Anxiety

Overview

Anxiety is the most common co-occurring condition with autism — affecting around 40–50% of autistic people. Causes are often environmental (sensory overload, unpredictability, social demand) as well as biological.

Key points to understand

Common presentations: avoidance, perfectionism, controlling routines, sleep difficulties, GI problems, rumination.
Generalised anxiety, social anxiety, OCD, health anxiety and PTSD all co-occur with autism.
Standard CBT may need adapting (more concrete, more visual, slower pace).
Anxiety often increases at transitions (school year, term, life stage).

Practical strategies that help

Reduce demands and increase predictability.
Use visual schedules and now/next boards.
Build interoception awareness (notice physical anxiety signs early).
Consider neurodiversity-affirming therapy — see the NAS therapist directory.

Common challenges to be aware of

Untreated anxiety drives much of what looks like 'behaviour' — treat the anxiety, the behaviour follows.
Medication (SSRIs) can help; autistic people may need lower starting doses.

How Bright Steps can help

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References & further reading

✏️ This article will be expanded with rich, UK-specific content, case studies, video explainers and downloadable resources. If you'd like to contribute a story or suggest a correction, contact the Bright Steps editors via the Community page.