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Does autism cause anxiety?

Autism spectrum disorder (ASD) is a complex developmental condition that affects how people communicate, interact, behave, and learn. Anxiety is a common challenge for many people with autism. But does autism directly cause anxiety? There is an ongoing debate about this.

The link between autism and anxiety

Many studies show that anxiety disorders are more common in people with ASD compared to the general population. According to a recent summary of research findings:

  • Around 40% of children with autism have one or more anxiety disorders, compared to around 15% of children without autism.
  • Up to 84% of adults with autism have clinical anxiety, compared to around 15% of adults without autism.

Some of the most common anxiety disorders seen in autism include:

  • Generalized anxiety disorder
  • Social anxiety disorder
  • Specific phobias
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder

This strongly suggests there is an association between autism and anxiety. But it’s complex to tease out whether autism directly leads to anxiety.

Theories on why anxiety is linked to autism

There are several theories on why anxiety is more common in people with ASD:

1. Biological factors

ASD has a strong genetic component. Research shows that first-degree relatives of people with autism are up to eight times more likely to have anxiety disorders compared to the general population. This suggests there may be shared genetic risk factors that predispose people to both autism and anxiety.

There are also theories around brain structure and neurotransmitters. For example, the amygdala region of the brain which regulates emotions like fear is different in people with autism. Differences in serotonin levels may also play a role in anxiety.

2. Cognitive aspects of autism

Certain cognitive characteristics associated with autism may contribute to anxiety, such as:

  • Sensory sensitivity – loud noises, bright lights, certain textures and other sensations can provoke anxiety.
  • Need for sameness – changes to routines or environments can be distressing and trigger anxiety.
  • Difficulties with communication – problems expressing needs or understanding others can lead to anxiety.
  • Challenges with social skills – social situations create anxiety due to difficulties reading cues.

3. Emotional regulation differences

Many autistic people have challenges regulating emotions. They may have intense emotional reactions to circumstances that provoke anxiety more easily. Coping strategies to manage emotions may also be underdeveloped.

4. Experiences of stress and trauma

People with autism are more likely to experience stressful or traumatic events that can contribute to anxiety disorders, such as:

  • Bullying
  • Social exclusion or rejection
  • Lack of appropriate educational support
  • Unemployment

Coping with everyday life demands is also very stressful and tiring for many people with autism due to having to mask symptoms, sensory overload, challenges with communication, etc.


The high rate of anxiety disorders among people with ASD suggests autism increases vulnerability to anxiety. But there is no evidence that autism directly causes anxiety disorders in all cases. Rather, the relationship between autism and anxiety is complex with multiple contributing factors.

While autism does not definitively cause anxiety, the characteristics of autism often interact with genetic, biological, cognitive, emotional and environmental factors in ways that elevate anxiety risk. Understanding these various factors can help people with autism get appropriate supports to prevent and manage anxiety.

Frequently Asked Questions

Is anxiety a symptom of autism?

Anxiety is not considered a core symptom of autism spectrum disorder according to diagnostic criteria. However, anxiety commonly co-occurs with autism.

Is anxiety part of autism?

Anxiety disorders and symptoms frequently overlap with autism, though anxiety is not formally part of the autism diagnosis. It is conceptualized as a co-occurring condition influenced by multiple factors related to autism.

Does anxiety cause autism?

No, there is no evidence that anxiety causes autism. Autism is a developmental disorder arising from genetic and neurobiological factors that originate very early in development, well before anxiety is present.

What age does anxiety start with autism?

Anxiety issues can begin early in childhood among children with autism, sometimes even by preschool age. Anxiety symptoms typically increase after school age, and may worsen further in adolescence and adulthood.

Can autism develop into anxiety?

Autism itself does not develop into an anxiety disorder. But the social communication challenges, need for sameness, sensory sensitivities and other traits associated with autism can interact with various risk factors to make anxiety more likely to emerge.

Key Statistics

Here are some key statistics on the prevalence of anxiety disorders among people with autism:

Anxiety Disorder Prevalence in Children with Autism Prevalence in Adults with Autism
Any anxiety disorder Around 40% Up to 84%
Generalized anxiety disorder Around 15% Around 15%
Social anxiety disorder Around 17% Around 35%
Specific phobia Around 30% Around 34%
Obsessive compulsive disorder Around 37% Around 28%
Panic disorder Around 5% Around 11%

Tips for Managing Anxiety with Autism

If you or someone you know has autism and struggles with anxiety, here are some tips that may help:

  • Learn calming techniques like deep breathing, meditation, sensory integration activities.
  • Establish routines and prepare for changes to reduce uncertainty.
  • Limit overwhelming sensory input when possible.
  • Work on social and communication skills.
  • Exercise regularly.
  • Get good sleep hygiene.
  • Practice self-compassion and celebrate strengths.
  • Use organizational tools like schedules and timers.
  • Seek professional help like therapy and medication when needed.

With the right supports and coping strategies tailored to individual needs, people with autism can successfully manage anxiety and reduce its impact on their lives.