Autism vs social anxiety: Similarities and differences

Autism vs social anxiety. What’s the difference? These two mental health disorders have overlapping symptoms, but the differences determine whether you’re socially anxious or autistic.

Are you experiencing social anxiety, or are you on the autism spectrum? While there are similarities between social anxiety disorder and autism spectrum disorder (ASD), the differences determine treatment. This article covers a list of symptoms of social anxiety and autism, along with guidance on how to tell the difference between the two. 

If you identify with any of the symptoms below and are wondering where to seek help, Klarity Health is here for you. We connect you to licensed healthcare providers online or in person. Get personalized treatment for your mental health today. 

What is social anxiety? 

Social anxiety is a mental health disorder marked by intense fear and anxiety in social situations. Specifically, people with social anxiety have a fear of being judged, criticized, or scrutinized by others. 

Social anxiety is particularly problematic because humans are social creatures. Humans survived and thrived in groups, and if we were ostracized by the group, our chance of survival decreased. While today’s social situations aren’t that dire, our bodies can react as if our inability to connect is a matter of life or death — making tailored social anxiety therapy necessary. 

The symptoms of social anxiety include poor eye contact, withdrawal, thinking the worst or catastrophizing, and losing ourselves while awake or mind blanking. Physical symptoms include sweating, increased heart rate, and shortness of breath. 

Left untreated, social anxiety can become worse and lead to other general anxiety symptoms, such as changes in physical health, inability to control negative thoughts outside of social settings, and trouble concentrating and sleeping.

What is autism?

Many of the symptoms of social anxiety are also present in autistic people, including poor eye contact, social awkwardness, and fidgeting. However, there are significant differences that impact diagnosis and treatment.

While social anxiety is a mental health disorder, autism is a neurodevelopmental disorder that impacts communication, behaviors, and social interactions. 

Neurodevelopment refers to the brain’s growth of neurological paths. When we learn, we improve neurodevelopment, and when there’s a barrier to learning, those pathways are challenged. As the name suggests, there are differences in the level of neurodevelopment for those with autism spectrum disorder, from higher functioning (Asperger’s syndrome) to lower functioning (pervasive development disorder).

Because autism is a neurodevelopmental disorder and not a mental health disorder, signs of autism typically appear by age 2 or 3 and can be seen as early as 18 months. The most common symptoms seen at a young age include developmental delays, difficulty with social skills and nonverbal communication, repetitive behaviors, motor skill delays, and sensory processing deficits. 

Autism vs social anxiety: Similarities 

While several symptoms of autism and social anxiety overlap, examining the “why” behind the symptoms helps determine whether it’s autism or social anxiety. 

Difficulty in Social Situations

It may be difficult to determine who has social anxiety and who has autism just by watching how someone affected by one or the other interacts in a social situation. Both may appear withdrawn, quiet, confused, shy, or restless. But the reasons why are different.

A person with social anxiety may appear withdrawn because of their fear of judgment, while a person with autism may seem withdrawn because of differences in their brain. A person with social anxiety may have poor eye contact because of lower self-esteem. In contrast a person with autism might avoid eye contact because of sensory overstimulation from sound or light.  

A desire to spend time alone

For both socially anxious and autistic individuals, spending time alone may be a welcome break from the challenges of being in a social setting. For an autistic person, spending time alone offers a respite from overstimulation and gives them time to spend on interests, the desire for which can often be intense. 

For the socially anxious person, spending time alone means a break from perceived judgment. Without the fear of being judged or scrutinized, a person with social anxiety will benefit physically, mentally, and emotionally from being alone in a more relaxed, calm state. 

Additional symptoms of anxiety

Without treatment, anxiety symptoms for both socially anxious and autistic people can worsen. The list of anxiety symptoms experienced by both disorders may grow to include those typically associated with general anxiety, such as trouble concentrating, fatigue, an overall negative perspective, sleep disturbances, and muscle tension. 

Autism vs social anxiety: Differences

While it’s easy to see the similarities between social anxiety and autism, when we dig a little deeper, the differences come to light. And it’s the differences that answer the question of autism vs social anxiety. The table below highlights the unique differences of each disorder.

The physiological symptoms of sweating, racing heart, and feeling breathless are unique to social anxiety. Additionally, there is an intense fear of judgment and the tendency to catastrophize or think the worst. 

Unique to autism are atypical development (missing mental growth milestones), intense and sometimes obsessive interests, difficulty understanding nonverbal communication and humor, and meltdowns when feeling overwhelmed by changes or stimuli.  

How to get diagnosed/screened for autism

While autism is ideally diagnosed in early childhood, finding out you fall on the autism spectrum as an adult can improve your life in two ways. First, you have a cause for your symptoms; second, there’s help. Therapeutic support and training, such as occupational therapy, social skills training, and applied behavioral analysis, can help ease symptoms.  

While there are no medical tests to determine whether someone has autism spectrum disorder, reviewing developmental history and observing behavior can help an experienced professional make a diagnosis. Developmental history includes reviewing childhood milestones — at the ages they were crawling, talking, and learning. Anything out of the norm doesn’t necessarily lead to a diagnosis. Still, it raises a concern, which may require a more in-depth screening by a physician, psychologist, or occupational therapist. 

As an adult, visiting a doctor specializing in autism is an important first step. In addition to evaluating how you respond to specific questions and situations, your description of your symptoms and challenges is important in determining a diagnosis and subsequent treatment. 

How to get diagnosed/screened for social anxiety

A mental health provider diagnoses social anxiety.  After ruling out physical conditions that may be triggering your anxiety symptoms, the next step is to schedule for therapy. A therapist can help you work through the source of your anxiety and develop coping skills.  

Like autism, there’s no specific test for social anxiety. There are screening tools for social anxiety, such as the Overall Anxiety Severity and Impairment Scale (OASIS) and the General Anxiety Disorder Scale – 7 (GAD-7). In general, if your symptoms of fear, avoidance, and anxiety related to social situations persist for at least 6 months, you may have social anxiety disorder.  

If symptoms are debilitating or aren’t relieved with the help of a therapist, you may need to see  a psychiatrist who can prescribe medication. Medication can help decrease the impact of anxiety symptoms, which can then help you focus more constructively on therapy and on making positive changes in your daily life. 

Treatment for social anxiety

Treating social anxiety is best done through psychotherapy, medication, or a combination of both. Cognitive behavioral therapy (CBT) is one of the most popular therapeutic approaches to treating social anxiety as it teaches different ways to think, behave, and react to stressful situations. Additionally, exposure therapy, where you gradually face fearful situations, and role-playing to practice social skills can be helpful. 

Connect with a licensed healthcare provider on Klarity Health

If you feel it’s time to seek help for your anxiety, the providers on Klarity Health are here to support you. Providers on Klarity Health offer sessions online or in person, so you can choose what’s best for you. 

Are you ready to find a provider to help you reduce anxiety? Fill out this assessment form and get started today.