Anxiety gets talked about like it's just “worrying too much,” like if you could think more positively it would go away. But anything you learn in a basic psychology class will tell you pretty quickly that anxiety isn't really a thinking problem. It's a body problem that shows up in your thoughts. For autistic people, anxiety also shows up much more often than it does for everyone else. This is why the brain can treat a math test like a predator, and why that happens so often for people like me.

What the Research Shows

Anxiety is very common in autistic people. A well-known meta-analysis by Sophie van Steensel and colleagues found that roughly 40 percent of autistic children and teens have at least one anxiety disorder, far higher than in the general population. There are many possible reasons, including constant uncertainty, sensory stress, and social situations that are harder to read. Biology likely plays a part too.

Here is the AP Psych version. When your brain perceives a threat, the amygdala sounds the alarm, and the hypothalamus starts the stress response in two ways. The fast route is the sympathetic nervous system, which releases epinephrine, or adrenaline. That is why your heart pounds and your palms sweat. The slower route is the HPA axis—the hypothalamus, pituitary, and adrenal glands—which ends with the adrenal glands releasing cortisol, a stress hormone that keeps your body on high alert.

This system is amazing if you are being chased by a tiger. The problem is that your brain uses the same system for a pop quiz, an awkward group project, or an unexpected change in plans. Hans Selye described what happens when this keeps going in his General Adaptation Syndrome: alarm, resistance, and exhaustion. When stress is constant, that last stage can mean trouble sleeping, getting sick more often, and feeling wiped out.

The prefrontal cortex, the part of your brain responsible for planning and reasoning, normally helps calm the amygdala by saying, “This isn't actually dangerous.” But when the stress response is strong, the amygdala can override that calming signal. That is why telling an anxious person to “think logically” often does not work in the moment. Neurotransmitters play a role too. GABA is the brain's main calming chemical, and many anxiety medications affect GABA or serotonin. Anxiety is a medical condition, not a character flaw.

There is one more piece that is especially relevant for autistic people: alexithymia, which means difficulty identifying and describing your own emotions. A meta-analysis by Kinnaird and colleagues found it in roughly half of autistic people, compared with a much smaller share of non-autistic people. This connects to interoception, your sense of what is happening inside your body, such as a racing heart or tight stomach. If you cannot tell whether those signals mean scared, excited, or hungry, anxiety can build without you ever naming it.

Why It Feels Different

It happens before you can explain it. The body reacts first, so by the time you know you are anxious, your heart rate is already up and your thoughts are already racing.

Not knowing what is coming can be the trigger. Many autistic people rely on routines and predictability, so a sudden schedule change or vague instruction can set off the alarm system the same way a real threat would.

Reassurance does not always work. “Don't worry, it'll be fine” asks the prefrontal cortex to override the amygdala, which is exactly what is hard to do when the stress response is already running.

Anxiety and autism can be confused with each other. Avoiding eye contact, shutting down, or relying on rigid routines can come from either one. Anxiety sometimes goes unnoticed because everything gets blamed on “just being autistic.”

The Different Shapes This Can Take

The racing mind. Thoughts loop over everything that could go wrong, replaying conversations and predicting worst-case scenarios.

The body-first version. Stomachaches, headaches, shaky hands, and trouble breathing show up without any clear worried thought attached, especially for people with alexithymia.

The avoidance spiral. Skipping a stressful thing feels like instant relief, which teaches the brain that avoidance works and makes the fear stronger next time. This is negative reinforcement in action.

The irritability. Sometimes anxiety looks like anger or snapping at people, because a body in fight-or-flight is not in a patient mood.

A Note From a Friend

Last year before my first AP exam, I had a stomachache for about three days. I assumed I had eaten something bad. I was not feeling “nervous,” or at least I could not have told you I was. My heart was going fast during practice tests and my hands were cold, and I just kept thinking something was wrong with me physically. It was not until my school counselor asked how I felt about the exam that I realized I genuinely did not know. Later, when we covered the stress response in class, it clicked that my body had been in alarm mode the whole time and my brain had not translated it into a word. Now I try to check what my body is doing before I ask what I am feeling. It does not always work, but it is better than guessing.

Where People Get Stuck

Anxiety is treated like a mindset problem when it is a physiological response that thinking differently cannot switch off by itself. Avoidance gets treated like the solution because it makes anxiety go away for now, even though it usually strengthens it over time. Physical symptoms get dismissed as “just nerves” or attention-seeking, even though they are real responses from a real system. People also assume that a student who looks calm must feel calm, which is not always true for someone who masks.

What Helps

Practice slow breathing. Long exhalations activate the parasympathetic nervous system, which counterbalances fight-or-flight. It is basic, but it is backed by how the body actually works.

Name what your body is doing. If feelings are hard to identify, start with physical cues like “my chest is tight” or “my hands are cold.” That can make the emotion easier to find.

Make the unknown smaller. Ask for schedules, instructions, or what to expect ahead of time. Less uncertainty means less for the amygdala to react to.

Face things in small steps. Gradual exposure, a technique used in cognitive behavioral therapy, helps the brain learn that something is not actually dangerous in a way avoidance cannot.

Support the basics. Sleep, movement, and regular meals all affect how your stress system runs. Exercise in particular is linked with lower anxiety.

Talk to a professional. Therapists and doctors can help work out whether it is anxiety, autism-related stress, or both. Treatment such as CBT, sometimes with medication, can help. This essay is not medical advice.

A Word on Boundaries

Not all stress is bad. A little can help you study and show up, and avoiding everything that makes you nervous is not realistic. The goal is not zero anxiety. It is getting to the point where your alarm system matches the actual size of the problem.

A Note for Teachers and Parents

If a student has frequent stomachaches, avoids certain situations, or seems irritable or shut down around changes and tests, anxiety may be behind it—especially if they are autistic. Predictable routines, clear expectations, and a calm adult who does not dismiss physical symptoms can help more than reassurance alone.

Anxiety is not proof that you are weak or broken. It is an alarm system doing its job a little too well, and learning how it works is the first step toward turning the volume down.