Anxiety and Sensory Issues
George has sensory sensitivities and gets easily overwhelmed by sounds and visuals. George also has anxiety and is afraid of public restrooms.
![George getting nervous in a bathroom and covering his ears. Germs are popping up near him](https://cdn.bcm.edu/sites/default/files/2025-01/teen-george-bathroom-360p-250131.gif)
George’s fear of public restrooms is a bit more complicated than his other fears. He is afraid of public restrooms for two reasons:
- Because he worries about all the germs in the restroom, and
- Because he gets extremely overwhelmed by all the loud noises (toilets flushing, automatic hand dries, and sinks running).
If George wants to make a plan of action for his fear of public restrooms, he needs to make sure he addresses his sensory sensitivities too, not just his anxiety about germs.
Is it Anxiety, Autism or Both?
Since autistic people’s brains work differently, it makes sense that you may experience the world differently as well. If you are more sensitive to lights, sounds, or textures, it is probably not something you are able to change about yourself. This is because sensory sensitivities are a trait of autism, and it is different from your anxiety.
But sometimes, sensory issues can start leading to anxiety. If you become afraid of situations or things because of your sensory triggers, or if you are anxious and on guard all the time because you are scared of being overwhelmed, then this can be a problem.
For example, George was not always afraid of public restrooms. George started avoiding public restrooms when he was younger after having lots of bad experiences with them. For instance, he would become so overwhelmed by all the noises in the restroom, that he would start crying. After avoiding public restrooms for so long, George developed a fear of them.
In LUNA, we want you to overcome any anxieties you have developed because of sensory issues. You may want to use flexible tools to help you get through sensory situations and face your anxieties. Our goal is not to get rid of your sensory sensitivity, but to lessen your anxiety about it.
Anxiety and Your Routine
Now, let’s look at Sophia. Sophia feels anxious when there are changes in her life that she does not expect. She doesn’t like any surprises and gets frustrated when her schedule or routine changes. This difficulty with change can be both related to anxiety and autism.
![Sophia scratching her head and looking confused. Various objects related to changes in routines popping up.](https://cdn.bcm.edu/sites/default/files/2025-01/module-9-visual-routine-disruption-360p-250131.gif)
In LUNA, we don’t want you to work on getting used to changes in your routine, unless it starts causing problems for you. Having a routine and sticking to it can be very helpful, especially for autistic people. It can help you to prepare for the day, stay organized, and manage your day with confidence and assurance.
But, if you feel like you must stick to your routine no matter what, and you feel unable to deal with occasional changes, then you may have some anxiety about routines that could lead to problems.
For instance, Sophia is often late to school because it makes her anxious to skip any step in her morning routine. If Sophia oversleeps, she still feels like she must complete her morning routine like usual, even if she would need to skip one small step to be at school on time. Sophia also doesn't hang out with her friends after school because she is anxious about changing her evening schedule to hang out with them.
Some autistic people rely on routines to help them function and accomplish the things they want to do. Our goal is not to take away your routines or schedules, but to lessen your anxiety when something unexpected happens or when you need to adjust your routine.
Now, let’s think more about how to create or adjust a plan of action for these two fears.
Adapting Your Plan of Action
- Carefully decide on a goal for your plan of action.
- Your goal should be something you feel comfortable with and something that makes sense for your life. For example, if you are making a plan for a fear that involves sound sensitivity, your goal could be to stay in a loud situation (like a school assembly or public restroom) with the help of noise-cancelling headphones.
- Think about tools or supports you can use to achieve your goal.
- Talk with your parent and come up with some things you can use to help you reach your goal. For instance, if routine changes give you anxiety, you could try setting an alarm that lets you know when you need to switch to a new activity. Or, you could ask your parent to let you know ahead of time when something changes. Talk to your parent about anything that you think will help you. It's important to let them know what you need to reach these goals.
- Make the exposure activities in your plan of action even more gradual.
- Get creative with the activities in your plan and make them as gradual as possible. This will help you get used to your fear more easily. For example, if you are afraid of fireworks and loud noises, one of your steps could be to listen to sounds of fireworks on your phone or watch a video of fireworks instead of waiting for the Fourth of July or New Years.