Alexithymia: a scientific link between Autism, Anorexia, and Anxiety

Do you frequently feel anxious? If so, you are in the right place because this post is all about the scientific link between anxiety, autism, anorexia, as well as OCD! I have personal experience with all these co-morbid disorders, so I completely understand how hard and overwhelming life can feel sometimes, if not all the time! However, just because you’re used to living a certain way, doesn’t mean you have to live that way forever. Life is an adventure that throws obstacles at you, but through overcoming the obstacles and learning strategies to dodge them, you discover your unique strengths. You learn how to not only manage what may seem like weaknesses, but you learn to embrace them and use them to your advantage. One of my favorite quotes:

Your mess will become your message

The truth of this phrase is so beautifully illustrated through my own journey: I almost died due to my eating disorder, but through literally fighting for my life to overcome the illness, I have found my purpose…or should I say, my purpose found me! That purpose is to spread the message that full recovery from an eating disorder is 100% possible for you, INCLUDING my fellow autistics, anyone who struggles with anxiety or OCD, as well as anyone who feels like the anomaly and just fears that full recovery is not possible for them.

Educating myself on the science behind why our bodies and brains behave in the way they do was a crucial part of my own recovery. It taught me that there was nothing wrong with me and that I was not broken. It allowed me to take responsibility for my health and gave me hope that there was a better life out there. By combining my research with my personal experience and incredible insights from working with clients, I now aim to help you gain a better understanding of yourself, so you can embark on your own journey to freedom.

In this post, I explain a biological link between anxiety, autism, anorexia, and OCD, and how a certain part of the brain can help us understand why these conditions often occur together. You’ll learn the role of the insula in managing our fight-flight-freeze response, how interoception contributes to anxiety, and what Alexithymia is and its role in heightened anxiety. I also share my 3 top tips for managing anxiety and increasing your sense of overall calm and peace, because don’t we all want that? If at any point in reading this you think “WOW, this is so interesting!” it would mean the WORLD to me if you could share this post with anyone who you believe would benefit. That’s a free and easy way for you to support me and all the FREE valuable content I provide! Now let’s get into loads of value and discuss the scientific link between anxiety, autism, anorexia, and everything in between!

The opposite of anxiety isn’t calm, it’s trust

Read that again! When I first heard this quote, I was completely awestruck by the accuracy of its simplicity. For as long as I can remember, I’ve struggled with anxiety. I was always worrying about what people thought of me, questioning whether I had studied enough to know the material on a test, and constantly checking to make sure everything was in its place…but when I heard this quote about anxiety being a lack of trust, it made me realize that really was at the core of my fear of the worst-case scenario. My desire to control people’s opinions of me was because I didn’t trust that they would like me for who I am. My obsessive studying and perfectionistic tendencies in school were because I didn’t trust I would know the material. The OCD around items being switched on or off a certain way, was due to a lack of trust that they were just that.

In the conversations I’ve had with my clients, community on Instagram, and other amazing people I’ve met on my journey, I know I’m not the only one who experiences heightened anxiety. In fact, anxiety is one of the most common co-morbid disorders amongst autistic individuals as well as those who struggle or have struggled with anorexia and/or other restrictive eating disorders. Not to mention OCD, another frequently co-occurring condition in the world of autism and eating disorders.

Why do so many people with Autism and Anorexia have Anxiety?

At a glance, it makes a lot of sense that feelings of anxiety and obsession are shared between the disability and disorder. Both share a deep desire for predictability and routine, obsessive thoughts and interests, as well as fear of the unknown…which ultimately comes down to anxiety being a lack of trust! We crave predictability because we don’t trust what we don’t know, and will form routines to make the situation as comfortable and familiar as possible. Because we are constantly trying to sift through the thoughts of our chaotic minds, we come across as antsy, hyperactive, and controlling. In reality, we’re just doing our best to manage the intense feelings of overwhelming fear and worry.

Despite it making sense that anxiety and OCD behaviors are shared among people on the autism spectrum and those who struggle with eating disorders, I simply cannot settle for a presumption without an explanation…and when I am looking for an explanation, I turn to science! I started to wonder if there was a biological explanation behind the anxious commonality in autism and eating disorders, and if so, what it was. Turns out, a possible explanation is the malfunctioning of the insula in affected individuals. 

Interoception and the Insula

A while back, I wrote a post and recorded a podcast explaining how interoception can help us understand the scientific link between autism and anorexia (I highly recommend you give it a read or listen in order to maximize your understanding of what I share in this post). Individuals who experience a combination of autistic, anorexic, and anxious traits are thought to lack interoceptive awareness, which is regulated by the insula. The insula is a small part of the brain responsible for a variety of homeostatic functions through regulation of the sympathetic and parasympathetic nervous systems, aka our fight-flight-freeze and rest & digest modes. When we are in our sympathetic nervous system due to heightened anxiety, our survival brain perceives a threat. Hence, the fight-flight-freeze response activates, and we may feel either angry and upset, antsy and hyperactive, or completely paralyzed by our own racing mind.

Alexithymia & Anxiety

This seemingly automatic recourse to our sympathetic nervous system can again be explained by improper functioning of the insula. Due to the lack of interoception – which also affects interpretation of emotions – a person may lack the ability to identify their own emotions, a trait known as alexithymia. People with alexithymia may be over-responsive to inner cues of fear or worry, resulting in excessive, and often debilitating, anxiety.

Alexithymia & OCD

Besides the connection in autism and eating disorders, there also seems to exist a correlation between alexithymia and obsessive-compulsive disorder (OCD). In a recent study evaluating the difference of alexithymia in OCD patients and healthy controls, patients with OCD had significantly higher scores of alexithymia compared to the control group. Thus, alexithymia may also help explain why so many people with autism, eating disorders and anxiety, ALSO struggle with OCD.

My top 3 tips for managing Anxiety!

Although you may be unable to physically change your genetic makeup when it comes to autism, eating disorders, anxiety and/or OCD, I have found several ways to make my anxiety more manageable.

Tip #1: Supplement with Magnesium

I originally started taking magnesium when I struggled with insomnia and no longer wanted to rely on melatonin supplements for sleep. I had been taking melatonin for years and thought it was the perfect solution! However, as I got more interested in a more holistic, natural approach to health & wellness, I started questioning the impact of relying on a hormonal pill to fall asleep each night. After lots of research, I learned that taking melatonin as a supplement (especially at the 5mg dose I was taking it at) can actually down-regulate your body’s natural melatonin receptors. So, in January 2020, I decided that I wanted to stop taking melatonin. This was definitely not an easy transition as I went through a long phase of sleepless nights to bring my hormones back to balance. During this time, it was magnesium that saved me!

What are the benefits of taking magnesium?

Magnesium is one of seven essential macrominerals, meaning us humans need to consume it in relatively large amounts compared to other microminerals. It has several roles in the body, one of which is supporting healthy brain function and helping with muscle relaxation. Research shows that magnesium plays an important role in regulating neurotransmitters, specifically Gamma-Aminobutyric acid (GABA). GABA’s role in the brain is to reduce the activity of the neurons to which it binds. Because of its inhibitory function, GABA plays an important role in managing anxiety. Therefore, a magnesium supplement is worth looking into if you are an anxious person and are craving some peace of mind!

Another key role of magnesium is to work alongside calcium to help regulate muscle movement. Taking a magnesium supplement before bedtime can help you feel more relaxed and thus, get a better night’s sleep. Furthermore, it can also help to reduce tension headaches and migraines because it relaxes the muscles that are tight. I take these Magnesium gummies every night!

Tip #2: Deep Breathing

When’s the last time you took a deep breath? If you’re like me in my anxious phases, I’d have no idea. Many of us who struggle with anxiety are constantly running around worrying about every small detail, that we “forget” to just execute the essential human functions properly! I used to tell myself “I don’t have time for deep breathing”, but this is EXACTLY why I started doing it.

Focusing on your breath is one of the easiest, most convenient, and most effective ways to reduce stress and anxiety. Not to mention, it’s completely FREE! I first started using the deep breathing technique to reduce eating-induced anxiety, a common type of anxiety among people recovering from eating disorders. When you take deep breaths, you stimulate your vagus nerve, which activates your parasympathetic nervous system, also known as your rest & digest mode. I dive way deep into how you can naturally improve your digestion through stimulating the vagus nerve in my Extreme Hunger Course, so check it out if you want guidance on that! When you take slow, controlled breaths, you are consciously slowing down your heart rate and allowing increased blood flow to the brain. This signals your brain that you are safe and results in a sense of peace and calm.

Because I am now more aware of my breath, I’m also more aware that I often hold in my breath. Perhaps, when I get an unexpected email or an invoice for a ridiculously high amount! These are all “shocks” to the system and thus signal “danger” to the brain. It’s in these moments that deep breathing can assure your body there is no immediate danger and the reality is that you are safe!

Tip #3: reducing exercise intensity and incorporating a daily yoga practice

As someone who’s been an athlete all my life, exercise was one of those things that was really hard for me to “dial down” on. I saw athleticism and exercise as part of my identity, just as I did getting good grades, trying to make everyone like me, and pretty much trying to make everything “perfect”. Little did I know these were ALL adding extra stress onto my body. People don’t often recognize exercise as a stressor because of the endorphin rush that you get after a good workout; isn’t exercise GOOD for you? Yes, but TOO MUCH of a good thing is no longer a good thing! If you feel you NEED to exercise (just as you may feel you NEED to eat “healthy” or “clean”), it isn’t so healthy anymore.

Too much exercise can result in high levels of cortisol, which is your stress hormone. This puts your body into your sympathetic nervous system (back into that fight or flight mode) and results in feelings of anxiety and trouble falling asleep. I mean think about it: how easily do you think you’d be able to fall asleep if a tiger were chasing after you? Well, that excessive exercise is making your body think you ARE being chased! 

Don’t get me wrong, I absolutely love working out, but one very important thing I’ve learned about my body on my recovery journey, is that high intensity workouts simply don’t agree with me if I’m doing them too frequently. I have always been a very hyperactive and energetic person and found it’s essential for me to move my body in some way every day, but it was a revolutionary discovery for me that movement DOES NOT equal what’s commonly known as “exercise”. Since incorporating stretching and yoga into my daily routine (which combines deep breathing, double win!), I have drastically improved my feelings of overall calm. If you follow me on Instagram stories, you also know I am obsessed with my walks because I also get to listen and learn from my favorite audiobooks and podcasts!

I’m not going to lie: in the beginning, it was HARD switching up my routine and swapping out HIIT workouts for lower-intensity movement…but just as with everything, it WILL get easier over time! As I explained in my podcast episode How I’m Trusting the Process During Uncertain Times, our brains DO NOT LIKE change; we’re not called creatures of habit for nothing! When you initially do something differently, it WILL bring up anxiety because you literally don’t trust a new outcome. However, in order for your brain to learn that another outcome is also okay – and may even be better – you need to allow yourself to discover this outcome through exposure.

I hope this post gave you a better understanding of the link between anxiety, autism, anorexia, and OCD, as well as some guidance on how manage your own anxiety! If you want to dive even deeper and get personalized guidance to overcome your anxiety and fully recover from your eating disorder, I invite you to look into 1:1 Coaching! Surviving with an eating disorder is a lonely existence, so luckily, you don’t have to go through recovery alone.

Sources:

1. Interoception in Autism and Anorexia

2. Interoception, homeostatic emotions and sympathovagal balance: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062099/

3. Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology: https://pubmed.ncbi.nlm.nih.gov/32758290/

4. Alexithymia in obsessive-compulsive disorder: clinical correlates and symptom dimensions: https://pubmed.ncbi.nlm.nih.gov/21878784/

5. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452159/

6. All you need to know about melatonin: https://www.medicalnewstoday.com/articles/232138

7. Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders: https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00044/full