Autism often exists with many co-morbid conditions and one of these is anxiety. Anxiety is something that most people suffer with at some point and to some degree. There’s also a lot of debate whether or not anxiety should be considered when somebody is seeking an autistic diagnosis. There are lots of reasons discussed online why this may be worth adding to the diagnosis criteria as a core feature.
Personally I’m not sure whether it should or not. I suffer with anxiety quite a lot and I think part of the reason that I do, is due to the way that my mind works. I am autistic, which is the reason that my mind works in a way different to most. What I mean by this is that autistic people like myself, can be prone to over-thinking and this is a where a lot of the time, anxious thoughts can creep in. When a person over-thinks something, especially if it’s in a negative manner, they can do what is called catastrophising. This is where they expect the worst thing to happen. Or the most dangerous thing to happen. Basically, the least positive outcome will definitely occur no matter what the likelihood of it actually happening is.
One way to determine if anxiety is a factor when it comes to any diagnosis involving stress and worry, is to think about risk aversion. Risk aversion is when somebody won’t undertake an activity, or do a particular task because the risk involved creates anxiety for them. The risk involved means there is a fair chance that they’re going to get hurt, or something’s going to go wrong. Therefore the only way to make sure that this does not happen is to simply not to do the activity.
Now I’m quite a risk-averse person. I won’t undertake any activity or do anything if I think it’s going to create a negative outcome. For example I wouldn’t get on a roller-coaster ride. For me it’s just putting yourself at risk unnecessarily and there is a chance you could be seriously hurt (or worse) if something goes wrong. Even though statistically this is unlikely to happen. However this is my perspective, and I know a lot of autistic people who like roller coasters because of the sudden adrenaline rush.
Now these people enjoy these rushes of doing risky things and taking risk, because the thrill is greater than the anxiety. The risk for them is not as high as the pleasure factor. Unfortunately if you are susceptible to being risk averse, and are someone who over-thinks, then you are less likely to take part in activities with even smaller levels of risk. For me even an activity with just a 1% risk might make me think “well there is a real danger here…. no way am I doing that…” whereas there is a 99% that nothing bad will happen and it could be a really good thing to do.
This is when risk aversion and related anxiety can be a problem. If it stops you doing things that are really not considered a serious risk. After all, crossing the street will involve risk, but if done correctly and sensibly then there should not be a problem. If risk aversion is making you avoid crossing the road, then this is an issue that needs to be addressed. Okay, I am using extreme examples, but there will be a level for everyone to whether or not a risk is to be undertaken and the crucial thing is ensuring that this level is pitched right for you as an individual.
So for me, if your mind works differently, is prone to over-thinking and catastrophising then you are probably going to be anxious and risk averse to some degree. I don’t think it should be a key factor in autism diagnosis as everyone suffers from anxiety, and you don’t have to be autistic to be risk averse. However, I do think it is worth considering as part of the diagnosis process, simply because of the difference in the way autistic minds can work.
Plus there are other key aspects in autism diagnosis such as sensory issues and social interaction that also cause anxiety. Therefore somebody who describes a lot of sensory issues that cause them stress, or high levels of worry when being around others, are giving a diagnostician clues that they might be autistic. The key thing is being able to put all the pieces together without concentrating too much on just one factor. Hopefully then they will find the correct outcome, so that the person being diagnosed can move forwards to a better life.