The link between anxiety and neurodevelopmental disorders

If you live with an anxiety disorder, you may experience differences in the way your brain works. But does that mean you have a neurodevelopmental disorder?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the text mental health professionals use to make diagnosis and treatment decisions. According to the DSM, anxiety is not a neurodevelopmental disorder. This doesn’t mean that anxiety doesn’t affect the brain, but neurodevelopmental disorders have a specific definition that anxiety disorders don’t meet.

However, neurodevelopmental disorders and anxiety disorders have a deeply interwoven link, and many people with neurodevelopmental disorders, like autism, experience co-occurring anxiety. In addition, people with anxiety may consider themselves neurodivergent. 

Is anxiety neurological or psychological?

Anxiety doesn’t have one singular cause, but it’s generally considered to be a psychological condition. Anyone can develop anxiety at any time, and it often comes on as a response to stressful life events. For example, you might develop anxiety after going through a divorce. 

Anxiety isn’t a neurodevelopmental condition. These forms of neurodivergence appear in early childhood and affect a child’s development.

However, anxiety does still have some neurological components. Functional MRI studies have found that anxiety is linked to several neurological differences, especially in the amygdala and prefrontal cortex.

Compared with other mental health conditions, anxiety typically has an earlier onset. On average, anxiety symptoms start to show up around age 11. This is still a later onset than neurodevelopmental conditions, but it might suggest that anxiety could be considered a developmental condition, especially if you started experiencing symptoms at an earlier age. That being said, anxiety symptoms can manifest at an earlier age in response to a stressor, such as a child witnessing their parents divorce. 

Is anxiety connected to neurodivergence?

The question of whether anxiety is considered a type of neurodivergence is a complex one that goes beyond the fact that anxiety isn’t a neurodevelopmental disorder.

“Neurodivergence” is not a medical term. It was originally coined by a sociologist — not a mental health professional — and has only been around since the 1990s. The neurodiversity movement is primarily a social justice movement to normalize the fact that human brains are diverse. 

In short, the message behind the neurodiversity movement is that brain differences in people with neurodevelopmental disorders (particularly autism) aren’t bad or “wrong.” Rather, they’re normal variations of the human brain.

While anxiety isn’t a neurodevelopmental disorder, people with anxiety can still experience brain differences. For that reason, many people with anxiety identify with the concept of neurodivergence because it validates their experiences.

If you want more information about your experiences with anxiety and how it might relate to neurodivergence, talk to a therapist or your healthcare provider. You can also take Rula’s neurodivergence self-assessment quiz, although it’s not a replacement for a formal diagnosis.

Co-occurring neurodevelopmental conditions and anxiety

Anxiety disorders occur much more frequently in people who have neurodevelopmental conditions, so it’s possible to have both. 

For example, attention-deficit hyperactivity disorder (ADHD) — the most commonly diagnosed neurodevelopmental disorder — has been shown to have many psychiatric comorbidities. This means that people with ADHD are more likely to also live with mental health conditions. Anxiety and ADHD often appear together, with as many as 50% of people with ADHD experiencing symptoms of anxiety.

Autism is another neurodevelopmental condition, and autism and anxiety also appear together frequently. One study showed that over one in five autistic people are also diagnosed with an anxiety disorder.

In addition, people who start experiencing anxiety symptoms at an earlier age (during childhood vs. adolescence) are more likely to also live with a neurodevelopmental disorder.

What’s the difference between a mental health condition and a neurodevelopmental disorder?

The main difference between anxiety and conditions like ADHD and autism is that anxiety is a mental health condition, while the others are neurodevelopmental disorders.

While mental health conditions like anxiety can appear during early childhood, they can also start at any age. In addition, the symptoms of mental health conditions can come and go, while neurodevelopmental condition symptoms are chronic and consistent throughout life.

The DSM is very clear on which conditions are considered neurodevelopmental disorders. They include:

• Intellectual disorders/disabilities (which can be caused by genetic conditions like Down syndrome)
• Communication disorders (including language disorder and childhood-onset fluency disorder or stuttering)
• Autism spectrum disorder
• Attention-deficit hyperactivity disorder (ADHD)
• Learning disorders
• Motor disorders
• Tic disorders (including Tourette syndrome)

Mental health conditions, on the other hand, are diagnoses that describe a pattern of behavior, thought, or emotional disturbances that inherently cause distress. They don’t necessarily appear during child development — they can appear at any time.

Support for anxiety and neurodevelopmental conditions

Whether you live with anxiety, a neurodevelopmental disorder, or both, there are ways to cope with the effects that these conditions may have on your life.

• Practice self-compassion. If you’re neurodivergent, you may feel like you’ve been judged for having a brain that works differently. It’s essential to practice self-acceptance and self-compassion and understand that there’s nothing “wrong” with you. Reframing your attitude can help protect your self-esteem and mental health.
• Build a routine. Having a routine can help you manage your anxiety triggers. It can also keep you on track with treatment (like attending therapy appointments or taking medication on time). A predictable routine can also be comforting for people with neurodevelopmental conditions.
• Connect with supportive people. It’s easy to start feeling alone when you live with anxiety and/or a neurodevelopmental condition, but it’s important to remember that there are other people in the world who are going through similar experiences. By connecting with a community of other neurodivergent people, you can reduce feelings of isolation and loneliness.
• Communicate your needs. You may need different things to be able to perform tasks well. Under the Americans with Disabilities Act, you’re legally entitled to reasonable accommodations at work and school. Often, these conditions cause distress because of the way your surroundings aren’t set up with your brain type in mind. Don’t be afraid to ask for what you need — it’s nothing to be ashamed of.
• Seek professional support. Therapy is one of the most effective treatments available for anxiety disorders. Although neurodevelopmental conditions don’t require “treatment” in the same way, a therapist can help you learn how to deal with associated effects. For example, they can help you work on improving your relationships or self-esteem.

Find care with Rula

With the right support, you can learn to not only cope with but also celebrate your unique brain. At Rula, you can connect with a therapist who can support you as you deal with the effects that anxiety and a neurodevelopmental condition has had on your life. Rula is in network with most major insurers, providing 120 million people access to therapy covered by their insurance.

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