The Differences Between ASD and Social Anxiety

The Differences Between ASD and Social Anxiety

On the surface, social anxiety disorder and autism spectrum disorder (ASD) may look the same. Both people with autism and those with social anxiety can experience social situations differently than others.

While social anxiety and ASD can occur together, they are very different conditions. In some cases doctors even get the two mixed up, leading to misdiagnosis.

Let’s take a look at both the similarities and differences between ASD and social anxiety.

Similarities of ASD & Social Anxiety

A major similarity between social anxiety disorder and ASD is that both conditions look different in every person. With that said, there are plenty of similarities, including symptoms and treatment services offered. It’s also important to understand that social anxiety is not a form of autism and vice versa.

Similar Symptoms

One reason social anxiety and autism are sometimes confused is that some symptoms appear the same.

According to some educational psychologists, overlapping symptoms of autism and social anxiety disorder can include:

  • Limited social communication
  • Nervousness
  • Difficulty adapting to changing plans
  • Lack of eye contact

ASD & Social Anxiety Diagnosis

A psychologist can diagnose autism and/or social anxiety disorder using the Diagnostic and Statistical Manual of Mental Health Disorders 5th Edition (DSM-5). The DSM-5 is a handbook published by the American Psychiatric Association that helps healthcare professionals make diagnoses.

A healthcare professional will ask about symptoms and may observe a person in social situations before making a diagnosis. Sometimes a pediatrician or physician will recommend seeing a healthcare professional who can properly diagnose ASD, social anxiety, or other specific mental conditions. Ask your doctor for more information.

The DSM-5 diagnostic criteria for autism include:

  • Persistent differences in social communication, including but not limited to lack of back-and-forth conversations and differences in eye contact
  • Repetitive patterns of behaviors, such as lining up toys
  • Symptoms were present in early development, even if they went unnoticed
  • Symptoms interfere with daily functioning, such as schoolwork

The DSM-5 diagnostic criteria for social anxiety disorder include:

  • Fear of judgment in social situations
  • Consistent anxiety in social situations that does not fit the context
  • Avoidance of social interaction
  • Fear of social interaction that impedes day-to-day life
  • Having fear for at least 6 months (and the fear cannot be attributed to another mental health condition, such as panic or substance use disorder, or a disease like Parkinson’s)

Note that social anxiety can develop in children or adults.

ASD & Social Anxiety: Brain Functions

The amygdala, which affects the brain’s response to fear, may play a role in both ASD and social anxiety disorder. Research is still ongoing. Ultimately, however, brain functioning is very different in social anxiety and ASD. The neurological causes of autism aren’t yet fully understood.

Treatment for ASD & Social Anxiety

There’s no cure for social anxiety or autism. In addition, not everyone wants to “manage” or “fix” characteristics associated with autism. People can live fulfilling lives with customized support and treatment tailored to their goals.

Treatment and support options for ASD include:

  • Applied behavioral analysis (ABA) therapy
  • Occupational therapy
  • Social skills training
  • Cognitive behavioral therapy
  • Occupational therapy*

*Occupational therapy is often a first-line service for autism. It may also be used to help people cope with social anxiety in some cases.

High-Functioning Autism Vs. Social Anxiety Disorder

The current diagnostic process for ASD involves three potential levels of support needed:

level 1: requiring some support

level 2: requiring substantial support

level 3: requiring very substantial support

Autism is neurologically based, which makes it different from social anxiety disorder, regardless of communication abilities or any overlap in symptoms.

Differences Between ASD & Social Anxiety

The main difference between ASD and social anxiety is that autism is a neurodevelopmental condition, while social anxiety is a mental health condition. Experts say it’s essential to get the diagnosis correct.

Though a formal diagnosis is best made by a licensed professional, understanding the differences between social anxiety and autism can empower parents to seek an evaluation. Because autism and social anxiety are distinct conditions, they have nuanced symptoms and diagnostic criteria.

ASD & Social Anxiety Symptoms

People with autism and those with social anxiety alike may seem to avoid eye contact. Importantly, however, autistic people aren’t necessarily “avoiding” eye contact out of nervousness or fear. They’re simply not making eye contact in the first place, which is a distinct difference.

Researchers have suggested that individuals with autism look toward a person more slowly, while people with social anxiety look away faster. ASD is a spectrum, meaning people may communicate in different ways. Some may not speak at all, while others may engage in one-sided conversations or miss social cues.

On the other hand, people with social anxiety intentionally avoid conversations because of fear.

Social anxiety can be the result of trauma. A brain dealing with social anxiety may be compensating for something that happened or trying to prevent something from happening reoccurring. Social anxiety is different from autism because autism isn’t triggered by an event, experience, or trauma.

ASD & Social Anxiety Brain Functions

The amygdala may be implicated in both autism and social anxiety disorder, but current research supports the idea that autism is neurodevelopmental. There are comprehensive conclusions available concerning what causes ASD, but research is ongoing.

Social anxiety, on the other hand, is mental-emotional.

Please note that all of this information is for reference only. If you are concerned about your child, please contact your pediatrician or a mental healthcare specialist.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Originally Posted as How to Tell the Difference Between Social Anxiety and Autism at Healthline.com

The Two Wolves

The Two Wolves

Last week I wrote to you about how gratitude can be a life raft in the middle of adversity. Specifically, I wrote to you about the stressors of the COVID-19 pandemic knowing so many of us are exhausted. I hope that shifting to a mindset of gratitude was able to help you find a little joy last week as our nation’s COVID-19 cases continue to rise. I know firsthand, outside of the pandemic, how hard it is to find gratitude during pain. I also know firsthand that it is life-saving. I’d like to tell you more.

Fear or Love?

Around seven years ago I was new to running a business and had been single for a bit. During that time I was settling into my path. This was the beginning of building a spiritual mindset that still carries me today. Gabrielle Bernstein is a spiritual leader I followed who taught (and still teaches) about enlightenment. In her work, Gabrielle guides her readers through their egos back into their spirits. She encourages others to drop fear and embrace radical self-love. It is a hard and worthwhile journey I promise you. 

Back to me. At the time, I was light, joyful, and a little naive, if you will. I did give myself a piece of advice that was worth remembering; “Jessie, my love, there is fear and there is love. Both are hungry wolves within your soul-chose wisely which wolf you feed.” Even today, with much more at stake, I often center with this teaching and remember to lean into love, even when fear seeps in.

The Wolves of Fear

I would like to tell you that as I aged into my 30s I became wiser and kinder, that I was a cocoon that turned into a butterfly on my way to full enlightenment. I was not. I was breaking from the inside out. You see, in believing that love conquers all, I got married very quickly after my stint as a single woman. Within one week of becoming a married woman, my ex-husband changed his behavior towards me.

Five years later, in the office of a trauma counselor, I realized that I had experienced domestic abuse. 5 years of domestic abuse. It was only through the work of an amazing trauma team that I was able to quiet the fear, to rest the wolf. Yet, as I progressed through treatment, it was as though new wolves were growling to be fed.

To begin, I had just moved back home to Ohio. I had grown up incredibly close to my father’s family. I knew my family and I approached the world differently but I still loved them despite our differing beliefs. What I was unprepared for was what came when I opened up to my family about my experience of domestic abuse and what would come next.

Feeding the Wolves 

Within two weeks of opening up to my family about my experience with domestic abuse, my father’s family decided to side with my abuser because I was not submitting to my husband. I was told by a cousin I loved dearly that because I wasn’t being physically beaten that I was making it up. When my wonderful, kind, and bright father stood up for me, one of my uncles explained that an exorcism might be helpful (seriously). Another uncle, my favorite, sent me information on a retreat I could attend to learn my role as a wife so that God would restore my marriage (seriously). 

In leaning into my family I was exposed to a radical belief system that men are the head of the household and strong women need only to submit to make any abuse stop. To this day my ex-husband spends time with my father’s family and to this day my young sons are exposed to them on a regular basis. I just tell my little lions, “boys and girls are the same,” to hopefully plant the seed of equality amongst a field of bigotry. 

You may wonder why I haven’t shared this before or why I am sharing it with you now. I’ll tell you. I didn’t share this earlier because I was afraid of the court system. I thought if I spoke out it would be used against me. I guess it still might. I’m just not feeding the wolf of fear today. I am sharing it with you now because I want to let you know that I’m not just talking, I’m action. You see, leaving domestic abuse and going through a divorce combined with the exposure of and loss of a portion of my family is a pain I never saw myself dealing with. 

Finding Love

Yet here I am on a Monday morning, snuggled with my dogs, happily planning a quiet day on my farm. How? I remembered my own wisdom and, through the healing I embraced last winter, I also embraced gratitude. My experience with domestic abuse and divorce is just that, an experience. I got out and found that the most incredible family and friends were standing alongside me. They reminded me every day I was worthy and reflected love to me unconditionally until I was able to slowly feed my own wolf of love.

I’ve changed my own language from what I’ve lost to what I’ve gained. I haven’t lost a marriage, I’ve gained freedom. I haven’t lost a family, I found my true family. I haven’t lost myself, I’ve found her.

In shifting to a daily practice of gratitude I am not able to stop pain from happening and I am not totally free of fear. Remember the crowds in the stands? They can be hateful and loud. It hurts even more when a portion of the crowd shares your DNA. At least for me, it did. But outside of that noise is peace and knowledge that every human life matters, including mine. I am able to wipe the dust off my knees from whatever battle is ahead and bow in gratitude to the people standing beside me.

I do not know what pain outside of the COVID-19 pandemic you might be facing. But this I know to be true: love is stronger than fear. Dig deep into your soul and coax that darling wolf of love out. If you can’t feed her yet let others help, then say thank you. 

The world will always bring adversity but your heart will always offer you love. 

In gratitude to my family, friends, and employees for reminding me of who I am.

Xoxo,

Jessie

If you are experiencing domestic violence or abuse speak up, reach out, get out.

The Two Wolves

Peace Amidst Fear

Over the course of the summer, I’ve taken you through my understanding of anger. Quite personally I needed to write about it because it was pulsing through my veins. While I have an incredible amount of compassion, empathy, and a commitment to humanity, I am also a human. I cannot yet write fully about what caused this anger but I will tell you a broken system and injustice are involved.

As anger came to me I was overwhelmed by it. I knew that fear was a terrible driver (see blog) but I also knew my anger was real and there was no fear in my anger. It was raw rage. At first, I felt guilt and shame for the rage I felt. The only fear I had was not wanting to take it out on another. I am not perfect (to the woman at the 7th BMV I visited to get my adopted son his driving permit, I am sorry!). Anger pulsed through my veins and I did my best to not take it out on others. I was not my best self.

Dealing with Anger

When my anger spoke to me and said it would not go away I had to do something radical, something I’ve never done before; I sat with anger. Sitting with anger is incredibly uncomfortable. I’ve written to you about sitting with fear, hurt, and pain but never anger. The reason for this is that anger is an active emotion that needs an outlet and in our nervous system. Anger seeks a release. When we feel anger we want to get rid of it. We want to let it out! The problem with this is just as hate begets hate, anger begets anger. You cannot get away from anger by simply releasing it and by releasing it in its raw form you run the risk of hurting yourself or others. Personally, I become very upset if I hurt others or myself. I feel ashamed. 

Sitting with anger allowed me to finally be able to see what it was telling me. Instead of looking at anger as an uncomfortable emotion that needed to be released, I chose to look at my anger as a pissed-off friend.  I asked my anger, “what’s going on, what’s happening here?” When I lost my temper I quickly said sorry first to my own heart and then the person who received that anger. I don’t excuse the damaging behaviors of others and I certainly do not believe I have the right to damage another person.

As I sat with my anger I was able to see what was blocking my path, what was unjust, and what I could and could not control. What was out of my current control was, of course, the hardest to let go of. This leads me to write about peace amidst fear.

Anger & Fear

Personally, my tribe all knows about what I am fearful of and it’s a lot. Whenever I listen to Glennon Doyle talk about her struggle with anxiety from caring all the time I’m fist-pumping the air. At least half a dozen times a year I call my sister in a panic about something I’ve heard in the news. Mind you this is news someone else has reported to me because, for my mental health, I literally cannot read the news or stay on social media. Reading things like “girls in Africa have trouble going to school because of their menstrual cycle” (https://www.daysforgirls.org) or “the Native Americans are having a water crisis in our country” (https://www.navajowaterproject.org) just about break my soul in two. To me, worth is born the minute we take our first breath as humans, and when human rights are restricted and people are hurting, I hurt too.

I also know that so many of us are pretty well exhausted by the length of the pandemic, the wait for vaccinations for our young children, and hurt deeply by the divide amongst our country. It is a fearful time with no clear end in sight.

Reading through the works of spiritual teachers like Gabby Bernstein help me understand that peace is available to us all of the time. She and other teachers are not wrong in that peace does beat inside our hearts but there is a part of their teachings that I can’t get behind. It is taught that peace and a life of ease are the goals leaving so many feeling defeated and like they are not enough. Constantly trying to be a perfect yogi and find that place of zen as a way of life is not easy.

Learning from Anger 

What I have learned over this past year is that pain, grief, anxiety, anger, and fear are simply part of the human experience. These usually coined “negative” emotions are just as natural as joy, happiness, laughter, love, and peace. You cannot know the feeling of a joyful emotion without knowing the painful emotion; you would have no reference point.

Life is not about staying zen, it’s not about being peaceful, loving, warm, and kind all of the time. Life is about honoring your own worth, sharing the gifts you are born with, navigating the storms that may come your way, and knowing that peace is available amidst it all. Peace is not the end goal, peace is a kind teacher that tells us we have a space to land as we feel, learn, and navigate our lives. Peace quiets the noise around us to tell us what’s real–both inside of us and out in the world so we can walk in alignment with the truest form of ourselves. Peace is the friend offering a hand, a hug, and a hot cup of tea when the world is crashing down around you. Peace is the calm in the storm.

We cannot stop pain, thus fear exists. We cannot also not stop love, thus peace exists. The goal is not perfect peace. The goal is radical self-love regardless of what is crashing around the shores of life.

Walk gently with your lives, my darlings. Do not get lost in the waves. Place your hand on your heart, listen to peace beating against your hand, and know all is well.

Xoxo,

Jessie

ASD & Double Empathy (Part 2)

ASD & Double Empathy (Part 2)

What is double empathy and how does it relate to ASD? Click here for Part 1.

Double Empathy & Current Thinking About ASD

The double empathy problem stands at odds with several widely adopted ideas about people with autism, namely that their social difficulties are inherent. For example, one of the main diagnostic criteria for autism, as outlined in the Diagnostic and Statistical Manual of Mental Disorders, is “persistent deficits in social communication and social interaction across multiple contexts.” Similarly, the social motivation theory of autism holds that people with autism have a diminished drive for social interaction.

But the Double Empathy theory isn’t necessarily incompatible with the old ideas. Instead, the theory highlights the importance of examining both sides of social interactions instead of focusing solely on the ways people with autism diverge from the perceived norm.

Is ASD Research Changing in Light of the Double Empathy Problem?

Some modern ASD research is changing due to Double Empathy. For instance, scientists are rethinking how they examine social skills, calling for a revamp of autism studies to gauge the strengths, rather than the limits, of ASD communication. Researchers are also finding ways to probe the dynamics of social interactions instead of studying the isolated behavior of people lying in a brain scanner or sitting at a computer.

In addition, researchers who study predictive coding — the way people form internal models of the external world — are exploring how a mismatch in people’s predictions could hinder their interactions. For example, if a person with autism has expectations about how a conversation might unfold diverge from a neurotypical person’s, their interaction may falter.

Not everyone is convinced, or even aware, of the Double Empathy theory. Some questions at the core of the theory remain unanswered. For example, researchers are still figuring out why communication is smoother when people with autism interact with one another than it is when they engage with neurotypical people. And much of the existing evidence for the theory rests on anecdotal reports and small studies.

Are There Any Implications for ASD Treatment from Double Empathy?

In addition to suggesting new research angles, the double empathy problem may help explain why some autism assessments and treatments fall short. For example, standard measures of social abilities don’t seem to predict how people with autism fare in actual social interactions.

Therapies designed to teach people with autism normative social skills are not all that effective in helping them navigate real-life situations, such as forging friendships, studies suggest. Evaluating social situations surrounding people with autism and finding ways to facilitate their unique communication styles may be a more useful approach, he says.

Similarly, the double empathy problem underscores the importance of training programs — say, for doctors or law enforcement professionals — that help neurotypical people interact appropriately with people with autism. Being routinely misperceived can lead those with ASD to loneliness and feelings of isolation. And attempts to conform to social norms by suppressing who you are can be exhausting, many experts say.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment with ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Sources

Double Empathy Explained, spectrumnews.org

ASD & Double Empathy (Part 2)

ASD & Double Empathy (Part 1)

What is double empathy and how does it relate to ASD?

The basis of the Double Empathy Theory is that a mismatch between two people can lead to faulty communication. This disconnect can occur at many levels, from conversation styles to how people see the world. The greater the disconnect, the more difficulty the two people will have interacting.

In the case of autism, a communication gap between people with and without the condition may occur not only because people with autism have trouble understanding neurotypical people but also because neurotypical people have trouble understanding them. 

The problem, the theory posits, is mutual. For example, difficulty in reading the other person’s facial expressions may stunt conversations between people with autism and neurotypical people.

Double Empathy Origins

This conception of social issues in autism as a two-way street is decades old. Some ASD activists have argued for years that ASD modes of communication conflict with neurotypical ones.

The term ‘double empathy problem’ was first used in a 2012 paper by Damian Milton, a University of Kent lecturer. The idea offered a way to reframe the long-held notion that individuals on the spectrum have impaired theory of mind — the ability to infer the intentions or feelings of others — to include potential misunderstanding by neurotypical people.

Support for Double Empathy

Instead of focusing on how people with autism perform in social situations, new studies probe how neurotypical people perform when interacting with people with autism. The results hint that neurotypical people’s blind spots contribute to a communication gap. 

In one study, neurotypical people had trouble deciphering the mental states people with autism portrayed through animations. Another study showed that neurotypical individuals struggle to accurately interpret the facial indicators of people with autism.

Neurotypical people may also make snap judgments of people with autism that prevent, curtail, or sour interactions between the two. For example, neurotypical people may be prone to having negative first impressions of people with autism without knowing their diagnosis — rating them less approachable and more awkward than neurotypical people.

Are Social Difficulties a Core Trait of ASD?

Yes, plenty of evidence shows that people with autism differ from neurotypical people. Social interaction difficulties across several domains, such as facial expressions, speech patterns, and eye gaze (though the last notion may be shaky) have been observed and studied.

However, many other studies show that people with autism have social and communication issues that are not evident when they interact with other people with autism. For example, in the game of “telephone,” in which a message is relayed in whispers from one person to the next, chains of eight people with autism maintain the fidelity of the message just as well as sets of eight neurotypical people do. It’s only in mixed groups of people with autism and neurotypical people that the message quickly degrades.

There are other signs that people on the spectrum connect well with one another. People with autism report feeling more comfortable with other people with autism than with neurotypical people. Many adolescents with autism prefer to interact with ASD peers over neurotypical ones. And people with autism often build a greater sense of rapport and share more about themselves when conversing with others on the spectrum. 

One reason for this pattern may be that people with autism are less concerned with typical social norms, such as conversational reciprocity, and so don’t mind as much when these rules are not followed.

The principle of social compatibility may extend beyond autism diagnoses to autism traits. For example, the more similar two neurotypical people rate themselves on an autism trait assessment, the closer they rate their friendship.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment with ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Sources

Double Empathy Explained, spectrumnews.org