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Welcome to From the Spectrum Podcast. This is a podcast about autism. It is my goal to explain

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what is autism. I plan to use a mixture of scientific literature, personal experience,

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and opinion. With opinion, I will explain why. I fill the way I do and give examples.

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I will provide links to various references for each episode. For each episode, we will discuss

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various aspects of autism. The From the Spectrum Podcast will mostly avoid causes of autism.

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And I will try avoiding the increase of diagnoses of late. This is like playing tug-of-war with

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barbed wire and I don't think I want to travel down that path. For today's episode, we will discuss

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autism and anxiety. Autism and anxiety are closely linked. It is common. If you've received an

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autism diagnosis, you received one or more diagnosis of anxiety. The DSM classifies a few types of

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anxiety. And if you have been assessed and diagnosed with autism, approximately half receive at least

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one anxiety diagnosis as well. This is called co-morbid. And the structure of the DSM is to

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create co-morbid diagnosis. Some say or more accurately many say. Remember the medical paradigm

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and the prescriptions. I don't love it or agree with it. Anyway, I won't review the different

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anxiety diagnoses or the symptoms. But they are easy to find. Remember the combination of hour,

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restricted repetitive behaviors and our lack of social skills, social communication deficits,

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creates a vast conundrum and that confusing paradox of socialness. The outside world is

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very social. There's a huge social dynamic and it's pretty chaotic. Anxiety is a state of being

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aware, a protective state. It shifts our attention to something typically in the environment. The

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number one job of the brain or the nervous system for that matter is survival. A component of

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survival is safety. Anxiety intends to keep us safe. It wants to bias our attention into action,

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move us to something, whatever that something is. And now we will cover some biology of anxiety.

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The downstream projections of anxiety includes three components. It will give us three different

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immediate responses that we can measure and understand. The three are avoidance, shifts in

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the physiology and valence or how we feel. A brain area called the amygdala is heavily involved here.

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It is highly recognized with things like anxiety and fear but it also is associated with things

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like motivation. The amygdala sits at the end of another structure called the bad nucleus of the

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history of terminalis or BNST for short. The BNST sits alongside an area called the forenecks. These

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are kind of C shaped and at the end is the amygdala. If you've experienced a sudden jump, you see a

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shadow and you jump. That is the amygdala. However, if you give yourself a moment, just a brief

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moment and you think, oh yeah, that's just the shadow of the tree outside, then that's another

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area called the hippocampus which is associated with our memory. And the forenecks and the bad

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nucleus of the striaterminalis kind of joins the amygdala to areas like the hippocampus,

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the hypothalamus, and the thalamus which is that central area for processing senses. Now,

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one thing unique and cool about the amygdala is it's privileged. It has special privileges whereby

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it does not have to go through the normal sensory processing or informational processing. It receives

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information very quickly, more quickly, in order for that survival instinct. Probably best in the

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world on the amygdala is Joseph Ladoe and also worthy is Lisa Feldman Barrett. I think it was

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Ladoe explained, if you almost step on a snake, you're going to maybe jump back. Your instinct

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will be to quickly jump back. That's the amygdala. After the jump back, you will evaluate is the snake

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venomous or nonvenomous, am I in threat or is it not really a threat? So just imagine if you had

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to discriminate and process all of that information before you respond. Okay, a lot of sidetracks here,

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a lot of explanation, but back to the the BNST is associated with controlling autonomic functions.

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Remember the excitation and inhibition and some impact with neuroendocrine, which we will talk

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about momentarily. The BNST essentially helps determine our behavioral responses, which makes

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sense on the subject of anxiety. The BNST is also related to mood, motivation and stress,

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and valence. It is very central to our feelings and emotional information processing. So the

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first area or the first component of anxiety avoidance. It makes sense. With anxiety, we tend

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to avoid the situation or environment. A brief pathway is the amygdala to the BNST to the lateral

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hypothalamus. And don't worry about the lateral. That's just like a subdivision of the hypothalamus.

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The hypothalamus has direct influence on our autonomic nervous system. So you can see how

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these structures kind of share their function. Remember in a previous episode, you shouldn't

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really think about one area of the body or brain for being responsible. Typically, there's a whole

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system, it's a whole collection of areas, brain structures in our biology. Something to remember

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here is activating or excitation and inactivating or inhibition. Remember our previous discussions

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on this. This pathway can, depending on our responses, can recruit the prefrontal cortex.

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The cortex is the reason why we are the dominant species on Earth. If you draw a line straight

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from the eyes to the back of the brain, our heads extend up. It's taller, more than any other species.

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Now, at the bottom or below that line are a lot of reflexes. A lot of things that we don't have to

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think about. Our body, our nervous system, just responds to things like breathing and controlling

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temperature and appetite and digestion and all of these just reflexive responding. If you look

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at a brain of something like a mouse or a rat and compare it to our lower half, they look very

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similar. Mice and rats are considered modeled organisms. They are very similar to us on this area.

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Now, above that imaginary line are things like the cortex and the prefrontal cortex. The things

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that gives us that dominant species. The area responsible for logic and reasoning and executive

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planning, understanding consequences. Remember a previous episode and a previous comment. We want

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to recruit these areas so we can properly understand our surroundings and then properly evaluate the

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situation so we can make a reasonable response. We can understand what is actually going on. We

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also have a larger diameter of eyes and visual cortex. The last part is my observation. It seems

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that our eye diameter and the visual cortex is larger than most other species and remember this

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is brain and this is all relative, relative to size, the overall size of the brain, head and the

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visual cortex. We have to normalize for that. I have not looked up any data on that but it is

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interesting and it's probably something that I will do in the near future. Okay, so the hypothalamus,

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it also controls the body's hormones. Remember the neuroendocrine comment. This is one way that

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the brain and the body are connected. They're entangled through the hormones and those cellular

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and neural areas, those neural modulators that we've discussed. Simon Baron Cohen's team or teams

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are now looking into hormones and autism. I hope to have Sir Simon Baron Cohen on the podcast this

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fall and hopefully he can give us an update on the hormones and autism. The second component is

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physiology. Probably the most recognized things like heart rate activation and changes in breathing

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and for the experts eye gaze or eye tracking because our eyes dilate or the eyes dilation causes a

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stress system. That might be a bi-directional pathway. Remember how crucial the eyes are,

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especially to our responses in the nervous system. So much of the brain is dedicated to vision,

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roughly 40% or even higher to 50% and sensations approximately 70% of our sensation, sensory

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processing or the eyes, vision. The stress system is very finite. It's crude. There is not a lot

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of complexity here. It's breath, both the rate of breathing and the depth of your breath. So how

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fast you're breathing and if it's short or deep breaths. With stress and anxiety, that gives us

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shorter and more rapid breaths. Something that we have likely all of experienced. You know to relax,

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you can have deeper breaths or something called a physiological sigh, which is shown to be the

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fastest way to regulate. The physiological sigh is quite unique. It requires two inhales before the

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exhale. So the initial normal inhale and then a second more brief inhale and then you exhale.

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A side note, Jack Feldman at UCLA and David Spiegel at Stanford are worthy on this topic.

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Best in the field.

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I've heard David Spiegel either say or I'm paraphrasing. It's not about the state you were in.

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It's about whether or not you had anything to do with getting there. And if you think about autism

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and that social dynamic, those social complications and our interferences with our rigid thinking

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and those restricted repetitive behaviors, hopefully you can kind of see and understand

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some of the difficulties here. Remember we have discussed we love being in our state,

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being within ourselves. Autism gives us that comfort of being there. And it is not known if we

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are born like that or if it's learned early on, even before one can communicate with speech and

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language to explain it. This is a very interesting topic with autism.

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So the projections here include the amygdala, the BNST to the parabracchal nucleus,

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which is on the brain stem. So it makes sense why it goes here because it has position

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to move to the body. For the bodily responses via the spine, the spine features a couple of

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ganglion chain. One is the parasympathetic, which are activated to calm and relax the body.

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And then the sympathetic ganglion chain, maybe to no surprise, is used for activating

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the muscles and the vital organs, getting that blood flow out to those areas for responding,

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quickly responding and reacting to the environment. Remember these are responses

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used for survival. Anxiety doesn't care about the context. It doesn't think, it doesn't care

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that the situation might not be harmful or compromise our survival. And you can see this

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with autism and certainly with people that don't have autism. People are anxious.

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This is on a vast spectrum. We've discussed these internal states are all on spectrums.

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It's just autism is recognized as something on the spectrum. But everything, all of these

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situations, all of these responses in our body are on spectrums. So with the spine,

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just remember it is a crucial part of the nervous system.

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The third component is valence. Valence is the feelings we attach to the context.

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Remember, the nervous system will respond without context, but then we attach the context.

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Here it can be direct when we are in the environment or in the situation, or it can be indirect. It can

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be just from thinking about something without even being there. Maybe it's from planning

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or imagining being in that environment. Remember a critical role of the prefrontal cortex is running

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models, imagining ourselves in future situations. Planning, another example of what makes us the

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dominant species on earth. This is how we sustain our species. A future episode will parse out the

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medial prefrontal cortex, specifically the ACC anterior cingulate cortex, which is highly

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researched with autism, and the insula. The insula is a very unique structure in the brain that receives

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information from the body, other parts of the brain, and the outside world. It combines all those

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three elements into whatever it is we respond to, taking together the body response, the brain,

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the brain response, and the environment. It entangles those three components, those three sources

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of data. It's very unique. The valence projection is the amygdala to the BNST to the ventral

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tegmental area, or VTA. VTA is a hotspot for dopamine. You ought to remember dopamine from a

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previous episode. Check out part two of the excitation inhibition discussion. Dopamine is about

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pursuing and craving and wanting. Remember the Sapolsky quote, dopamine isn't about the pursuit

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of happiness. Dopamine is about the happiness of the pursuit. And if you want to parse that out,

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you can see that it doesn't matter the context or the environment, because we're still going to pursue

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with that pleasure. But if you don't have that pleasure, then you don't pursue. So you avoid.

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Hopefully it's not that complicated now as we are parsing this out.

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The more you experience this projection and attach negative valence, the less you will pursue it.

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Then the more you will avoid it. Okay, you should now understand there is a double path here in our

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brain that is creating this, that is creating the state of unwanted, that lack of pleasure.

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Now you can begin to see why anxiety is often challenging to reverse, to overcome. And maybe,

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maybe you don't know, but one good way to remove anxiety is biasing yourself into that action,

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pursuing it, experiencing it, that exposure, putting yourself in those environments.

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Remember neuroplasticity, which makes us more of what we do, more of what we are.

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Remember this is learning. Remember at the beginning of learning are underlying thoughts

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and feelings of frustration and agitation. We are working. The body, the nervous system, and the brain

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is working on changing and experiencing this. A side note, testosterone is highly involved here too.

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More information from Robert Sapolsky. Testosterone's role in the body is to make effort feel good.

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Dopamine and testosterone are closely related. They are very closely related in our biology.

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And they are two of maybe my most fascinating areas of the entire body.

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When we experience and we learn things, when we take on that neuroplasticity, this becomes preferred.

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Remember, the brain and nervous system does what it knows, does what is easiest for it. It does not

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like to work. We passively navigate the world based on this. As we experience this, the first few

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times, this is state, a temporary feeling. As we experience it more and more, it becomes a trait

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or personality or propensity or behavioral phenotype. Now, I basically just use several

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different words, definitions to describe the same thing. Remember that. You can see and definitely

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know people that are more anxious than others. The connections are thicker in the nervous system,

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though cellular connections. This is called morphology. And the thicker these are, the more

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they become activated. This is all people, autism or not. It shouldn't be hard to understand if

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frequency implicates this learning mechanism. This neuroplasticity, why autism and anxiety

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track so closely. I would like to review specific situations common in autism that leads us to

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anxiety. The easy one is socialness. Socialness is very unpredictable with many sources to keep up

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with, to evaluate and to interpret or said differently. Makes sense of. There's a lot to make sense of.

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One is the sensory processing phenomena, that trait of information. Remember Diceroth's explanation,

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that fire hose of information. Two things in the social world have many meanings.

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The same thing could have multiple meanings. How does this make sense?

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Three, the lack of social skills. This could be the top contour of the problem.

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But independent from that sensory processing, all of these things, all of these components or

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situations creates pressure. Remember simple things, simple things in life to most. Like how to join a

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conversation or how to end a conversation. Both are very challenging for autism.

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Another situation or examples include running plans, having expectations and that attention to

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detail. There's high attention to detail. Remember the episode on how thrilling it is to execute our

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plans with exact precision. Having these sets of items, this routine set. How we are going to execute

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this and doing it. When this is disrupted, we hate it. Especially because most or everything

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disrupting it does not make sense to us and it's coming from the outside, the outside world.

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Understanding the purpose of things in the outside world is chaotic.

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Now you can understand more about the preference for little or no social interaction.

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It allows us to control the environment. Be aware when this stuff is disrupted,

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especially for children or more challenging autism, level 2, level 3 or maybe that profound

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autism that I hope to discuss in the near future. It is crushing.

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I understand maybe our reaction does not match reality, but we just discussed that bodily states

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involved in anxiety and it must be mentioned and or asked who determines reality. Maybe our reality

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differs from you. Remember the comments about don't try to change someone with autism because

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they are different than you and different from others. Another component or a source of anxiety

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is language. You know my thoughts. The English language is pretentious and lazy. We briefly

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discussed how words have double meanings and so forth. It's all very confusing. It's all very human

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thought, human creation. Abstract thinking and starting task developed by others. This is complicated

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for several reasons. Some reasons we just discussed like language or making sense of others and not

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limited to verbal or written instructions, which is just more language or diagrams or the pace of

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others or us explaining something to others. Remember the challenges with us using speech and

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language to explain something, be it feelings or instructions or a process. Another component

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with language or human interaction is a lot of hypotheticals involved. I used to think to myself,

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I don't dance to hypotheticals. I used to say this to myself quite frequently. This is opposite of

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recall. Recalling information, details, facts, memorization, which are typically superpowers

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for autism. These hypotheticals in life are in complete contrast to those. Abstraction is more

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gray area. Autism enjoys less gray area and more black and white. We prefer or need that black and

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white. Remember B3 and if you don't remember B3, please look it up. Other factors include keeping up

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with outside conversations and transposing that language into visual thinking, getting stuck

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or delayed. Often people will just jump in and whenever I'm trying to finish or explain something

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and they just jump in to finish it themselves. I think maybe they have a propensity and inject

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themselves into others or maybe it's a combination of me, my speech and language and their personality.

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We or I can get caught while speaking, turning what is happening in my thoughts and feelings

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into speech and language. And remember echolalia. Echolalia is challenging or delays our social

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communication. It's just another barrier, another source of something that could cause anxiety.

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Pairing up, finding a task partner which is common in the classroom. I'm 43 and still hate this.

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Either I pair up with whoever is last, whoever does not have a partner yet or AG. I will not

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mention his name but AG will holler out to me to pair up and I appreciate that from him. I like AG.

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This is very hard to explain. If I ask others and they say no, perhaps they've paired already.

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It's just no. But approaching that and trying to navigate through and find someone is very awkward.

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Yes, this is certainly a super deficit and likely to change this I need to go back and listen to

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the neuroplasticity that we just discussed. Putting myself in that environment, in that

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situation and learning it and experiencing it. That is how I would overcome this problem.

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Much like any other person with autism. Another source is changes in routine. The world is a

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constant change. The outside world. Remember is a chaotic environment insofar as considering

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all of the variables and variations. This sits criteria B hard. Especially B2 and B3. Remember

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our very first episode. I have B2 and B3 pretty severe. Identifying emotions, labeling them or

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understanding them. So therefore managing them. The emotions. Especially younger.

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Younger people with autism and those with level two or three. Those requiring more and more support.

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Identifying emotions or an inability to identify them. I should say has a clinical definition

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called elexithymia. During the ADOS2 mod 4. There was a section on this. That section was of.

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Was one of a couple of sections there that made me uncomfortable during this test.

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The ADOS2 is considered the gold standard. In the near future. The podcast hopes to have

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Dr. Catherine Lord on to discuss autism. Dr. Lord is a top researcher and scientist on autism.

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As we wrap up today on autism and anxiety. It is important to understand anxiety is very finite

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within the body. But pretty powerful. Anxiety is not necessarily a bad thing. Anxiety just helps us

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identify certain things. Anxiety helps us bias ourselves into action. But when our perception

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of reality is mismatched or it's off. Our biasing into action can become a problem.

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Instead of healthy adaptation or active coping. We can bias ourselves into some negative responses.

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Also just the whole neuroplasticity aspects regarding anxiety. Learning how we go from these

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acute bouts of anxious and stress into this being preferred in our nervous system. So as we encounter

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certain outside stimuli or unexpected things in the outside world. Our responses start becoming

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preferred and ingrained in us. And that changes us. That builds us straight. These things build up

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and they thicken our connections and increases our propensity of experiencing these. Increasing our

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propensity of just reacting and responding in such a manner. Avoiding things. Because

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avoiding them becomes safer for us. If you are enjoying the episode or enjoying the podcast.

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Please feel free to leave a review or rating. In podcasting reviews ratings and downloads are huge.

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And I very much appreciate your feedback. If you would like to contact me please do by email

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at info.fromthespectrum.atgmail.com. And thank you for listening to From the Spectrum podcast.