Social Anxiety vs Autism: Similarities and Differences

What is the similarities and differences between autism and social anxiety? On the surface, social anxiety disorder and autism may look the same. All in all, both autistic people and those with social anxiety may experience social situations differently than others. While social anxiety and autism can occur together, the two are very different conditions. Still, even doctors sometimes get the two mixed up, leading to misdiagnoses.

It is confusing for doctors because some symptoms appear the same. While both can result in difficulty navigating social situations, social anxiety stems from fear of negative evaluation, whereas autism involves innate differences in understanding and processing social information. Want to understand the difference and similarities between autism and social anxiety disorder? Read on to learn more.

“He who has a why to live for can bear almost any how.”― Friedrich Nietzsche

Similarities Between Autism and Social Anxiety

Additionally, a major similarity between social anxiety disorder and autism spectrum disorder (ASD) is that both conditions present differently in every person.

 Social skills

A key trait of ASD is differences in social interaction, such as difficulty maintaining eye contact, different body posture, and speech qualities such as tone, volume, and rate.

Although this is not the case for all people with ASD, many with this disorder prefer limited social communication and might appear quiet or withdrawn in social situations.
Due to those with SAD being anxious in social situations, they are also likely not to speak so much, talking quietly, and may present with a less confident posture.

 Spending time alone

Basically, those with ASD and SAD may be more likely to want to spend time alone than be in social situations, although the reasons for avoiding these situations are different.

 Anxiety

An obvious trait of SAD is severe anxiety symptoms, especially in social situations. It is also common for people with ASD to experience extreme anxiety in social situations, such as feeling nervous or only being comfortable around a few certain people.

The Differences between Autism and Social Anxiety

While ASD and SAD share a lot of similarities with each other, they are distinct conditions in many ways.

The main difference is that ASD is a neurodevelopmental condition while SAD is a mental health condition. Below are some of the other key differences between these disorders:

Symptoms are present in ASD, which are not common in those with SAD. People with ASD may:

Firstly, have atypical development, such as hitting milestones differently.
Present with repetitive movements and noises – stimming.
Have passionate special interests.
Have sensory differences (e.g., finding bright lights overstimulating or preferring to wear certain fabrics over others).
Have motor skill delays or difficulties.
Miss social cues or understand certain humor.
Lastly, have meltdowns and/or shutdowns when overwhelmed.

There are also physical symptoms that are present in SAD when in social situations but are not common in those with ASD:

Sweating
Rapid heartbeat
Feeling breathless
Shaking or trembling
Persistent difficulties in social communication, including but not limited to lack of back-and-forth conversations and differences in eye contact.
Repetitive patterns of behavior.
Symptoms were present in early development, even if they went unnoticed.
The symptoms interfere with daily functioning.

Consequently, it is not just SAD, which is common in those with ASD – in a review of around 30 studies of Autistic children, almost 40% had at least one associated anxiety disorder.

Due to the struggles of trying to navigate a neurotypical world, those with ASD may find life very anxiety-inducing, which may be why so many of them develop anxiety disorders.

Although a lot of people with ASD experience anxiety, not all of them do and find that they can navigate their way through the world in a way that is comforting to them.

Can ASD Be Misdiagnosed As SAD?

Often due to similarities in socially related traits in both ASD and SAD, a misdiagnosis of SAD may be given when it could be, in fact, Autism. Although, this is most likely to happen for girls and women with ASD who present struggles with social situations. There are a number of reasons why females are more likely to be diagnosed with SAD than ASD. The first is that Autism has typically been viewed as a mostly male disorder.

Much early research and theorists, which helped develop our understanding of autism, used primarily male individuals with ASD in their studies. Therefore, the way that Autism is conceived, measured, and diagnosed probably revolves around a male-centric presentation (Hiller et al., 2016). Autistic females may be more likely to experience bullying from their peers for acting ‘socially inappropriate’ in conversations. So many females with Autism have learned to mask (or camouflage) their Autistic traits to fit in (Head et al., 2014).

Therefore, this means that they have learned to hide their autistic traits by forcing eye contact, using learned phrases, mirroring others’ social behavior, and imitating facial expressions.

Since females with autism can be good at hiding their autistic traits, this can make it harder for others to notice that they are Autistic. This may result in the anxiety in social situations escalating, meaning they can be more likely to be diagnosed with SAD than ASD.

“If you want to be happy, do not dwell in the past, do not worry about the future, focus on living fully in the present.”― Roy T. Bennett, The Light in the Heart

Symptoms of Autism Spectrum Disorder and Social Anxiety

 Autism

Subsequently, common signs of autism in adults include:

firstly, finding it hard to understand what others are thinking or feeling
getting very anxious about social situations
finding it hard to make friends or preferring to be on your own
seeming blunt, rude or not interested in others without meaning to
finding it hard to say how you feel
taking things very literally – for example, you may not understand sarcasm or phrases like “break a leg”
lastly, having the same routine every day and getting very anxious if it changes

Altogether, other symptoms are present in ASD, which are not common in those with SAD. People with ASD may:

Have atypical development, such as hitting milestones differently.
Present with repetitive movements and noises – stimming.
Have passionate special interests.
Have sensory differences (e.g., finding bright lights overstimulating or preferring to wear certain fabrics over others).
Have motor skill delays or difficulties.
Miss social cues or understand certain humor.

 Social Anxiety

When having to perform in front of or be around others, people with social anxiety disorder may:

Firstly, blush, sweat, or tremble.
Have a rapid heart rate.
Feel their “mind going blank,” or feel sick to their stomach.
Have a rigid body posture, or speak with an overly soft voice.
Find it difficult to make eye contact, be around people they don’t know, or talk to people in social situations, even when they want to.
Feel self-consciousness or fear that people will judge them negatively.
Lastly, avoid places where there are other people.

Conclusion

A considerable proportion of individuals with ASD also fulfill the criteria for SAD, meaning it is possible to have both disorders. Hence, it is thought that up to 50% of Autistic individuals qualify for a diagnosis of social phobia, compared to 7-13% in non-ASD individuals (Spain et al., 2018).

However, this may be because those with ASD often struggle socially and are at risk of being bullied. As a result of the trauma of being bullied and fear of this happening again, these individuals may develop social anxiety as a result.

Consequently, it is not just SAD, which is common in those with ASD – in a review of around 30 studies of Autistic children, almost 40% had at least one associated anxiety disorder.

Due to the struggles of trying to navigate a neurotypical world, those with ASD may find life very anxiety-inducing. Therefore, this may be why so many of them develop anxiety disorders.