Dynamic Duo Series: Anxiety
Updated: Mar 23, 2019
Part 2 of the series exploring the Dynamic Duo and related issues more in depth
Like most autistics, I deal with a lot of anxiety. Sometimes, my anxiety feels like a cage - a place filled with darkness and loneliness, the bars of which are made of insecurity and self-doubt. Other times, it's this anxious energy, making me need to pace and move around.
A lot of things made me anxious when I was growing up - talking to unfamiliar or less familiar people, talking on the phone (this one still gets me), confrontation, going new or unfamiliar places, or just dealing with the unexpected.
But why is this an issue in autism? And what can be done about it? It's a question I'm sure many parents have. In answering this, I'll revisit body mechanisms and issues I've talked about before, but this time looking at them from the perspective of anxiety.
Let's start with what's causing the anxious feelings. Autistics tend to have lower levels of vitamin D. Preliminary research shows that this may be due to a genetic issue with metabolizing it, making it difficult for the body to use the Vitamin D it has available.
Vitamin D helps the brain make serotonin from tryptophan. Most of the serotonin in the body is made in the gut, but it cannot cross the blood-brain barrier. So the brain has to make it's own supply. Serotonin is sometimes called the happy hormone because it helps regulate mood. So, less vitamin D means the brain makes less serotonin, so it can't regulate mood as well. This leads to anxiety, depression, and mood issues.
It's worth noting too that the low serotonin and its effects don't just apply to autism - antidepressants and anxiety medications in general all work by increasing the amount of serotonin in circulation.
And to make matters worse, not only is the brain not able to regulate mood, there are things going on that are actively causing anxiety as well.
In autism, there is also a high level of dopamine. I discuss why this is more in-depth in my article about fixation, but the short explanation is that a genetic defect is causing the body to have too much dopamine in circulation, but that this defect can be corrected by zinc.
Dopamine is the reward chemical in the brain. High dopamine by itself doesn't create any anxiety. The issue comes from something the body makes dopamine into - norepinephrine and adrenaline. Both norepinephrine and adrenaline are part of the fight-or-flight response. High levels of dopamine make for high levels of norepinephrine and adrenaline, which makes for an overactive fight-or-flight response.
An overactive fight-or-flight response means that the body is ready to respond to things all the time. Fight-or-flight produces stress hormones, dilates the pupils, raises heart rate and blood pressure, sends blood to the arms and legs, and slows digestion, When there's no situation or threat to actually respond to, this leaves us worked up and leads to anxiety.
An anxious brain needs something to be anxious about (or it invents them). And in autism, that anxiety often comes from difficulty in understanding the world around us. Here, dopamine comes into play as well.
As I've talked about before in Information Overload, the autistic brain has trouble filtering things out. Too much information gets passed to the decision making part of the brain, the prefrontal cortex. And the high level of dopamine rewards the brain for learning detail, and so that's what the prefrontal cortex focuses on - the detail.
Too much detail means that the prefrontal cortex can't do one of its jobs - to categorize things, and therefore make sense of the world. Without the ability to categorize things, every person, place, social interaction, or situation is new and unfamiliar. That means that we don't know what to expect or how to respond to them. And that gives us anxiety.
I think that's why autistic children often like watching the same entertainment over and over again. It's familiar. We know what we can expect. It's a source of stability in an otherwise confusing world.
So together, vitamin D and zinc can help calm the anxiety. Zinc lowers a high dopamine level and helps stop the body from working itself up. And vitamin D raises a lowered serotonin level in the brain and helps calm and regulate mood. Together they are a powerful combination, and you can see why I call them the Autism Dynamic Duo.
Vitamin D and zinc make a difference for me. Just this past week I forgot to take my morning pills two days in a row, and I found myself more anxious, antsy, and fearful.
If you are considering giving your child vitamin D or zinc, please consult a doctor, especially about dosage. For your doctor's reference, there are references linked at the end of this article.
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