Anxiety Or Autistic Overwhelm: How To Differentiate And Treat Anxiety Attacks And Autistic Meltdowns

On the outside, a meltdown and an anxiety attack may look similar, and both can be very intense and scary experiences. It can be helpful to distinguish between the two so you can identify how to best cope with the symptoms. 

What is an anxiety attack 

An anxiety attack is an increase in fear and physiological symptoms, often based on a perceived fear/threat or internal stress.

What is an autistic meltdown

An autistic meltdown is an intense involuntary response resulting in a decrease in control over oneself, often due to overwhelming stress, emotions, or sensory input. 

Similarities 

From an outside perspective, autistic meltdowns and anxiety attacks may look similar. They both can be very intense and overwhelming and often come with feelings of being out of control.  Both can interfere with daily functioning and emotional well-being. There is also often shame and embarrassment that many feel with both of these experiences, so it is important to approach them with compassion and gentle curiosity. 

Differences 

The trigger/cause:

One of the main differences between meltdowns and anxiety attacks is the cause or trigger of the experience. 

Anxiety is often triggered by a perceived threat or internal stressor. This threat may not be a real threat, but it feels real to the body and is often related to a real-life stressor. Anxiety attacks can also be related to trauma or triggers related to past experiences of feeling unsafe. 

Autistic meltdowns often stem from being overstimulated or overwhelmed. Autistic people take in more sensory information than neurotypicals, which can cause their brains and bodies to become so overwhelmed that it triggers a meltdown. Sometimes one of the overwhelming things may be anxiety or fear, but it is typically not the only element. For some autistic people, triggers of meltdowns can be hard to pinpoint. This could be because there are multiple triggers, or the triggers can be more abstract. Meltdown triggers are often sensory-based (bright lighting, loud noises), a reaction to changes in routines/environment, or stem from difficulty communicating needs and feelings.

The experience: 

Every meltdown or panic attack is going to look different based on the individual experiencing it, but there are some signs that can help distinguish each. 

Anxiety attacks typically have internal psychological symptoms like rapid or difficult breathing, a high heart rate, or shaking. Anxiety attacks often come with racing or intense thoughts, and someone having an anxiety attack may say out loud what they are feeling or experiencing. Anxiety attacks are also shorter in duration and typically resolve within 30 minutes. 

Someone having a meltdown will likely either shut down completely or attempt to self-regulate through outward behaviors (rapid physical movements, rocking, yelling). Due to the way that autism affects communication and processing, an autistic person may struggle to say any words at all during a meltdown and may either be unable to communicate or need non-verbal communication methods. Meltdowns can last significantly longer than anxiety attacks depending on the individual and level of overwhelm. 

Treatment 

One reason why it can be important to distinguish between anxiety attacks and meltdowns is that the way that we cope with them will look different. At Spotted Rabbit, we specialize in helping people develop self-care routines and coping strategies so they can feel more able to cope with anxiety attacks or meltdowns. A therapist can help you identify triggers, come up with personalized coping strategies, and develop plans to be able to prevent or intervene in anxiety attacks and meltdowns before they happen. 

Treating anxiety attacks and meltdowns can be broken down into coping strategies and self-care. Coping strategies are used when you are already dysregulated and experiencing symptoms. Self-care is preventative care and includes various lifestyle changes in order to reduce the impact, severity, and frequency of symptoms. Both are important and, when used together, can greatly improve your well-being and ability to handle difficult situations. 

Coping with anxiety attacks

Anxiety attacks are the body exhibiting a fear/panic response due to a perceived trigger. One of the best ways to cope with an anxiety attack is grounding exercises that calm the body down, like breathing exercises or progressive muscle relaxation. Other grounding techniques include mindful observation exercises like counting all objects of a certain color around you, or noticing 5 things you can see, 4 things you can hear, 3 things you can smell, 2 things you can touch, and 1 thing you can taste. In addition, using cold water, sour candy, or other sensory-based methods can help shift your body out of its current state into a calmer, more grounded state. 

Coping with meltdowns 

Since meltdowns are often caused or exacerbated by sensory triggers, one of the best tools is to reduce negative sensory input and increase positive sensory input. This could look like turning off lights or utilizing sensory objects like weighted blankets. This is also a great time to lean into other comfort items like a favorite TV show or band. If you are able, engage in things that bring you joy and comfort and that you are familiar with. Creativity can be a great strategy for engaging with positive sensory items and expressing emotions in a non-verbal way. Many of the suggested grounding exercises for anxiety attacks may also help with a meltdown. 

Another important strategy for meltdowns is to take the time and space needed to feel regulated again. Oftentimes, meltdowns are the body’s attempt to self-regulate. Trying to push yourself back into a task when still experiencing a meltdown will likely not help since you haven’t finished regulating. This may mean canceling plans or asking for support from others as you regulate yourself. If you are having trouble communicating with people, it is okay to utilize different types of communication like only texting/writing or using hand signals. 

Self-care/preventive approaches

Taking time to figure out what your specific triggers, needs, and preferred regulation strategies are in advance is a great way to reduce the negative impact of meltdowns and anxiety attacks. Coming up with a plan with a therapist can allow you to figure out what your needs are and can give you and your loved ones tools to help you in a way that works for you. A therapist can guide you through the above coping strategies and even suggest alternatives that are based on your specific needs and interests. Coping strategies and self-care don’t have to be boring. You are more likely to use and benefit from strategies that you enjoy engaging with. It is also really helpful to practice coping strategies when you are not in a dysregulated state. This allows your body and mind to get familiar with the coping strategy so it will be more accessible when you need it. Creative arts therapy can also be a great way to explore the experience of an anxiety attack or meltdown through visuals to gain a better understanding of the experience. Art can help us access internal emotions and states that words alone may miss. 

Self-care includes all aspects of taking care of yourself, including movement, nutrition, sleep, fun, social, etc. All of these aspects of life are connected to your mental well-being and will improve your overall symptoms. Taking care of yourself can also reduce the amount and severity of anxiety attacks or meltdowns you are experiencing. Self-care can feel very overwhelming and often gets set aside because of other responsibilities, but self-care is the foundation of your wellbeing and is worth prioritizing. A therapist can help you identify what aspects of your life need more support and attention and help you set realistic and achievable goals in these areas. 

Both anxiety attacks and meltdowns are difficult and oftentimes scary experiences. They can be intense and negatively impact multiple aspects of your life. While you may feel out of control during this experience, there still is a lot within your control that can greatly improve your well-being. A therapist can be a great resource to guide you towards feeling more confident in managing your experiences in a way that works for you.