Why So Many Autistic Empaths Struggle With Chronic Anxiety: A Systems View

Anxiety for autistic empaths isn’t just emotion — it’s embodied, recursive, relational. Revisiting this piece two years later, I explore how alexithymia, empathic overload, and embodied trauma shape the anxious system — and how we heal.

Introduction

Anxiety is not simply an emotion. For many autistic empaths — especially those of us with alexithymia — anxiety operates more like a system: recursive, embodied, and deeply relational. Left unchecked, it drains not only our energy but our sense of safety, coherence, and vitality.

Much public discussion treats anxiety as something wholly internal: a personal failure of regulation, a flaw to be fixed. But for those of us whose systems are structured differently, that framing often misreads both cause and consequence.

The Amplifier Effect of Alexithymia

Alexithymia complicates emotional processing by limiting access to clear internal signals. This is not absence of emotion; rather, it is difficulty naming, sourcing, localising, or parsing what we feel. Our systems detect input — often hyper-acutely — but struggle to distinguish its source or nature.

Emotional energy becomes sticky. It adheres. We absorb affect from others — individuals, environments, even mediated sources like social media or world events. Without clear internal tagging, these emotions get misfiled as our own, compounding existing tensions. The system ramps up. Hypervigilance sets in.

This is part of why so many of us feel like we are carrying anxiety, even when nothing obvious has happened. The unfiltered inputs of the external world are interpreted by our bodies as persistent threat. The physiological fight-flight cascade engages: adrenaline surges, breath tightens, muscles tense. Yet without a discrete external danger to resolve, this mobilised state becomes chronic, saturating both mind and body.

Why Social Context Feels So Dangerous

Social environments are especially fraught. Lacking spontaneous scripts (gestalts) for fluid interaction, many of us enter these spaces without reliable predictive models. The brain treats unpredictability as potential threat. Without stable ground to stand on, any deviation — a facial microexpression, a shift in tone — can feel like an oncoming wave we’re unprepared to surf.

This hypervigilance is not a moral failing. It is, in many ways, a form of protective intelligence. But the constant scanning taxes our system. Each unresolved micro-threat deposits another layer of adrenaline into the bloodstream, with nowhere for it to discharge. Over time, this accumulated activation leaves us exhausted, depleted, and brittle.

Anxiety Feeds on Ambiguity

For the alexithymic autistic system, ambiguity is dangerous precisely because we cannot reliably sort our internal data. Is this feeling mine? Theirs? Old? Current? Rational? Disproportionate? The inability to answer these questions becomes itself a driver of anxiety.

In many cases, we are not consciously afraid of something. We are simply afraid. The feeling self-perpetuates because the body detects physiological arousal and then interprets that arousal as evidence that something must be wrong.

This is why advice like “just calm down” is not only unhelpful but often counterproductive. The thinking brain is not the driver of the anxiety loop. The body is already in motion.

Moving Through, Not Around

For me — and for many like me — stillness often amplifies the problem. Traditional seated mindfulness, whilst useful for some, can leave my system stewing in its own unresolved arousal. What has been most effective are embodied practices that give the nervous system a regulated, contained outlet for discharge: martial arts (Systema, Sambo), Qi Gong, structured breathwork.

In sparring, the system has a socially agreed container for controlled aggression, allowing safe activation and release. In Qi Gong, the breath synchronises with slow, intentional movement, retraining the system to recognise regulated states. These practices create what I think of as somatic literacy — teaching my system what safety feels like, not just intellectually, but physically.

The Double Bind of Empathic Overload

An often overlooked complication arises when those of us with high empathic sensitivity find ourselves in proximity to emotionally dysregulated others. Without adequate boundaries or training, we can unwittingly synchronise with their cycles — absorbing manic highs, depressive crashes, or volatile shifts as though they were our own.

For this reason, we must carefully curate our relational spaces. This is not avoidance; it is stewardship. Just as one might limit environmental allergens to support physical health, we must tend to the relational inputs that affect our emotional systems.

Trauma, Anxiety, and Autistic Bodies

Unchecked, chronic anxiety can scaffold into trauma states. The system learns to anticipate danger, even when none is present. Over time, this pattern may calcify into complex PTSD, particularly for autistic bodies that have lived for decades inside misattuned, invalidating environments.

This is not merely a problem of irrational beliefs or cognitive distortions, as many therapies assume. It is a problem of embodiment. When your system has been primed for threat long enough, it no longer waits for danger. It prepares for it by default.

A Note on Medical Intervention

Many turn to psychiatric medication to manage these spirals — sometimes out of necessity. But too often, providers lack sufficient understanding of alexithymia or autistic systems more broadly. Treatments aimed at the neurotypical experience of anxiety may miss the mark for us entirely.

Do your homework. Be selective with your care team. Ask whether they understand autistic sensory profiles, empathic overload, or embodied trauma. Many clinicians simply do not.

Toward a Different Kind of Mastery

Breaking the anxiety cycle is not about forcefully suppressing thoughts. Nor is it about dismissing emotions as irrational. It is about learning to sit beside what arises — with curiosity, with movement, with breath — and allowing the storm to pass without feeding it. With time, the system can re-learn what calm feels like.

We don’t rise to our ideals. We rise to our level of training. Like self-defence, emotional regulation requires practice under non-threatening conditions so that the body knows, when crisis comes, how to access its calmer state.

Mastery, in this context, is not the absence of anxiety. It is the capacity to remain rooted while the wave passes through.

Closing Note

As always: this reflection is not a substitute for clinical guidance. I offer it as a lived perspective for others navigating similar systems. If you are struggling, seek support from qualified providers who understand neurodivergent embodiment. Choose carefully.

—June 2025 Update—

The AutSide has always served as my digital repository — a holding space for the long gestalts that arrive when they’re ready, sometimes long after their first beginnings. I visit the archives often, not always searching for anything in particular, but following the quiet pull of my system’s recursive loops.

This week, whilst looking for something else, I stumbled back upon this piece. And as sometimes happens in the Theatre of My Mind, the scene lit up again, calling for revision. Not out of error, but evolution. The core truths remain, but the language — the flow, the coherence, the structure — wanted to move differently now.

Two years further in time, into transition and HRT, into fuller alignment with myself, I can feel how my system assembles language differently. What once emerged in fits and fragments now arrives more whole. Not effortless, but integrated. And I marvel at that shift — at what becomes possible when the body, the breath, and the words finally begin to move together.

This revision is offered with gratitude — to the version of me who first assembled these scattered threads, and to the current self who can now carry them forward with clearer rhythm.