STRESS & AUTISM SPECTRUM DISORDERS

Stress is part of everyday life and a natural reaction to change and adjustment with a major life change. Stress also occurs in response to ongoing daily hassles such as traffic, noise or inconsiderate people. The body responds to stress with the ‘flight or fight’ response in the central and peripheral nervous system. This involves a series of chemical changes which prepare people for a stressful event.

Imagine the body's reaction to the sound of a loud siren late at night outside a person’s home. During this stressful event the body becomes mobilized into action via the brain’s messages. Changes may include increased heart rate and blood pressure, sweating, dilated pupils and extra sensitive senses such as hearing and vision. While the ‘flight or fight’ response is vital for survival, if this occurs too often to the body as a result of chronic stress, there can be negative effects such as reduced protection from disease and infection, hypertension, heart, liver and kidney conditions and psychological disorders.

Stress and Autism Spectrum Disorders

In many cases, people find it much harder to deal with stress if they have autism or Asperger's syndrome. Sensory problems can create many difficulties in coping with too much sensory stimulation. Coping with stress uses many different cognitive functions of the brains such as recognizing the symptoms, identifying causes, formulating a coping strategy, maintaining control of emotions appropriately and remembering these techniques. Being on the autism spectrum can make it difficult to balance all these processes to manage stress.
A possible analogy is comparing ability to handle stress on the autism spectrum with roadworks on a six lane highway. If one or two lanes are closed down, there is little disruption to a light flow of traffic. But once the traffic reaches a critical point those closed down lanes suddenly result in traffic at a standstill backing up for kilometers. An adult with Asperger's will usually be able to handle a light load of stress, conversation, noise or workload, but at a critical point they often can no longer cope and the stress sets in.

Understanding and Managing Stress

The first step a person can take to reduce stress is to become aware of the major sources, or triggers, of stress in your life. It can help to keep a stress awareness diary for a few weeks that lists the date, time, event, severity, symptoms, and coping strategies they used to ease the situation. The second step is to categorize different stressful situations as follows:
Controllable – Uncontrollable
Important – Unimportant
This can help you to stand back from your situation in order to view it more clearly and objectively.

Four skills for managing stressful situations

These are Awareness, Acceptance, Coping and Action skills. Some skills may be more useful in certain situations. Each skill may be explained better using a situation which a person may face in real life. To illustrate these skills, let us use the example of a person who is stressed because they have a job interview.

Awareness skills

This is getting a clearer understanding of the situation and how it affects the person.
Example: finding out what the interview involves and what is required.

Acceptance skills

Acknowledging the stress and being realistic about its effects e.g. what aspects are controllable/uncontrollable or important/unimportant.
Example: Recognize that the interview needs to be conducted to get work, and that it will probably be quite tiring and demanding. The person may not be able to control when and how long the interview is but they can manage their thoughts and reactions to it.

Coping skills

Prepare to cope with the stressful situation by learning various strategies. Identify what changes you can make to control the situation and reduce stress levels.
Example: Using positive self-talk to develop a constructive outlook towards the interview and practice.

Action skills

Actively making changes to counteract or reduce the level of stress.
Example: Following through with the anxiety management plan and monitoring stress levels. After the interview the person can find a relaxing and enjoyable activity to wind down.

Some Coping Strategies for Managing Stressful Situations

Progressive muscle relaxation

A person learns to identify muscle groups and the difference between tension and relaxation in the muscles.
Focus upon 4 main muscle groups:
1. hands, forearms and biceps
2. head, face, throat and shoulders
3. chest, stomach and lower back
4. thighs, buttocks, calves and feet.
Tense muscles for 5-7 seconds and relax for 10-15 seconds.
Time to master: 1-2 weeks, 2 x 15 minute sessions per day.

Slow breathing techniques

Proper breathing habits are essential for good mental and physical health. First, a person needs to focus upon their breathing pattern. They need to identify whether they breathe mainly through the chest or through their stomach. Short, shallow and rapid breaths from the upper chest should be avoided. The aim is to breathe deeply and slowly through the nose. A person should feel greater movement in the stomach than the chest as they inhale and exhale. Practice breathing exercises everyday. Learn to apply slow breathing as needed e.g. when feeling stressed, angry or anxious.

Visualization

A person uses imagination e.g. pleasant daydreams or memories to will him or herself into a relaxed state, by:
• Getting comfortable, scanning the body for tension and relaxing the muscles
• Selecting a favorite peaceful place which is real or imagined
• Focusing the imagination using all 5 senses
• Using affirmations such as repeating ‘I am letting go of tension’; or ‘I am feeling peaceful’.

Practice using visualization three times a day for a few minutes or longer. This is usually easiest for the person in the morning and at night in bed. Eventually, with practice a person can use visualization in everyday situations when feeling uptight. The effectiveness of whatever strategies are used to manage stress will be improved if after each strategy is used, it is evaluated. This can be done by:
• Noticing the physical, mental and behavioral signs of stress
• Selecting a coping strategy for reducing stress
• Evaluating whether or not the strategy worked by reassessing the level of severity
• Maintaining the use of the strategy.
If there has been no change or an increase in stress levels, try using other strategies.

Click here to read the fact sheet on handling panic attacks.
Click here for an interview with a specialist on stress and the autism spectrum.

Click here to go to the home page to view the full range of autism fact sheets at www.autism-help.org
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