What are some healthy ways I can learn to express what I'm feeling and how I can stay in the moment?

I am autistic, and have ADHD, with a bit of anxiety as well. During stressful and high anxiety experiences, I tend to become unaware and freeze up basically.
Asked by Hiccups
Answered
10/07/2022

Hello Hiccups!

Thank you for your question. 

You indicated that you are autistic, and have ADHD and anxiety. My first question would be "do you have a psychiatrist, a psychiatric APRN, or any other kind of doctor who has made these diagnoses and/or treats you for these conditions?" If you and I were working together, I would consider this important information to ensure that your provider and I do not provide you with conflicting information. And also, if you did have a provider, I would want to know what, if anything, that person has suggested that you try to help with your symptoms. So that would be first on the list.

Then you said that you become unaware and sort of freeze up when you experience high anxiety and stress. This would suggest that your body is interpreting various situations as "threats" and is automatically going into the "fight/flight/freeze" mode. Our nervous system tends to respond to perceived threats even before we are able to process the situation with our logical brain.

Probably the most common suggestion that you would likely hear (although this would not be the only one) would be to learn mindfulness practices. This would involve learning to take note of what your body is telling you on a pretty regular basis. Awareness of thoughts and feelings (both emotional and physical) are important aspects of mindfulness. What am I thinking? What am I feeling? The purpose of this is to be able to notice if/when we are starting to escalate so that we can take some action before it gets any worse.

There are many mindfulness practices that help calm the nervous system. The most common -- the easiest technique -- is intentional breathing -- deep breathing. Deep breathing helps to calm down the nervous system. There is a therapy called Dialectical Behavior Therapy (DBT for short) that is essentially a curriculum of skills that help people learn how to manage strong emotions. If we were working together, I would provide you with DBT information. These skills would be very helpful not only to avoid emotional dysregulation but also to manage it if it has already started.

There are certainly other skills that would help with both the ADHD and the anxiety. For example, having a fairly organized schedule written on a calendar will help keep you on task. Creating a "to do" list helps people manage their time better so they don't become overwhelmed and stressed. Learning boundary skills such as saying "no" to things you just don't have time to do (or don't want to do) also helps with stress and anxiety. Keeping an organized home and work space helps with stress, anxiety, and the symptoms of ADHD. So all of this could probably be summed up under the heading of "planning and organizing." These  skills are very helpful in maintaining a sense of calm.

Many people like to use meditation techniques to help with their strong feelings. Meditation does not have to be difficult. It can be a traditional approach or it can be as simple as taking a walk among the trees and just noticing the features of the trees.

Self care is also important on a regular daily basis. I call this taking care of your emotional bank account. Your EBA is like a regular bank account -- money in, money out. No money in, no way to pay bills. Same with your EBA. Every day that you get out of bed and do whatever you do during the day you are making withdrawals from your EBA. You have to make regular deposits to have a reserve to draw from. When a person does not have anything in their EBA, the withdrawals tend to feel something like stress, anger, frustration, depression and anxiety. So taking care of yourself very regularly is important to managing these strong emotions.

Many people do not have a good understanding of autism, anxiety, ADHD, and the fight/flight/freeze response. So, helping the people who are in your environment to understand these conditions and symptoms would be helpful to you as well. You could educate them as to what would be most helpful to you in certain situations.

And then you also want to be able to express what you are feeling. Learning a "feelings vocabulary" along with healthy assertiveness skills (which is part of the DBT curriculum) would help you identify and express to others what you are feeling and what you need or want from them.

One other skill that is worth mentioning is called exposure therapy. It just means that you expose yourself little by little in small increments to situations that cause you high anxiety. You start out very small and work your way up every so slightly each time -- like going up the steps of a ladder -- until you get to a place where you can tolerate the situation that you fear or makes you anxious.

Another skill would be to examine your thinking patterns to see where you can reframe your thoughts about a situation so that the situation is not quite so frightening or anxiety provoking.   

These are many, but not all, of the techniques that you could use to help manage your symptoms. There certainly are others. I hope you have found this overview helpful.

Judi

(MA, LMHP, LADC)