Anxiety in Neurodivergent Teens
The world can already feel confusing for a neurodivergent teen, and when anxiety is added into the mix, it can become even more overwhelming and frightening. This is why, for parents, it’s important to understand how anxiety may present itself in your teen and how everyday situations that don’t affect others in the same way can act as triggers for your child.
On this page, we explore anxiety in neurodivergent teens to help parents understand the signs and symptoms and guide families to appropriate mental health support.
We will do this by looking at:
- Mental health issues and neurodivergent teens
- The different types of anxiety linked with neurodivergent teens
- How anxiety can affect neurodivergent teens’ lives
- What mental health support for neurodivergent teens looks like
- How Mission Prep can provide support for neurodivergent teen anxiety
How Common Are Mental Health Issues Among Neurodivergent Teens?
Before getting into anxiety in neurodivergent teens, it is important to first understand that neurodivergent teens are more vulnerable to developing a range of mental health issues.
Research shows that having ADHD or autism significantly increases the likelihood of developing PTSD later in life, even after controlling for other factors.1 In terms of depression, autistic adolescents are around four times more likely to experience major depression compared to neurotypical teens.2
This pattern extends to anxiety. Nearly 1 in 5 teenagers with ADHD also meet criteria for an anxiety disorder, a rate significantly higher than in neurotypical peers.3
There are many factors that contribute to this increased vulnerability, including how neurodivergent teens view and process the world around them, and certain neurological functions that work differently compared to neurotypical peers.
What Types of Anxiety Are Linked With Neurodivergent Youth?
Neurodivergent conditions can increase the likelihood and intensity of anxiety, but the term anxiety on its own can unintentionally oversimplify what is often a much more complex picture. There are different types of anxiety, each presenting distinct challenges and affecting neurodivergent children and teens in different ways. To highlight these differences, below we explore some of the most common types of anxiety in autistic teens and anxiety in ADHD teenagers.
Sensory anxiety
Sensory anxiety is a form of anxiety that can be triggered by sensory stimuli, such as loud noises or strong smells. Sensory anxiety is frequently reported by neurodivergent teens who experience sensory over-responsivity, which means their nervous systems react strongly to everyday inputs.
Symptoms include:
- Overwhelm in noisy environments
- Aversion to certain textures
- Tantrums
- Hypervigilance
- Physical stress responses, such as a rapid heartbeat or freezing when faced with sensory input4
Studies have found that children with Asperger’s have high sensory over-responsivity along with significantly higher anxiety scores than their peers.5 Other research shows a similar link with ADHD and anxiety in teens, suggesting that ADHD should be considered in conjunction with anxiety and sensory responsivity.5
Social anxiety
Research shows that autistic and ADHD youth have much higher rates of social anxiety than their neurotypical peers.6 Social anxiety in autistic teenagers is common, with around half meeting the criteria for social anxiety disorder. This is often linked to difficulties with eye contact and nonverbal communication.6 Some researchers suggest that this strong link is largely because many autistic teens struggle to understand social cues and feel uncomfortable in unpredictable social situations.6
Similar findings were found in the ADHD population, with one review finding that up to 49% of adolescents with ADHD had social anxiety disorder.7
These findings help to explain why so many neurodivergent teens develop social anxiety.
Generalized anxiety
Research shows that up to 84% of autistic children experience clinically significant anxiety.8 It is suggested that autistic youth may be particularly prone to generalized anxiety due to traits like an inhibited temperament and physiological hyperarousal, making them more sensitive to stress.
In adolescents with ADHD, anxiety is also frequent, with reviews showing that 15–35% of neurodivergent teens have symptoms of generalized anxiety.8 In one study that focused on generalized anxiety disorder specifically, it was found that around 16% of youth with ADHD met the criteria for GAD.9
How Can Anxiety Affect a Neurodivergent Teen’s Life?
Anxiety can negatively affect anyone it touches, but for a neurodivergent teen, it has significant impacts on many aspects of their lives. Below, we explore how anxiety can exacerbate everyday challenges.
Emotional Dysregulation
Many autistic or ADHD teens have trouble managing intense feelings, and when anxiety is also present, it can increase the intensity of these emotional responses. One study found that neurodiverse young people, particularly those with autism and ADHD, showed elevated emotional lability and reactivity, which are key signs of difficulties with emotion regulation.10
These intense emotions can feed into anxiety, with research finding that the extra emotional burden experienced at school independently predicted higher levels of anxiety.10
That is why, when a neurodivergent teen gets upset by something that happens in their life, it can create a cycle where emotional dysregulation and anxiety feed off each other.
School Avoidance
Studies show that neurodivergent students are far more likely to experience school avoidance due to the effects of anxiety. One study in particular found that 43% of autistic students had significant attendance problems, with high anxiety and fear of sensory overload being the main reasons for school avoidance.11
Shutdowns and Meltdowns
Neurodivergent teens have been reported to experience higher levels of shutdowns and meltdowns compared to neurotypical teens. An autistic meltdown is an intense and sometimes explosive reaction to feeling overwhelmed, while a shutdown is more commonly an internal freeze response.12
Research based on autistic youths’ own reports finds that meltdowns often occur following a significant build-up of burnout and stress. One autistic child described one experience of a meltdown that resulted from an accumulation of task demands at school:12
“I was all… a little bit mad, at first, but I was a little… really tired, but then when they got back to school, the education assistant (EA) was constantly bugging me ‘do the work, do the work, do this, do this work…’ And he was like ‘no, no no, you’re going to do the work’ like, ‘No, I’m tired.’ And I was getting more agitated.”
This highlights how prolonged anxiety, pressure, or sensory overload can push a neurodivergent teen beyond their coping capacity, resulting in a meltdown or shutdown.
Masking and Burnout
To cope with the anxiety that their condition brings on, some neurodivergent teens try to mask their traits. This means they will make an effort to hide their tics or pretend not to be overwhelmed in order to fit in socially.13
While masking can reduce visible distress in the short term, it can be exhausting and often leads to eventual burnout. A recent study of neurodivergent adolescents found a strong link between masking and poor mental health, especially higher levels of anxiety and depression.13
Autistic individuals themselves frequently describe burnout as being utterly drained by everyday life, especially when masking is sustained over long periods.12
Social Stress
Everyday social situations that may not cause anxiety for a neurotypical person can be especially difficult for a neurodivergent teen.
Research shows that during play or conversation with peers, autistic children have much stronger stress responses than neurotypical children.14 The study found that neurodivergent teens’ levels of cortisol, the stress hormone, were much higher in everyday situations, showing just how physiologically difficult these encounters can be.14
Social interactions can feel overwhelming when there is too much happening at once or when situations feel unpredictable, both of which can lead to real anxiety and stress.
Bullying Issues
Sadly, neurodivergent teens are bullied at much higher rates than their neurotypical peers, which can significantly worsen anxiety. One study found that bullied autistic or ADHD teens had much higher levels of anxiety and depression than their peers.15
This can create a distressing cycle, where anxiety makes it harder to cope with bullying, and bullying further feeds the teen’s anxiety and sense of isolation.
How Are Neurodivergent Teens With Anxiety Treated?
Mission Prep
If you are noticing that anxiety is influencing your child’s day-to-day life, for example, through avoidance or emotional overload, it may help to speak with experienced mental health professionals. Many families find that reaching out for support helps clarify what is anxiety-driven and what is part of how their teen naturally processes the world.
At Mission Prep, we support neurodivergent teens whose anxiety affects key areas of their lives, including learning, relationships, and confidence. Our clinicians use evidence-based treatments, such as CBT adaptations for autistic teens, that focus on helping them feel calmer in their thinking and better equipped to handle situations that feel overwhelming.
We also place a strong emphasis on family involvement. This includes helping parents better understand how everyday interactions may feel for their neurodivergent teen. This shared understanding can help families support emotional safety in the home.
We offer treatment in two main settings, outpatient and residential care, allowing treatment and support to match each teen’s needs.
Outpatient care provides comprehensive therapeutic support, while allowing teens to continue with familiar daily routines like school and home life.
Residential care offers a more structured and supportive environment where anxiety has the chance to settle, and expectations are clear and consistent. In residential settings, neurodivergent teens have the opportunities to build confidence in peer relationships, which can help anxiety feel more manageable in social and everyday situations.
Contact Mission Prep today to learn more about how anxiety treatment can be tailored to support your child.
References
- Song, Y., Zhao, Y., Baranova, A., Cao, H., Yue, W., & Zhang, F. (2024). Causal association of attention-deficit/hyperactivity disorder and autism spectrum disorder with post-traumatic stress disorder. Psychiatric Genetics, 34(2), 37–42. https://doi.org/10.1097/YPG.0000000000000357
- Briot, K., Jean, F., Jouni, A., Geoffray, M.-M., Moal, M. L.-L., Umbricht, D., Chatham, C., Murtagh, L., Delorme, R., Bouvard, M., Leboyer, M., & Amestoy, A. (2020). Social anxiety in children and adolescents with autism spectrum disorders contributes to impairments in social communication and social motivation. Frontiers in Psychiatry, 11, 710. https://doi.org/10.3389/fpsyt.2020.00710
- Njardvik, U., Wergeland, G. J., Riise, E. N., Hannesdottir, D. Kr., & Öst, L.-G. (2025). Psychiatric comorbidity in children and adolescents with ADHD: A systematic review and meta-analysis. Clinical Psychology Review, 118, 102571. https://doi.org/10.1016/j.cpr.2025.102571
- Wheeler, T. (2023, June 5). What is sensory overload with anxiety? WebMD. https://www.webmd.com/balance/what-is-sensory-overload-with-anxiety
- Lane, S. J. (2010). Sensory over-responsivity and ADHD: Differentiating using electrodermal responses, cortisol, and anxiety. Frontiers in Integrative Neuroscience, 4, Article 8. https://doi.org/10.3389/fnint.2010.00008
- Montaser, J., Umeano, L., Pujari, H. P., Nasiri, S., Parisapogu, A., Shah, A., & Khan, S. (2023). Correlations Between the Development of Social Anxiety and Individuals With Autism Spectrum Disorder: A Systematic Review. Cureus, 15(9). https://doi.org/10.7759/cureus.44841
- Jakobsson Støre, S., Van Zalk, N., Granander Schwartz, W., Nilsson, V., & Tillfors, M. (2024). The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review. Journal of Attention Disorders, 28(9). https://doi.org/10.1177/10870547241247448
- McNally Keehn, R. H., Lincoln, A. J., Brown, M. Z., & Chavira, D. A. (2012). The Coping Cat Program for Children with Anxiety and Autism Spectrum Disorder: A Pilot Randomized Controlled Trial. Journal of Autism and Developmental Disorders, 43(1), 57–67. https://doi.org/10.1007/s10803-012-1541-9
- Melegari, M. G., Bruni, O., Sacco, R., Barni, D., Sette, S., & Donfrancesco, R. (2018). Comorbidity of Attention Deficit Hyperactivity Disorder and Generalized Anxiety Disorder in children and adolescents. Psychiatry Research, 270, 780–785. https://doi.org/10.1016/j.psychres.2018.10.078
- Lukito, S., Chandler, S., Kakoulidou, M., Griffiths, K., Wyatt, A., Funnell, E., Pavlopoulou, G., Baker, S., Stahl, D., & Sonuga-Barke, E. (2025). Emotional burden in school as a source of mental health problems associated with ADHD and/or autism: Development and validation of a new co-produced self-report measure. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.70003
- Connolly, S., Constable, H. L., & Mullally, S. L. (2023). School distress and the school attendance crisis: A story dominated by neurodivergence and unmet need. Frontiers in Psychiatry, 14, Article 1237052. https://doi.org/10.3389/fpsyt.2023.1237052
- Phung, J., Penner, M., Pirlot, C., & Welch, C. (2021). What I wish you knew: Insights on burnout, inertia, meltdown, and shutdown from autistic youth. Frontiers in Psychology, 12, Article 741421. https://doi.org/10.3389/fpsyg.2021.741421
- McKinney, A., O’Brien, S., Maybin, J. A., Chan, S., Richer, S., & Rhodes, S. (2024). Camouflaging in neurodivergent and neurotypical girls at the transition to adolescence and its relationship to mental health: A participatory methods research study. JCPP Advances, 4(4). https://doi.org/10.1002/jcv2.12294
- Corbett, B. A., Muscatello, R. A., & Blain, S. D. (2016). Impact of sensory sensitivity on physiological stress response and novel peer interaction in children with and without autism spectrum disorder. Frontiers in Neuroscience, 10, Article 278. https://doi.org/10.3389/fnins.2016.00278
- Accardo, A. L., Neely, L. C., Pontes, N. M. H., & Pontes, M. C. F. (2024). Bullying victimization is associated with heightened rates of anxiety and depression among autistic and ADHD youth: National Survey of Children’s Health 2016–2020. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-024-06479-z
- Onwumere, D. D., & Patten, K. K. (2024). Adapting cognitive behavioral therapy for anxiety in autistic children: A commentary. Research in Autism Spectrum Disorders, 115, 102404. https://doi.org/10.1016/j.rasd.2024.102404
- Cooper, K., Loades, M. E., & Russell, A. (2018). Adapting psychological therapies for autism. Research in Autism Spectrum Disorders, 45, 43–50. https://doi.org/10.1016/j.rasd.2017.11.002
- Simione, L., Frolli, A., Sciattella, F., & Chiarella, S. G. (2024). Mindfulness-based interventions for people with autism spectrum disorder: A systematic literature review. Brain Sciences, 14(10), 1001. https://doi.org/10.3390/brainsci14101001
- Romney, J. S., & Garcia, M. (2021). TF-CBT informed teletherapy for children with autism and their families. Journal of Child & Adolescent Trauma. https://doi.org/10.1007/s40653-021-00354-0
