Ways to De-Stress for Individuals with Autism

Introduction to Stress

According to the World Health Organization (2023), stress can be defined as, “a state of worry or mental tension caused by a difficult situation. Stress is a natural human response that prompts us to address challenges and threats in our lives. Everyone experiences stress to some degree” (para. 1). Stress can often trigger an automatic physiological reaction to trauma or other stressors, even when we’re not consciously aware of it. In order words, our body reacts to stressful situations even when our mind is unaware. This blog explores the effects of stress on the body, both in the short-term and long-term, for neurotypical and neurodivergent individuals. It will discuss interventions and coping strategies that can help people with Autism manage stress. This blog presents information and viewpoints grounded in scientific research and personal accounts from autistic individuals. It aims to share helpful, evidence-based strategies for managing stress that are inclusive of and relevant to the real-world experiences of people on the autism spectrum.

Stress and its Impact on the Body in Neurotypical & Neurodivergent Individuals 

For clarification in the study below, here are two important terms and their definitions to note:

• Cardiometabolic: refers to a group of common, often preventable conditions including heart attack, stroke, diabetes, insulin resistance, etc.
• Adverse Childhood Experiences: are defined as stressful experiences occurring during childhood.

Stress and its impact on neurotypical individuals

A systematic review by Suglia et al. (2018) found that childhood adversity was associated with increased health risks later in life such as obesity, high blood pressure, and cardiac disease. Similarly, childhood maltreatment such as physical, sexual, or emotional abuse and neglect is by far the most frequent operationalization of adversity, and was associated with an increased risk of cardiometabolic risk. Accumulation of these stressful events and co-occurring adversities was associated with an even greater risk of cardiometabolic problems in adulthood.

People from racial and ethnic minority groups, as well as children from low-income families, tend to experience higher levels of chronic stress compared to their White counterparts. This prolonged stress is linked to poorer cardiometabolic health outcomes that are more prevalent among these populations. Exposure to racism, racist structures, and inaccessibility to economic, social, and emotional resources to cope creates higher levels of stress in children and can be impactful in adulthood. The study acknowledged that more research on health outcomes from this area needs to be addressed. Suglia and colleagues also found that childhood adversity increases the risk of mood and anxiety disorders, which are also associated with increased cardiometabolic risk. Lastly, they mentioned that childhood adversity associated with high stress response may be helpful in some environments such as the need to be more alert in dangerous settings in the short-term. However, in the long-term this continuous biological stress response could trigger health problems (Suglia et al., 2018).

Stress and its impact on neurodivergent individuals

Though this study is particularly useful for understanding stress and its impact on neurotypical individuals, it is not generalizable to other populations, such as those with Autism. It is important to highlight the CDC’s (2023) research on mental distress in individuals with a disability and those without one. Mental distress, as defined by the CDC, is noted as 14 or more self-reported mentally unhealthy days in the past 30 days. This is associated with adverse health behaviors, increased use of health services, mental disorders, chronic diseases, and functional limitations. The demographics data collected by the CDC showed that 26.2% of U.S. adults who responded to questions about disability and mental distress reported having a disability and one third of those with a disability (32.9%) reported experiencing mental distress compared to 7.2% of adults without a disability.

Another study published in 2016 by Bishop-fitzpatrick and colleagues (2015) investigated stress in adults with ASD. They hypothesized that adults with ASD would experience more perceived stress than healthy controls and found this to be true. They also found that stress contributed significantly to the prediction of social functioning for both the healthy controls and adults with ASD. 

Interventions & De-Stress Strategies

Stress Autism Mate (SAM app) was developed for and by adults with autism to detect and cope with daily life stress. The goal is to take stress measurements four times daily and develop personalized advice to reduce stress. Hoeberichts and colleagues (n.d.) conducted a study examining the efficacy of the application for people with ASD. Researchers found that adults with ASD benefited from utilizing the SAM app, with participants noting they experienced less stress and improved coping-self efficacy after four weeks of using the app. Participants also rated their quality of life higher after the four weeks. Some limitations of the study, such as the lack of a control group and small sample size, indicate that further research on coping with stress would be beneficial. Including control groups and larger samples in future studies could strengthen the evidence on the effectiveness of stress management strategies for this population. Though this is one strategy, it is important to note the impact that coping strategies can have on individuals experiencing high levels of stress.

Stress is an ongoing challenge, especially for people from marginalized groups who may lack healthcare access and have difficulty finding coping strategies tailored to their situations. However, there are some beneficial coping methods that can help manage stress, including:

• Practice mindfulness: mindfulness means maintaining awareness of our thoughts, emotions, and the environment around us. Mindfulness has been found to reduce stress, increase emotional reactivity, and increase cognitive flexibility. Body scans and breathing techniques (such as box breathing) may be helpful in the practice of mindfulness. 
• Understanding triggers: identify common individual triggers for stress and take note of them, including how one feels when they experience them.
• Make adaptations to the environment: for example, using noise-canceling headphones if it is too loud or lowering unnatural light.
• Visual schedules: making a visual schedule may be helpful in structuring the day and reducing uncertainty, therefore lowering stress surrounding daily life activities.

• Monitor energy levels: noticing how one feels after social interactions or events that may be particularly stressful, and taking time to oneself doing something you enjoy.
• Self-soothing with sensory tools and stimming: sensory tool examples may be pop-it toys, spinning chairs, weighted blankets, weighted vests, bite beads, etc.

 

Final Remarks

Stress is an unavoidable part of life that everyone experiences. While some stress can help build resilience, it can also negatively impact physical and mental health, especially for neurodiverse individuals. This blog summarizes how stress affects wellbeing and highlights tools and strategies tailored to help autistic individuals and others manage stress effectively. Finding healthy ways to cope with stress is crucial for the health and wellbeing of all people, particularly those on the autism spectrum. Customizing stress management approaches to suit each person’s unique requirements can be highly beneficial.

References

Autism Services, Education, Resources, and Training Collaborative (ASERT). (n.d.). ASSIST: Autism sensory strategies, information, and toolkit. PA Autism. https://paautism.org/resource/assist-toolkit

Bishop-Fitzpatrick, L., Mazefsky, C. A., Minshew, N. J., & Eack, S. M. (2015). The relationship between stress and social functioning in adults with autism spectrum disorder and without intellectual disability. Autism research : official journal of the International Society for Autism Research, 8(2), 164–173. https://doi.org/10.1002/aur.1433

Braveman, Paula. (2023). Stress Mediates the Health Effects of Many Social Determinants. The Social Determinants of Health and Health Disparities, 4, C4-113. https://doi.org/10.1093/oso/9780190624118.003.0004,

CDC. (2020, September 11). Frequent mental distress among adults, by disability status, disability type, and selected characteristics – United States 2018. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report. https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a2.htm

Corbett, B. A., Schupp, C. W., Levine, S., & Mendoza, S. (2009). Comparing cortisol, stress, and sensory sensitivity in children with autism. Autism research: Official journal of the International Society for Autism Research, 2(1), 39–49. https://doi.org/10.1002/aur.64

Ghanouni, P., & Quirke, S. (2023). Resilience and Coping Strategies in Adults with Autism Spectrum Disorder. Journal of autism and developmental disorders, 53(1), 456–467. https://doi.org/10.1007/s10803-022-05436-y

Gundersen, C., Mahatmya, D., Garasky, S., & Lohman, B. (2011). Linking psychosocial stressors and childhood obesity. Obesity Reviews, 12(5), e54-e63.  https://doi.org/10.1111/j.1467-789X.2010.00813.x

Healthdirect Australia. (2022, September). The role of cortisol in the body. healthdirect. https://www.healthdirect.gov.au/the-role-of-cortisol-in-the-body#:~:text=Cortisol%20is%20a%20steroid%20hormone,cortisol%20can%20cause%20health%20problems. 

Hoeberichts, K., Roke, Y.,Niks, I., Van Harten, P.N. (n.d.). Use of a mHealth Mobile Application to Reduce Stress in Adults with Autism: a Pre-Post Pilot Study of the Stress Autism Mate (SAM). Advances in neurodevelopmental disorders. Cham: Springer International Publishing.

Mind. (2023). Stress. Mind. https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/signs-and-symptoms-of-stress/

National Autistic Society. (2023). Anxiety. Advice and Guidance. https://www.autism.org.uk/advice-and-guidance/topics/mental-health

Okoro, C. A., McKnight-Eily, L. R., Strine, T. W., Crews, J. E., Holt, J. B., & Balluz, L. S. (2011). State and local area estimates of depression and anxiety among adults with disabilities in 2006. Disability and health journal, 4(2), 78–90. https://doi.org/10.1016/j.dhjo.2010.05.001

Suglia, S.F., Koenen, K.C., Boynton-Jarrett, R., Chan, P.S., Clark, C.J., Danese, A., Faith, M.S., Golfstein, B.I., Harman, L.L., Isasi, C.R., Pratt, C.A., Slopen, N., Sumner, J.A., Turer, A., Turer, C.B., & Zachariah, J.P. (2018). Childhood and adolescent adversity and cardio metabolic outcomes: A scientific statement from the American Heart Association. Circulation, 137(5), e15-e28. https://doi.org/10.1161/CIR.0000000000000536

World Health Organization. (2023, February 21). Stress. https://www.who.int/news-room/questions-and-answers/item/stress#:~:text=What%20is%20stress%3F,experiences%20stress%20to%20some%20degree