT therapy for self-regulation
- Mindfulness approaches
- Movement / activity approaches
- medication
Sum up
Many people on the autism spectrum have some form of social anxiety, and some people diagnosed with ASD also have a diagnosis of SAD. However, it is important to note that the two conditions are not the same and there are differences in their symptoms.
As a parent, carer, or friend of people on the autism spectrum with social anxiety, the most important thing is to show patience and support – and always seek medical advice if you are concerned about your loved one’s safety and wellbeing.
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