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Coronavirus (COVID-19) Health and Safety Guide

ASERT has put together some resources for those with autism and those who care for people with autism relating to the current Coronavirus outbreak.

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Be Well, Think Well Resources

Mental Health Resources

Welcome to the mental health resource collection created by the ASERT Collaborative. This page features a collection of mental health resources developed by the ASERT team. These resources are designed to help people understand the mental health challenges experienced by individuals with autism.

Mental health problems impact the way that people think, feel, and behave. These mental health problems can affect functioning for people diagnosed with autism even more. Therefore, we have created a variety of resources that can help a variety of people understand the impact of mental health problems for individuals with autism. We have developed resources specifically for self-advocates with autism, parents and caregivers, first responders, and professionals.

Information about general mental health treatment is followed by specific information about each mental health disorder. All anxiety information is grouped together by tabs, followed by information on depression.

Anxiety Information and Resources

What is Anxiety?

Anxiety is a normal emotion that everyone feels. Anxiety helps us react the right away when we’re in danger. However, our brains sometimes think there is danger when there is none.

Why do people feel anxious?

You might have heard people describe anxiety as worry, uncertainty, concern, fear, or stress. These are all different words for anxiety.

Some causes of anxiety may include:

  • Going certain places, like school or the doctor’s office.
  • Being in social settings, like making friends or going to parties.
  • Specific things like heights, bugs, or clowns.

People might feel nervous when they are around these things

Signs of anxiety

  • Anxiety affects how people think, feel, or behave and can make our bodies feel differently.
  • Some people might feel sick to their stomach, sweaty, have a hard time breathing, or trouble thinking clearly.
  • Anxiety causes people to “Fight, Flight or Freeze.”
  • Some people “fight” when they are anxious. This means they may argue, becoming angry, yell, or becoming physically aggressive.
  • Some people experience feelings that make them want to take “flight,” or that they have to run away or get out of the situation immediately.
  • Other people “freeze” when they are anxious. This may make them feel like they can’t talk, feel stuck in their body, have trouble remembering what happened, or feel cold.
  • Other signs of anxiety for people with autism may include an increase in self-stimulatory behaviors, asking repetitive questions, having a harder time communicating, or pacing.

What is next?

If you feel like your anxiety is severe or causing problems in your everyday life, there are
different ways to help.

  • Therapists can help teach how to recognize the signs of anxiety and different coping strategies.
  • Doctors can prescribe medications when anxiety impacts everyday life.

Signs and Symptoms of Anxiety

Anxiety is common for individuals with autism and can look very different depending on the person and the situation.

Asking repetitive questions or being preoccupied about one subject

The person may ask questions over and over. These questions might not be related to the current situation. The questions may or not make sense to the listener. This person is checking to make sure things have not changed.

Attempting to elope or wander away

The person may go to a place that feels more comfortable. The person may try to get away from a person, place or situation that is uncomfortable

Increase in stimming behaviors

“Stimming” (self-stimulating) behaviors are things the person does to try and change the way they feel. Some of the common stimming behaviors in autism are rocking back-and-forth, spinning in circles and flapping their hands. If a person is doing these behaviors more than usual, it might be a sign that they are anxious.

Decreased abilities

The person might have a harder time talking or telling people how they feel. The person might have a harder time doing things they already learned how to do.

Increase in self-injurious behavior

The person might pull on their hair or eyelashes. The person might scratch himself/herself until they bleed. The person might bang their head against hard surfaces. The person might cut or burn himself/herself on purpose.

Increased irritability

The person might refuse to do things or go places they used to enjoy. Even when the person does their favorite activity, they don’t appear to enjoy it as much as they used to. The person might try to spend more time away from other people.

Differences Between Obsessive-Compulsive Disorder and Autism

There are many symptoms of Obsessive-Compulsive Disorder (OCD) and autism that are similar. It can be hard to know if symptoms are due to one diagnosis or the other, or if a person has both.

What is OCD?

Obsessions are thoughts that are hard to ignore or make go away. These thoughts are usually fears like:

  • Getting sick and dying from germs
  • That you have hurt someone
  • A need to do things or feel “just right”

There are different types of obsessions that people with OCD can have. In order to get rid of these “obsessions,” people do certain behaviors over and over. These are called “compulsions.” Common compulsions include:

  • Excessive washing or cleaning
  • Checking things over and over
  • Repeating actions or phrases until it feels “just right”

 

Symptoms of Autism Similar to OCD

Obsessions and Perseverations

Many people with autism have unique interests and it may seem like they are “obsessed” with those topics. Unlike obsessive thoughts in OCD, these interests aren’t upsetting to the person or make them anxious. Often these interests are considered hobbies. Obsessions in OCD are not things people like a lot, they are intrusive, reoccurring thoughts that are scary, upsetting and cause anxiety.

Repetitive Behavior

For people with autism, repetitive behaviors are often a way to help manage overwhelming situations. Their behaviors may help them calm down, relax or feel good. For people with OCD, the repetitive behaviors to decrease anxiety based on their obsessive thoughts. These behaviors often make the person feel bad, and only decrease their anxiety for a little bit.

OCD in ASD

Some people with autism are also diagnosed with OCD. This means they show obessive and compulsive behaviors that cause problems and impairs their everyday life. They also have to be more or in addition to the person’s typical symptoms of autism. If you think a person with autism may also have OCD, it should be discussed with the individual’s doctor.

Panic Attacks

What do panic attacks look and feel like?

The sudden onset of intense fear and anxiety may mean someone is having a panic attack. During a panic attack, they may feel like they are losing control or that danger is near, even if there is none.

During a panic attack, people may feel very anxious or have feelings that make them think they’re dying. These may include a fast heartbeat, sweating, shaking, inability to catch breath, nausea, chest pain and dizziness.

Panic attacks usually only last a few minutes but can be scary. The person may think about panic attacks and worry about having another one. They may avoid people, places or things due to fear of triggering another attack.

What can I do to help people who experience panic attacks?

Panic attacks can be treated by therapy and/or medication. Cognitive Behavior Therapy (CBT) is commonly used to help people think differently and practice managing their reactions. Medications may also be part of treatment.

Other downloads

Name Description Type File
What is Anxiety? This resource provides basic information about anxiety. pdf Download file: What is Anxiety?
Signs and Symptoms of Anxiety This resource provides information to help you recognize signs and symptoms of anxiety for individuals who have autism. pdf Download file: Signs and Symptoms of Anxiety
Panic Attacks This resource provides information about what a panic attack looks and feels like and what you can do to help people who experience them. pdf Download file: Panic Attacks
Differences Between Obsessive-Compulsive Disorder and Autism This resource will review some of the differences between these diagnoses. pdf Download file: Differences Between Obsessive-Compulsive Disorder and Autism

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.

Tips for Working with Individuals with Autism and Anxiety

  • Be aware of stressful environments.
    People with ASD are often nervous or anxious in new places. People can get easily upset by places that are noisy or crowded. or anxious in new places. People with ASD can also feel easily upset by crowded places and places that are very noisy.Think about the environment you are going in and prepare for stress ahead of time. Bring soothing objects, headphones, or technology to help the person cope better with stress.
  • Prepare the person for a change in their routine as much as possible.
    Some people may feel more anxious when their schedule is changed. Tell the person about changes in their schedule ahead of time to help them to feel ready for it.
  • Give simple directions when the person you are working with is really anxious.
    Make sure your directions are clear. Try giving one direction at a time. Give them plenty of time to think about what you said. Remember, people with ASD need to be given longer to understand and respond.
  • Know their coping skills.
    Some people find distractions, music, games or a comfort item helpful when they are anxious. Know what works for the individual that you are supporting. Make sure there are multiple calming strategies in case one item or activity is unavailable.
  • Teach skills to decrease anxiety.
    Help them practice coping skills even when they are calm. You can do this by acting it out or using social stories. Other strategies include: teach deep breathing and how to control their breathing, how to ask for a break from an activity, and how to ask for other things that help them feel calm.

Know where to get help.

  • Think about who else might have a good relationship with the individual. Family members, other staff members, and supervisors can be good people to help with more tips.
  • Talk with your supervisor about other ways you can help in crisis situations. Ask if there is training available to improve your own skills.
  • If needed, help the person to make an appointment with their primary doctor, psychiatrist, or therapist. Let the doctor know about the problems with anxiety.
  • Put emergency numbers (like a family members, number, the crisis hotline or 911) somewhere the individual can easily find them. It may be helpful to hang them on the wall near a phone or to save them in a cell phone’s contact list.

Supporting Someone Through A Panic Attack

Panic attacks can be scary and overwhelming for both the person experiencing it and those around them. The information below explains how to help someone who is experiencing a panic attack.

Remain calm

It’s important that you appear calm and relaxed in order to avoid escalating the person further. Appearing calm can also help model behavior that you want the person to follow. Keep your voice quiet, relaxed and talk slowly. Although panic attacks are intense and can look scary, they are not life threatening. Keeping this in mind may help you remain calm and be a positive support for the individual.

Talk to them

People get lost in their thoughts when having a panic attack. Talking can help distract them from their thoughts. Ask them questions, but keep them brief and simple. You don’t want to overwhelm them. Ask them to describe what they see or hear around them in that moment. You can also ask what you can do to help to make sure you’re providing them with the type of support they need.

Walk them through coping skills

A person may have racing thoughts when experiencing a panic attack, making it difficult to remember to use their coping strategies. One way you can help support them is by reminding them of strategies that help them relax. Prompting them to take slow, deep breaths and modeling it for them may be helpful. Remind them that they are safe. Prompt them to think of a place that makes them happy and have them describe every detail.

Reassure them

A little comfort can go a long way in a panic attack. Remind them that what they’re experiencing is not dangerous and it will not last forever. Be sure to be positive and give positive feedback about how they’re handling the attack. Keep your statements short and clear.  They can only handle so much while they’re experiencing panic symptoms.

Stick with them

Being alone can be frightening during a panic attack. Staying with them as they gradually come out of the panic attack will help them get through it and may also help strengthen your relationship with that person. Once the panic attack stops you’ll want to acknowledge how difficult the experience must have been and praise them for getting through it.

Relaxation Techniques

If you experience anxiety or stress, you may have heard someone recommend relaxation techniques. There are many types of relaxation techniques that are used to help anxiety and stress. Everyone is different and not all relaxation techniques will work for everyone.

Breathing is the only bodily function that we do both voluntarily and involuntarily, meaning that you breathe on your own without thinking, but are also able to change your breathing when you want to.

During times of stress, there may be changes in body functions – heart rate rises, sweating occurs, muscles tense, and breathing becomes rapid and shallow.

These physical changes can affect how people think and feel. If a person is anxious and their breathing becomes faster, this can make them feel even more anxious. To help get rid of those feelings, individuals can practice deep breathing, also called abdominal or diaphragmatic breathing.

Steps for Deep Breathing

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Place one hand on the chest and the other on the stomach.
  3. Take a slow, deep breath in through the nose for a count of between 5 and 10. The
    hand on the stomach should move first and further than the one on the chest. This shows that the diaphragm is pulling air deep into the lungs.
  4. Hold the breath for a count of between 5 and 10, but not so long to be uncomfortable.
  5. Exhale slowly through the mouth for a count of between 5 and 10. Gently squeeze the stomach muscles to completely remove the air from the lungs.
  6. Repeat this cycle four more times for a total of 5 deep breaths.
  7. Should be done at least twice a day to start, or whenever a person notices signs of anxiety

Anxiety and stress can cause a person to think negatively and imagine the worst happening. Imagery can help them focus on positive and pleasant memories and experiences and help combat negative thoughts. Focusing on these types of mental images can help the person feel relaxed.

Steps for Using Imagery

1. Be relaxed in a quiet, comfortable place with eyes closed.

2. Think of a calming place in your mind. Don’t just think of the place briefly, but imagine every detail about it. Go through each of the senses – sight, sound, touch, taste, and smell – and imagine what someone would experience in that place.

3. Here’s an example using a beach.

  • Sight – sun in the sky, sand under your feet, crystal clear water, calm waves rolling in
  • Sound – rustling waves, seagulls in the sky, wind blowing
  • Touch – sand or water under feet, warm sun on skin, wind on skin
  • Taste – saltwater in your mouth, cool glass of lemonade
  • Smell – ocean air and salt water, sunscreen

4. Imagine this scene for as long as possible or at least until anxiety begins to lower. If negative thoughts or imagines try to pop up, return thoughts to the calming place and try to stay focused on the relaxing image.

When people feel anxious, their muscles may get tense and make them feel stiff or sore. Progressive muscle relaxation teaches people to relax their muscles and lower tension. It also helps people learn to identify when they are experiencing stress so they can handle it better.

Steps for Using Progressive Muscle Relaxation

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Tense muscle groups, one by one. Use the diagram and instructions below as a guide, starting from the top and moving down the body.
    • Forehead: raise your eyebrows
    • Eyes: clench your eyelids tightly shut
    • Mouth: open your mouth wide to stretch the hinges of jaw
    • Neck and shoulders: raise your shoulders to touch your ears
    • Chest: tighten by taking a deep breath
    • Stomach: suck in your stomach
    • Arm: tighten your biceps and “make a muscle”
    • Hand: clench your fist
    • Buttocks: tighten by squeezing your buttocks together
    • Leg: squeeze your thigh muscles
    • Lower leg: tighten your calf muscle by pointing toes up
    • Foot: curl your toes under
  3. Hold the tension for 5 seconds for each body part, then release.
  4. Notice how the muscles feel when you relaxed.
  5. This should take about 15 minutes to complete, and be practiced twice a day to start.

A diagram used for Progressive Muscle Relaxation highlighting ways to move forehead, eyes, mouth, neck and shoulders, chest, stomach, arm, hand, buttocks, leg, lower leg, and foot.

  • Forehead: raise your eyebrows
  • Eyes: clench your eyelids tightly shut
  • Mouth: open your mouth wide to stretch the hinges of jaw
  • Neck and shoulders: raise your shoulders to touch your ears.
  • Chest: tighten by taking a deep breath
  • Arm: tighten your biceps and “make a muscle”
  • Hand: clench your fist
  • Stomach: suck in your stomach
  • Buttocks: tighten by squeezing your buttocks together
  • Leg: squeeze your thigh muscles
  • Lower leg: tighten your calf muscle by pointing toes up
  • Foot: curl your toes under

Panic attacks can be scary. You might feel overwhelmed, like you can’t breathe, or like you are having a heart attack. This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called grounding techniques. Grounding techniques can help you calm down quickly.

Steps for using Grounding Techniques

1. Scan the Room
Take a look around you. Reminding yourself that you’re safe can reduce the panic and help you return to normal.

2. Relax Your Body
It’s sometimes easier to relax your body than it is to relax your mind. Relaxation techniques can help your body relax and calm your mind. Take slow, deep breaths. Breathe in through your nose. Pay attention to the feeling of your lungs getting bigger as you breathe in. Then breathe out through your mouth. Repeat this for a minute or two and feel the tension leaving your body.

3. The 5-4-3-2-1 Grounding Technique
During a panic attack, people can get stuck in their thoughts. Try to focus on things that are going on around you. Pay attention to all five senses. To do this, concentrate really hard. Name five things you can see around you. Name four things you can feel. Name three things you can hear. Name two things you can smell. Name one thing you can taste. Repeat until you’ve calmed down.

4. Picture a Calm Place in Your Mind
Think about a place where you feel totally calm. Maybe it’s a beach, a forest, or a special place you go that makes you feel calm. Take a few moments and take some deep breaths. Close your eyes. Imagine yourself in your calm place. Think about all of the details. Imagine the sights, smells, noises, and temperature. Really try to imagine what it would be like if you were there. Imagine yourself in your calm place for a few minutes before you open your eyes.

Other downloads

Name Description Type File
Be Well, Think Well: Deep Breathing Relaxation Technique This resource provides information about one relaxation technique, Deep Breathing. pdf Download file: Be Well, Think Well: Deep Breathing Relaxation Technique
Be Well, Think Well: Imagery Relaxation Technique This resource provides information about one relaxation technique, Imagery. pdf Download file: Be Well, Think Well: Imagery Relaxation Technique
Be Well, Think Well: Progressive Muscle Relaxation This resource provides information about one relaxation technique, Progressive Muscle Relaxation. pdf Download file: Be Well, Think Well: Progressive Muscle Relaxation
Be Well, Think Well: Supporting Someone Through A Panic Attack This resource provides some techniques to help others cope with panic attacks. pdf Download file: Be Well, Think Well: Supporting Someone Through A Panic Attack
Be Well, Think Well: Tips for Working with Individuals with Autism and Anxiety This resource provides some tips and suggestions that staff can use to recognize when someone is anxious and help lower their anxiety. pdf Download file: Be Well, Think Well: Tips for Working with Individuals with Autism and Anxiety
Be Well, Think Well: Grounding Techniques for A Panic Attack This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called grounding techniques. Grounding techniques can help you calm down quickly. pdf Download file: Be Well, Think Well: Grounding Techniques for A Panic Attack

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.

Managing Anxiety

Anxiety is normal and helps keep us safe and lets us know if there’s danger. Having some anxiety is okay, but too much can be bad.

CHANGE HOW YOU THINK: Learning how to solve problems can help you feel more confident and less anxious- Learn that you can’t control everything, and that’s okay – Try to stay positive – Learn that everyone makes mistakes, and that’s okay too

BE ACTIVE: Exercise can help you relax – Spend time outdoors

TAKE A BREAK: Do something relaxing that you enjoy- Practice meditation – Listen to calming music – Watch funny movies, TV or videos -Read- Paint, draw or doodle -Play games – Take a warm shower or bath

TAKE DEEP BREATHS: Taking long, slow breaths in through the nose and out through the mouth can help you relax if you’re feeling anxious

GET SOME SLEEP: Getting plenty of sleep helps your body rest and handle stress better

 

LEARN WHAT MAKES YOU ANXIOUS: Write down when you feel anxious – Pay attention to where you are, what you are doing and who is with you – This can help show who or what makes you anxious

AVOID STRESS: Taking long, slow breaths in through the nose and out through the mouth can help you relax if you’re feeling anxious

TALK IT OUT: Surround yourself with supportive friends and family – Express your feelings and talk when things bother you

EAT WELL: Eating healthy foods like fruits and vegetables helps your body work better and handle stress and anxiety more easily – Reduce how much caffeine and sugar you eat – Avoid alcohol, cigarettes, and drugs

How to Face Your Fears

Some people have fears and things that make them feel anxious. It’s important to be able to manage these feelings so they don’t get in the way of everyday life.

1. Create a plan

Anxiety can make people want to avoid the things that make them scared or afraid. Avoiding these things doesn’t help people learn ways to cope with or face their fears. Make a plan to face your fears. Start with things that are less scary, then work your way up to bigger challenges. Over time, you will learn that you are able to control these worries and face your fears.

2. Know your supports

Family members, friends, teachers, and support staff can help you create your plan. They can also cheer you on and provide help as you work through your plan.

3. Start small

As you develop your plan, make sure you break it into small steps that are easier to reach. You can always push yourself to do more. It’s important to have success as you work on the next step.

4. Use your calming skills

Find ways to help you to stay calm as you practice facing your fears. There are lots of different ways to help relax and stay calm when feeling anxious. Things like taking deep breaths, listening to music, writing down your thoughts, talking to a friend or family member, or watching a favorite show or movie are some examples.

5. Reward yourself for trying

You don’t have to master each step on your first try. Fear is a hard thing to overcome. Give yourself a reward every time you try deal with your fear, even if it did not end the way you had hoped.

Therapies for Anxiety

Therapy can be useful to decrease anxiety. A psychologist or therapist provides therapy to treat mental health concerns like anxiety or depression.

Cognitive Behavioral Therapy (CBT)

CBT focuses on how thoughts, behavior, and feelings affect each other. Therapists who use CBT teach new ways to behave and think in order to lower anxiety. This therapy usually only lasts a short period of time, between 8 and 12 sessions.

Acceptance and Commitment Therapy (ACT)

ACT teaches people to focus on the present moment and pay less attention to thoughts that may be causing anxiety. ACT focuses on the person’s values and helping them identify ways to live in a way that is meaningful to them, rather than letting emotions and anxiety change their behavior. ACT treatments are usually between 10 and 15 sessions.

Cognitive Therapy (CT)

Our thoughts are often affected by past experiences and our
emotions. CT teaches the person to look at their thoughts in a more objective way. CT also helps to teach people to tolerate uncertainty as a way to help reduce anxiety. CT treatments may last up to 20 sessions.

Applied Relaxtion

Applied relaxation focuses on teaching coping strategies that help people relax quickly when they’re anxious. Applied relaxation is used during situations that make the person anxious, in order to interrupt and stop the anxiety from getting worse. Over time and with practice, the person can apply these relaxation techniques when they start feeling anxious, without having to think about using them. Applied relaxation typically lasts up to 15 sessions.

Relaxation Techniques

If you experience anxiety or stress, you may have heard someone recommend relaxation techniques. There are many types of relaxation techniques that are used to help anxiety and stress. Everyone is different and not all relaxation techniques will work for everyone.

Breathing is the only bodily function that we do both voluntarily and involuntarily, meaning that you breathe on your own without thinking, but are also able to change your breathing when you want to.

During times of stress, there may be changes in body functions – heart rate rises, sweating occurs, muscles tense, and breathing becomes rapid and shallow.

These physical changes, this can affect how people think and feel. If a person is anxious and their breathing becomes faster, this can make them feel even more anxious. To help get rid of those feelings, individuals can practice deep breathing, also called abdominal or diaphragmatic breathing.

Steps for Deep Breathing

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Place one hand on the chest and the other on the stomach.
  3. Take a slow, deep breath in through the nose for a count of between 5 and 10. The
    hand on the stomach should move first and further than the one on the chest. This shows that the diaphragm is pulling air deep into the lungs.
  4. Hold the breath for a count of between 5 and 10, but not so long to be uncomfortable.
  5. Exhale slowly through the mouth for a count of between 5 and 10. Gently squeeze the stomach muscles to completely remove the air from the lungs.
  6. Repeat this cycle four more times for a total of 5 deep breaths.
  7. Should be done at least twice a day to start, or whenever a person notices signs of anxiety

Anxiety and stress can cause a person to think negatively and imagine the worst happening. Imagery can help them focus on positive and pleasant memories and experiences and help combat negative thoughts. Focusing on these types of mental images can help the person feel relaxed.

Steps for Using Imagery

1. Be relaxed in a quiet, comfortable place with eyes closed.

2. Think of a calming place in your mind. Don’t just think of the place briefly, but imagine every detail about it. Go through each of the senses – sight, sound, touch, taste, and smell – and imagine what someone would experience in that place.

3. Here’s an example using a beach.

  • Sight – sun in the sky, sand under your feet, crystal clear water, calm waves rolling in
  • Sound – rustling waves, seagulls in the sky, wind blowing
  • Touch – sand or water under feet, warm sun on skin, wind on skin
  • Taste – saltwater in your mouth, cool glass of lemonade
  • Smell – ocean air and salt water, sunscreen

4. Imagine this scene for as long as possible or at least until anxiety begins to lower. If negative thoughts or imagines try to pop up, return thoughts to the calming place and try to stay focused on the relaxing image.

When people feel anxious, their muscles may get tense and make them feel stiff or sore. Progressive muscle relaxation teaches people to relax their muscles and lower tension. It also helps people learn to identify when they are experiencing stress so they can handle it better.

Steps for Using Progressive Muscle Relaxation

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Tense muscle groups, one by one. Use the diagram and instructions below as a guide, starting from the top and moving down the body.
    • Forehead: raise your eyebrows
    • Eyes: clench your eyelids tightly shut
    • Mouth: open your mouth wide to stretch the hinges of jaw
    • Neck and shoulders: raise your shoulders to touch your ears
    • Chest: tighten by taking a deep breath
    • Stomach: suck in your stomach
    • Arm: tighten your biceps and “make a muscle”
    • Hand: clench your fist
    • Buttocks: tighten by squeezing your buttocks together
    • Leg: squeeze your thigh muscles
    • Lower leg: tighten your calf muscle by pointing toes up
    • Foot: curl your toes under
  3. Hold the tension for 5 seconds for each body part, then release.
  4. Notice how the muscles feel when you relaxed.
  5. This should take about 15 minutes to complete, and be practiced twice a day to start.

A diagram used for Progressive Muscle Relaxation highlighting ways to move forehead, eyes, mouth, neck and shoulders, chest, stomach, arm, hand, buttocks, leg, lower leg, and foot.

Panic attacks can be scary. You might feel overwhelmed. You might feel like you can’t breathe. You might feel like you are having a heart attack. This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called “grounding” techniques. Grounding techniques can help you calm down quickly.

Steps for using Grounding Techniques

1. Scan the Room
Take a look around you. Reminding yourself that you’re safe can reduce the panic and help you return to normal.

2. Relax Your Body
It’s sometimes easier to relax your body than it is to relax your mind. Relaxation techniques can help your body relax and calm your mind. Take slow, deep breaths. Breathe in through your nose. Pay attention to the feeling of your lungs getting bigger as you breathe in. Then breathe out through your mouth. Repeat this for a minute or two and feel the tension leaving your body.

3. The 5-4-3-2-1 Grounding Technique
During a panic attack, people can get stuck in their thoughts. Try to focus on things that are going on around you. Pay attention to all five senses. To do this, concentrate really hard. Name five things you can see around you. Name four things you can feel. Name three things you can hear. Name two things you can smell. Name one thing you can taste. Repeat until you’ve calmed down.

4. Picture a Calm Place in Your Mind
Think about a place where you feel totally calm. Maybe it’s a beach, a forest, or a special place you go that makes you feel calm. Take a few moments and take some deep breaths. Close your eyes. Imagine yourself in your calm place. Think about all of the details. Imagine the sights, smells, noises, and temperature. Really try to imagine what it would be like if you were there. Imagine yourself in your calm place for a few minutes before you open your eyes.

Medication for Treating Anxiety and Depression

Sometimes doctors will prescribe medicine to help with anxiety and depression.

Depression 

When people take medicine for depression, they usually take it for at least 6-12 months. It may take this type of medicine a few weeks to work. Once you begin to feel better, your doctor may want you to keep taking the medicine for another 6-9 months.

Anxiety

Some medicines for anxiety work the first time you take it. Others may take days or weeks to work. Some may even make you feel more anxious the first few days you take it. This can be normal and should go away after a few days.

REMEMBER!

  • Never stop taking your medicine without talking to your doctor
  • It’s important to not miss doses of medicine. Use reminders, such as alarms on your smart phone, or using a weekly pill container placed where you will see it
  • Never share your medications with others
  • Always talk with your doctor if you have any side effects
  • If you don’t feel like you’re getting better, talk to your doctor
  • Keep appointments and check ups with your doctor, they’re very important
  • Your doctor may ask that you do other things to help your physical and mental health. These may include therapy, healthy food, exercise, or a daily schedule with the right amount of sleep. It’s important to follow these as best as you can

How To Find a Therapist for an Individual with Autism

1. Contact the insurance company

Insurance companies can be a great starting point for the search for a therapist. You can typically search for local therapists through the insurance company’s online self-service portal or by calling the customer service number on the back of the insurance card. You can find out what therapists are nearby, what insurance they accept, and whether or not they’re accepting new patients. If the person has medical assistance, contact the Special Needs Unit for additional help.

2. Psychology Today

Psychology Today is another great resource for finding a therapist. Their therapist directory can match people to a number of qualified therapists nearby. Therapist profiles typically include what insurance plans they accept, how much they charge, and what the therapist specializes in treating, letting you know exactly what to expect before scheduling the appointment. However, it’s good to contact the therapist to verify the information on the website and make sure they have experience working with individuals who have autism before scheduling an appointment.

3. Ask a healthcare provider

Primary care physicians often have therapists or agencies that they partner with and can give a referral. An added benefit is that they may be able to answer some questions about the provider and the services that they offer before contacting them to schedule a session.

4. Do some research

When choosing a therapist it’s important to know that type of treatment they use. Some types of treatment are better than others depending on the mental health condition, and have research to support using those strategies. These are called Evidence Based Practices. Research the treatment types local providers specialize in to select a therapist that uses an Evidence Based Practice. A quick Google search can give plenty of information about which types of therapy are evidenced based.

5. Don't give up!

Sometimes the first therapist doesn’t work out, and that’s okay! The relationship between a therapist and client is a key part of treatment success and sometimes that relationship doesn’t develop. Don’t get discouraged if the person doesn’t connect with the first therapist, there are others out there and they can always try again with someone else!

6. Plan ahead

Therapy is a big commitment and can take a lot of time and energy, so it’s important to ensure that the therapist can meet the person’s scheduling needs. Think about things like: Do their hours accommodate the person’s schedule? How will they get there? Therapy should be an experience that is enjoyable and helps the person, not something that adds stress. Planning early on can help reduce stress and lead to a better experience.

Other downloads

Name Description Type File
Be Well, Think Well: Managing Anxiety This resource provides some tips to help people manage anxiety. pdf Download file: Be Well, Think Well: Managing Anxiety
Be Well, Think Well: How to Face Your Fears This resource provides some tips to help people deal with fears. pdf Download file: Be Well, Think Well: How to Face Your Fears
Be Well, Think Well: Therapies for Anxiety This resource explains some common types of therapy that are helpful in reducing anxiety. pdf Download file: Be Well, Think Well: Therapies for Anxiety
Be Well, Think Well: Deep Breathing This resource provides information about one technique, Deep Breathing. pdf Download file: Be Well, Think Well: Deep Breathing
Be Well, Think Well: Imagery This resource provides information about one technique, Imagery. pdf Download file: Be Well, Think Well: Imagery
Be Well, Think Well: Progressive Muscle Relaxation This resource provides information about one technique, Progressive Muscle Relaxation. pdf Download file: Be Well, Think Well: Progressive Muscle Relaxation
Be Well, Think Well: Grounding Techniques This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called “grounding” techniques. pdf Download file: Be Well, Think Well: Grounding Techniques
Be Well, Think Well: Medication for Treating Anxiety and Depression This resource gives general information about medicine for depression and anxiety, and important things to remember. pdf Download file: Be Well, Think Well: Medication for Treating Anxiety and Depression
Be Well, Think Well: Finding a Therapist for an Individual with Autism This resource gives information about different ways to find a therapist for an individual with autism. pdf Download file: Be Well, Think Well: Finding a Therapist for an Individual with Autism

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.

Depression Information and Resources

Recognizing Depression

Everyone feels sad or down sometimes, usually when something bad or sad happens. Depression is when people feel really sad for a few months or longer.

BRAIN

  • Feeling tired and having little energy
  • Changes in how much you you sleep: a lot less or a lot more
  • Changes in how much you eat: a lot less or a lot more

THOUGHTS/EMOTIONS

  • Not interested in favorite subjects or activities
  • Thoughts about death or not wanting to be alive
  • Don’t want to spend time with friends or loved ones
  • Easily frustrated, irritable, easily upset about things that don’t normally bother you

BODY

  • Not caring about taking care of your body like brushing teeth or showering
  • Feeling achy or having pain you can’t explain
  • Having an upset stomach

Signs and Symptoms of Depression in Individuals with Autism

Depression is a serious mental health disorder that consists of long periods of low mood, a loss of interest or pleasure in activities, and physical changes that get in the way of everyday tasks. Depression is more than a bad day.

Changes in mood

These feelings might include feelings like sadness, hopelessness, or irritability that last two weeks or more. It may be difficult to notice changes in mood in individuals with autism since they sometimes have trouble identifying and talking about emotions.

Physical changes

People with depression might have a loss of energy, changes in sleep, changes in appetite, or changes in their weight. Some people might have an increase in compulsive behaviors or stereotypic behaviors when they are depressed.

Changes in activity

Motivation to participate in activities goes down when people have depression. They may miss work or school, spend less time on hobbies, isolate themselves from family or friends, or not take care of their personal hygiene. For individuals with autism, there may be an increase of self-injurious behaviors.

Changes in thoughts

Depression can change the way people think about the world, themselves, and the future. A person with depression may be more negative and easily frustrated than usual. They may think about negative events and emotions over and over again.

There are several risk factors that might increase the chances of depression. These things include:

  • genetics
  • stressful life events
  • medications
  • medical problems
  • a history of depression

There are a few ways to treat and manage depression. Therapists can help recognize the signs of depression and teach people coping strategies. Doctors may prescribe medications when depression is impacting an individual’s everyday life.

Diagnosing Anxiety & Depression in Autism Spectrum Disorder

Clinical Interview

Mental health professionals can diagnose anxiety and depression by asking questions. These questions include details about the individual’s history, mood symptoms, appetite, sleep patterns, and other signs of anxiety or depression. They will use that information to determine if the individual meets the criteria for anxiety or depression and make a plan to treat the anxiety or depression.

Screening Tools

Screening tools ask about specific symptoms an individual might have. Screening tools can be completed by the individual, a family member or support staff who knows them well. A mental health professional will interpret the screening tools and discuss the results. Screening tools can also be used to help track anxiety and depression over time to see if symptoms improve.

Input From Family and Friends

Sometimes it’s hard for individuals with autism to describe their thoughts or feelings to others. Some people might not notice concerns with their mood or behavior. It is important for mental health professionals to get input from people close to the individual to make a correct diagnosis.

Who Can Diagnose

There are many health professionals who can diagnose anxiety or depression. Some examples are: a psychologist, a psychiatrist, a primary care physician, a physician’s assistant, or a nurse practitioner.

Symptoms of Autism that Could Be Misinterpreted

Autism can have symptoms that seem similar to other mental health issues, especially when the person is stressed or in crisis.

Non-Responsiveness

A person with autism who is in crisis may get overwhelmed and shut down. For people with autism, they may behave in a certain way as a result of anxiety, sensory overload or over-stimulation.They may have their head down, be completely silent, or not respond to attempts to gain their attention. These behaviors could be mistaken for someone under the influence of drugs or alcohol, or someone with schizophrenia who is in a catatonic state.

Self-Stimulatory Behavior

A person with autism may engage in self-stimulatory behavior because of their sensory needs. This may look like: making unusual noises, rocking, spinning, or flapping hands. They may even engage in self-injurious behavior (e.g., slapping their head, biting themselves). These behaviors could be mistaken for being under the influence of drugs or alcohol, schizophrenia, or hallucinations. For people with autism, they may do these things as a way to stimulate their senses, manage anxiety, or help calm down.

Intense Anxiety

Many people with autism prefer strict routines and schedules. Changes to their schedule can cause intense fear, anxiety, or distress. When these changes happen, they may become aggressive, may try to run away, or may become unresponsive. Some ask repetitive questions or be preoccupied with time and schedule. This is a natural response for anyone who experiences anxiety, but for an individual with autism it could be due to changes in their schedules or routines rather than due to an anxiety disorder.

Communication Difficulty

One of the core deficits of autism is communication. Some people have little or no verbal communication, while others can talk but may not respond well to vague or open-ended questions. Poor, or no response to communication attempts may seem like the person is being oppositional or “non-compliant’. For people with autism, it could mean that the person didn’t understand what was being said or asked of them, or is having a hard time expressing themselves verbally. Presenting information in verbal and visual ways can help by giving the person plenty of time and different ways to respond.

Types of Depression

Major Depressive Disorder

Major depressive disorder is one of the most common mood disorders. It is also called clinical depression. Signs of clinical depression include: changes in appetite (eating more or less), changes in sleep (sleeping more or less), losing interest in things you used to enjoy, having a low mood, and a lack of energy and motivation to do things. Children with clinical depression may be more angry or irritated than usual. Clinical depression can be mild, moderate, or severe.

Dysthymia

Dysthymia is a long-lasting depression. People with dysthymia have symptoms of clinical depression, but the depression lasts at least two years. Symptoms might get a little better or worse during that time, but they are depressed more often than not for two years or more.

Cyclothymia

Cyclothymia is when a person has ups and downs in their mood. The person will go back and forth between feeling depressed and periods of exaggerated happiness. The person’s low moods are somewhat mild and do not reach the level of clinical depression. The person might have a lot more energy than usual during their high moods. This might look like poor judgment, racing thoughts, and not needing to sleep. You may have heard people use the word “bipolar” to describe people who have ups and downs in their mood. This is different from cyclothymia. In bipolar disorder, the highs and lows are more intense and last longer than in cyclothymia.

Other downloads

Name Description Type File
Recognizing Depression This resource describes some of the ways you may think or feel if you have depression. pdf Download file: Recognizing Depression
Signs and Symptoms of Depression in Individuals with Autism This resource provides information about depression in individuals with autism. pdf Download file: Signs and Symptoms of Depression in Individuals with Autism
Diagnosing Anxiety & Depression in Autism Spectrum Disorder This resource reviews how a mental health professional might check to see if an individual meets the criteria for a diagnosis of anxiety or depression. pdf Download file: Diagnosing Anxiety & Depression in Autism Spectrum Disorder
Symptoms of Autism that Could Be Misinterpreted This resource will review behaviors to look for to identify whether what you’re seeing is a symptom of autism or something else. pdf Download file: Symptoms of Autism that Could Be Misinterpreted
What is Depression This resource provides information on the different types of depression that individuals can be diagnosed with. pdf Download file: What is Depression

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.

Therapies for Depression

Therapy can be a helpful tool in treating depression. A psychotherapist, psychologist, or clinical social worker can provide treatment for depression and other mental health issues.

Cognitive Behavioral Therapy (CBT)

CBT focuses on the way our thoughts, behavior, and emotions impact each other. Therapists who use CBT teach new ways to behave and think in order to treat depression. Treatment is usually brief, lasting between 8 and 12 sessions.

Interpersonal Therapy (IPT)

Interpersonal therapy is all about relationships. Therapists trained in IPT work to change relationships that cause and maintain depression. IPT normally lasts between 12 and 16 sessions.

Problem Solving Therapy (PST)

Problem solving therapy focuses on identifying problems and ways to solve them. Therapists who use PST help individuals to find multiple solutions to a problem, identify the best one, and find a way to use it to resolve the issue.

Electroconvulsive Therapy (ECT)

ECT is used in cases of severe depression that is not getting better with therapy and medication. An electronic current is carefully sent into the brain to try to help reduce depression. ECT is painless as the person receiving treatment is under anesthesia.

Medication for Treating Anxiety and Depression

Sometimes doctors will prescribe medicine to help with anxiety and depression.

Depression:

When people take medicine for depression, they usually take it for at least 6-12 months. It may take this type of medicine a few weeks to work. Once you begin to feel better, your doctor may want you to keep taking the medicine for another 6-9 months.

Anxiety:

Some medicines for anxiety work the first time you take it. Others may take days or weeks to work. Some may even make you feel more anxious the first few days you take it. This can be normal and should go away after a few days.

Remember!

  • Never stop taking your medicine without talking to your doctor
  • It’s important to not miss doses of medicine. Use reminders, such as alarms on your smart phone, or using a weekly pill container placed where you will see it
  • Never share your medications with others
  • Always talk with your doctor if you have any side effects
  • If you don’t feel like you’re getting better, talk to your doctor
  • Keep appointments and check ups with your doctor, they’re very important
  • Your doctor may ask that you do other things to help your physical and mental health. These may include therapy, healthy food, exercise, or a daily schedule with the right amount of sleep. It’s important to follow these as best as you can

How To Find a Therapist for an Individual with Autism

1. Contact the insurance company

Insurance companies can be a great starting point for the search for a therapist. You can typically search for local therapists through the insurance company’s online self-service portal or by calling the customer service number on the back of the insurance card. You can find out what therapists are nearby, what insurance they accept, and whether or not they’re accepting new patients. If the person has medical assistance, contact the Special Needs Unit for additional help.

2. Psychology Today

Psychology Today is another great resource for finding a therapist. Their therapist directory can match people to a number of qualified therapists nearby. Therapist profiles typically include what insurance plans they accept, how much they charge, and what the therapist specializes in treating, letting you know exactly what to expect before scheduling the appointment. However, it’s good to contact the therapist to verify the information on the website and make sure they have experience working with individuals who have autism before scheduling an appointment.

3. Ask a healthcare provider

Primary care physicians often have therapists or agencies that they partner with and can give a referral. An added benefit is that they may be able to answer some questions about the provider and the services that they offer before contacting them to schedule a session.

4. Do some research

When choosing a therapist it’s important to know that type of treatment they use. Some types of treatment are better than others depending on the mental health condition and have research to support using those strategies. These are called Evidence Based Practices. Research the treatment types local providers specialize in to select a therapist that uses an Evidence Based Practice. A quick Google search can give plenty of information about which types of therapy are evidenced based.

5. Don't give up!

Sometimes the first therapist doesn’t work out, and that’s okay! The relationship between a therapist and client is a key part of treatment success and sometimes that relationship  doesn’t develop. Don’t get discouraged if the person doesn’t connect with the first therapist, there are others out there and they can always try again with someone else!

6. Plan ahead

Therapy is a big commitment and can take a lot of time and energy, so it’s important to ensure that the therapist can meet the person’s scheduling needs. Think about things like: Do their hours accommodate the person’s schedule? How will they get there? Therapy should be an experience that is enjoyable and helps the person, not something that adds stress. Planning early on can help reduce stress and lead to a better experience.

Other downloads

Name Description Type File
Therapies for Depression This resource explains some common types of therapy for depression. pdf Download file: Therapies for Depression
Medication for Treating Anxiety and Depression This resource gives general information about medicine for depression and anxiety, and important things to remember. pdf Download file: Medication for Treating Anxiety and Depression
How To Find a Therapist for an Individual with Autism This resources outlines tips for finding a therapist for an individual with Autism pdf Download file: How To Find a Therapist for an Individual with Autism

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.

Managing Depression

Everyone feels sad or down from time to time, especially when something bad or unexpected happens. However, depression is a condition where people experience a persistently depressed mood or loss of interest in daily activities.

Be Active

Find exercises that are continuous and rhythmic like swimming, walking or dancing

Do Things You Enjoy

Listen to music, watch TV, read, draw or play games.

Continue Everyday Tasks

Try to keep doing your regular daily activities like going to school/work, doing chores and maintaining your hygiene.

Seek Help

Talking to a therapist, physician or other mental health professional can help.

Challenge Negative Thoughts

Try to find other ways of looking at a situation. It may not be as bad as you initially think.

Spend Time in Sunlight

Get outside or increase sunlight in your home.

Stay Connected

Surround yourself with friends and family to support you. Keep up with social activities, even if you don’t want to.

Get the Right Sleep

Sleeping too little or too much can make depression worse, so aim to get 8 hours of sleep a night.

Tips for Supporting Individuals with Depression

Teach how to get help

Help the person to make an appointment with their doctor or therapist. Let the doctor or therapist know there are signs of depression.

Teach ways to speak up for themselves

  • Help them to recognize their emotions.
  • Help them recognize triggers for low mood.
  • Teach them how to find people who can help. Teach the person how to call, email or talk with these people.

Help develop healthy habits

  • Help them to use routines and alarms to sleep and wake up at the same times each day.
  • Encourage the person to avoid taking naps during the day.
  • Help the person to avoid using electronics (for at least an hour) prior to going to bed.
  • Encourage the person to avoid caffeine and sugar in the afternoon and evening.
  • Individuals should be encouraged to eat plenty of fruits and vegetables. Try to limit foods high in sugar and fat.
  • Follow the guidelines at choosemyplate.gov for more information on portions and how to choose foods.

Help to stay involved in activities

  • Help them to complete chores and other tasks around the house.
  • Invite them to go on a walk, play catch, lift weights or other forms of exercise.
  • A good goal for most people is to exercise for at least 30 minutes every day.

Support them in developing and maintaining relationships

  • Encourage participating in social activities to improve mood.
  • Help set up times and activities so that they can be with friends and family.

Modify treatment and service plans

  • If you have concerns about the individual’s mood and it is not included in the plan, talk with a supervisor about how to get a new goal added to the plan.
  • If there is a goal about improving mood but it does not seem to be working, talk with your supervisor about how the plan could be updated. You may be asked to continue with the current plan for a few weeks in order to see if the plan just needs more time to work. However, the supervisor may also try including other ways of helping the individual to feel better.

Remove access to dangerous items if suicidal

  • Put all sharp objects, weapons, and medications in a locked area. This locked area should be a place where the individual cannot get access.
  • If there is not a safe space, try asking other family members to store these items.
  • Put emergency numbers somewhere the individual can easily find them. It may be helpful to hang them on the wall near a phone or to save them in a cell phone’s contact list.
  • Give the individual phone numbers for the National Suicide Prevention Lifeline (1-800-273-8255), the local Crisis Intervention phone number, and 9-1-1.

Other downloads

Name Description Type File
Managing Depression Tips and suggestions for helping individuals manage depression. pdf Download file: Managing Depression
Working with Individuals who have Depression and Autism Tips for supporting individuals who have autism and depression. pdf Download file: Working with Individuals who have Depression and Autism

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.

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This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.