Interconnected brain and heart jigsaw puzzle representing autism and anxiety.

Unlocking the Puzzle: How Anxiety and Autism Intertwine

Soraya Malik in Health & Wellness November 2025 • 4 min read.

"Understanding the Overlap, Similarities, and Differences to Better Support Neurodivergent Individuals"

Anxiety and autism spectrum disorder (ASD) have long been recognized as co-occurring conditions. From the earliest descriptions of autism by Kanner and Asperger, anxiety symptoms were noted as significant features. Understanding how these two conditions interact is crucial for providing effective support and interventions.

The relationship between anxiety and ASD is complex. Is anxiety simply another symptom of ASD, or is it a distinct condition that individuals with ASD are more vulnerable to? This question has puzzled clinicians and researchers for decades, complicated by the fact that mental health issues are often overshadowed by the more prominent features of ASD.

This article delves into the intricate connection between anxiety and ASD, exploring their overlapping characteristics, unique presentations, and the challenges in diagnosis and treatment. By understanding these nuances, we can better support individuals navigating both conditions.

The Confounding Overlap: Untangling Shared Symptoms

Interconnected brain and heart jigsaw puzzle representing autism and anxiety.

One of the primary challenges in understanding anxiety in ASD is the significant overlap in symptoms. Several behaviors and characteristics common in ASD can mimic or mask anxiety, making accurate diagnosis difficult. Some of the key areas of overlap include:

Social awkwardness and avoidance are core features of ASD, but they are also common manifestations of social anxiety. Individuals with ASD may avoid social situations due to difficulty understanding social cues or feeling overwhelmed, while those with social anxiety may avoid social interactions due to fear of judgment or negative evaluation.

Compulsive and ritualistic behaviors are often associated with ASD, but they can also be indicative of obsessive-compulsive disorder (OCD), an anxiety disorder.
Communication deficits can further complicate the picture. Individuals with ASD may struggle to express their feelings of anxiety, leading to misinterpretations or underreporting of their distress.
Restricted and repetitive interests: Can also be a symptom, if anxiety gets in the way of doing it.

The challenge lies in determining when these behaviors are primarily driven by the core characteristics of ASD versus underlying anxiety. Studies comparing youth with anxiety disorders and youth with ASD have found that while communication and social deficits may help differentiate the disorders, the lines are often blurred.

Moving Forward: A Call for Comprehensive Understanding and Tailored Support

The journey to understanding anxiety in ASD is ongoing, with much progress made and more still needed. By acknowledging the complexities, refining assessment methods, and embracing tailored interventions, we can empower individuals with ASD to navigate anxiety effectively and thrive. The key lies in recognizing that anxiety in ASD may present differently but is no less real or impactful and deserves the same level of attention and support.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/978-3-319-06796-4_6, Alternate LINK

Title: Autism And Anxiety: Overlap, Similarities, And Differences

Journal: Handbook of Autism and Anxiety

Publisher: Springer International Publishing

Authors: Connor Morrow Kerns, Philip C. Kendall

Published: 2014-01-01

Everything You Need To Know

How long have anxiety and Autism Spectrum Disorder (ASD) been recognized as co-occurring conditions?

Anxiety symptoms were noted in the earliest descriptions of Autism Spectrum Disorder (ASD) by Kanner and Asperger. It's crucial to understand how anxiety and ASD interact to provide effective support and interventions for affected individuals.

What is the central question regarding the relationship between anxiety and Autism Spectrum Disorder (ASD), and what complicates its understanding?

The relationship between anxiety and Autism Spectrum Disorder (ASD) is complex. It's a long-standing question whether anxiety is a symptom of ASD or a distinct condition individuals with ASD are more prone to. Mental health issues are often overshadowed by the prominent features of ASD, complicating the understanding of this relationship.

What are some of the key areas where symptoms of anxiety and Autism Spectrum Disorder (ASD) overlap, making diagnosis difficult?

Several behaviors and characteristics common in Autism Spectrum Disorder (ASD) can mimic or mask anxiety, making accurate diagnosis difficult. Social awkwardness and avoidance, compulsive and ritualistic behaviors, communication deficits, and restricted and repetitive interests are some overlapping symptoms. Determining whether these behaviors are driven by ASD or underlying anxiety is challenging.

What is the approach to understanding and supporting individuals with Autism Spectrum Disorder (ASD) and anxiety?

Communication and social deficits are factors, but the lines are often blurred. It's essential to acknowledge the complexities, refine assessment methods, and embrace tailored interventions. Recognize that anxiety in Autism Spectrum Disorder (ASD) may present differently but is no less impactful and deserves the same level of attention and support.

Considering the shared symptoms, how might anxiety present differently in individuals with Autism Spectrum Disorder (ASD) compared to neurotypical individuals?

Anxiety in individuals with Autism Spectrum Disorder (ASD) can manifest differently due to the overlap in symptoms such as social awkwardness, compulsive behaviors, and communication difficulties. Unlike neurotypical individuals where anxiety might be more readily identified through verbal expression or distinct behavioral changes, in ASD, these signs can be misinterpreted as core ASD traits. Furthermore, the presence of restricted interests can sometimes mask underlying anxiety, making it challenging to distinguish between genuine enjoyment and a coping mechanism for anxiety.