As parents, we want to support our kids in every way. But when a teen with autism starts showing difficult behaviors, it can be hard to recognize what’s really going on. Is it just part of autism? Typical teen moodiness? Or could it be anxiety?
According to Dr. Melissa Hendriks, a child and adolescent psychiatrist with Henry Ford Health, anxiety often hides in plain sight. “With autism, having comorbidity is often the rule rather than the exception,” she says. “Anxiety is a very common presenting problem, but it may not look the way it does in neurotypical teens.”
What anxiety can look like in your teen
Anxiety in a teen with autism may not show up as verbal worries or nervousness. Instead, parents might see:
- Increased meltdowns or shutdowns
- More repetitive behaviors or obsessive questioning
- Irritability or moodiness
- Changes in appetite or sleep
- Complaints of headaches or stomachaches
- Refusal to enter new environments or follow routines
Dr. Hendriks emphasizes that many of these behaviors can be misread.
“People might assume, well, that’s just autism or that’s defiance,” she says. “But it could be anxiety, especially if the behavior shows up around changes in routine, sensory overload or transitions.”
How autism and anxiety interact
Teens with autism may be especially vulnerable to anxiety because of how their brains process information. “Triggers might include things like not knowing what to expect, demands that exceed their abilities or sensory overload,” says Dr. Hendriks.
And because many teens with autism have trouble identifying or describing emotions, they may not be able to say, “I feel anxious.”
Instead, parents see the behavior — not the feeling behind it.
That’s why Dr. Hendriks says it’s crucial for adults to pause and ask: What’s the underlying reason here? “It relies on health care providers, teachers, and parents to work together to understand what’s really going on.”
Ways parents can support their teen at home
Even when anxiety isn’t obvious, parents can make a big difference. Dr. Hendriks recommends:
- Validate emotions: Say things like “I can see you’re really frustrated” or “It makes sense that you’re upset.”
- Avoid dismissive phrases: Skip things like “Just relax” or “There’s nothing to worry about.” It may feel invalidating.
- Use open-ended questions: Ask, “What helped you feel better last time?” or “What do you need from me right now?”
- Collaborate when calm: Talk through anxiety strategies after the stressful moment has passed.
- Create a go-to plan: Decide together what helps — turning off lights, stepping away, or staying close — and revisit the plan regularly.
And give yourself grace. “Parents may not get it right every time,” says Dr. Hendriks. “But with practice, openness and calm, they can make a huge difference.”
When to seek extra help — and where to go
If your teen’s anxiety seems to interfere with school, daily life or relationships, it may be time to reach out. Start with your pediatrician, who can offer referrals to a therapist, psychiatrist or other mental health professional.
Treatment options may include:
- Cognitive behavioral therapy (CBT) tailored for autism
- Dialectical behavior therapy (DBT)
- Occupational therapy, if sensory issues play a role
- ABA therapy, especially for help with transitions or routines
- Social skills groups, if anxiety is driven by peer interactions
Medication may also be appropriate in some cases, under the guidance of a pediatrician or psychiatrist.
You’re not alone — and your support makes a difference
Anxiety is common in teens with autism. And even if it doesn’t look the way you expected, it’s real and treatable.
“By being understanding and really trying to help understand where the teen’s coming from,” says Dr. Hendriks, “parents can play a crucial role.”
You don’t need all the answers — just a willingness to listen, learn and keep showing up. That alone can mean everything.
This content is sponsored by Henry Ford Health. Learn more at henryford.com.
Read more articles like this at Metro Parent’s Your Top Kids Health Questions — Answered!
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