Hope, Anxiety & ASD

By Julie Gordon, LCSW - Heart SOS - Heart of the Spectrum Outpatient Services - Asdheartsos.com

Autism Spectrum Disorder comes with co-occurring mental health disorders of depression, attention-deficit, attachment, oppositional defiant, obsessive compulsive, post-traumatic stress and the most common, generalized anxiety.

Can anxiety be treated on its own? Or is it a symptom of ASD that can only improve if the core deficits of ASD improve?

All of us get anxious about things that are out of our control. We use our past experiences, resources and other coping mechanisms to calm us down and push forward. When an individual has a physical response to uncertainty, excessive worry about future events or apprehension so significant that it impacts their daily functioning; they are diagnosed with an anxiety disorder.

The brain’s limbic system is responsible for our stress response, “flight or fight” response and our emotions. The hippocampus, part of the limbic system is responsible for our memory consolidation. The brain’s prefrontal cortex is responsible for empathy, responsive communication, impulse control and self-regulation, morality, emotional regulation, fear modulation, intuition, insight and flexible thinking.

What happens when the limbic brain is starts to panic? It talks to the prefrontal cortex to calm down and react appropriately.

With therapy, individuals with anxiety can learn to access their pre-frontal cortex to provide them with means to inhibit their perceived fears or the hippocampus to pull from their past experiences to cope by remembering effective strategies.

However, in ASD, not only are the pre-frontal cortex skill areas underdeveloped, but the neural networks are between the limbic brain and the prefrontal cortex are not communicating well with one another. So even if an individual with ASD could access their prefrontal cortex in times of stress, they would lack the episodic memory and the social, emotional and cognitive skills to regulate, problem solve and adapt successfully.

In 2013, ASD was reclassified as a “Neurodevelopmental Disorder” due to the new understanding that the specific underdeveloped neural connections lead to a domino effect on learning and skill development. This leads to a cycle of failure and stress – a cycle that creates a significant amount of chronic anxiety.

There is hope. The brain is resilient and neural pathways can reconnect! Intensive behavior therapy with a highly qualified clinician or team of clinicians, an individual with ASD can slowly become competent in problem solving, reading environmental and social cues, processing and integrating information. Then, with these positive experiences to pull from, they can practice accessing the prefrontal cortex to cope with stress under the careful guidance of trusted technicians supporting them. Mistakes and change no longer results in anxiety but inspires determination to try again.

Julie Gordon has been in the field of ASD for 19 years. She is the owner of The Hope Source and founder of Dynamic Minds Academy.

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