Anxiety and intellectual disability are two phenomena that often coincide. There does appear to be a link between the two, but the evidence is mixed. The question is: is anxiety an intellectual disability? Are they the same or entirely different?
First, we’ll look into what anxiety and intellectual disability are, then focus on unpicking their relationship.
Anxiety and Intellectual Disability: What Are They?
What is Anxiety?
Anxiety is a natural human emotion that helps us respond to a threatening or stressful environment. But regular old anxiety isn’t what we’re talking about when we’re discussing the relationship with intellectual disability - we’re looking at anxiety disorder.
An anxiety disorder is when someone experiences intense feelings of fear and unease in situations that don’t call for such a response. Alongside these pervasive feelings of worry, there are other physical symptoms, such as:
- Rapid, shallow breaths
- Chest pain
- Increased heart rate
- Feeling overwhelmed
- Breathing difficulties - struggling to catch your breath
- Muscle tension/soreness
You can find a detailed guide on anxiety symptoms here.
What is Intellectual Disability?
Intellectual disability (ID) is a developmental disability. In fact, it's the most common one. Someone is believed to have an intellectual disability if their IQ score is below 70 - 75. To receive a diagnosis of intellectually disabled, they must have two adaptive areas of significant impairment (such as skills required for living, working, communicating, taking care of themself, and engaging in the community). Additionally, the condition will only be classed as an intellectual disability if it manifests in childhood, before 18 years of age.
Someone with an intellectual disability may struggle to learn new skills, which makes living independently a challenge.
There are several believed causes of intellectual disability:
- Pregnancy complications
- Birth problems
- Disease (whooping cough, meningitis, measles) or exposure to poison (from mercury or lead).
Intellectual disability affects approximately 1 - 3 % of the global population. However, it's more prevalent in low-income countries.
Is Anxiety an Intellectual Disability?
While anxiety is considered a disability, researchers don't regard it as an intellectual disability - they believe the two are separate entities. The evidence suggests that those who are socially anxious or have generalized anxiety disorder tend to have a higher IQ than those without.
But that doesn't stop people with anxiety disorders from feeling unintelligent at times. Anxiety disorders are often associated with lower self-esteem. Individuals suffering from the condition may experience confusion and forgetfulness, which can make it trickier to perform everyday tasks.
Although intellectual disability isn’t the same as anxiety, the two are frequently comorbid. The research demonstrates that around 22% of children and adolescents with an intellectual disability also suffer from an anxiety disorder. In adults, this statistic supposedly drops to up to 17.4%.
However, this statistic may not illustrate the true prevalence of anxiety disorder in people with ID, as it is often challenging to identify anxiety in these individuals. Why is this, you ask?
It can be difficult for those with ID to communicate and describe their anxious thoughts and feelings, and they may struggle to understand them themselves. Another possibility is that their challenging behaviors might mask their anxiety.
Usually, those with intellectual disabilities receive an anxiety disorder diagnosis because their parent/carer notices a sudden change in their behavior. For example, they may become irritable or aggressive, have trouble sleeping, and become less interested in activities they used to enjoy.
It's vitally important to seek treatment for anxiety in those with intellectual disabilities. If not, their quality of life will likely suffer significantly. Below, we explore how to treat those with anxiety and an ID.
Treating Anxious Symptoms in People with Intellectual Disability
There are many treatment options to help relieve those with an ID of their anxiety symptoms. These include:
- Cognitive Behavioral Therapy (CBT)
- Stress-relieving daily activities
Cognitive Behavioral Therapy for Anxiety
Cognitive Behavioral Therapy (CBT) is a form of talking therapy that focuses on how a person feels in the here and now. A CBT practitioner will provide tools to help individuals cope with their anxious thoughts, feelings, and behaviors.
CBT is one of the first ports of call for treating those with anxiety, and evidence demonstrates it has positive outcomes for people with ID who are experiencing anxiety, too.
However, the CBT administered may need to be adapted for those with intellectual disabilities.
Counseling for Anxiety
The evidence for the effectiveness of counseling for people with ID and anxiety is mixed. While some reports suggest that it’s ineffective, others argue that counseling can assist an individual with ID and anxiety cope with their everyday challenges.
Counseling also has the benefit of being highly adaptable - therefore, the therapist can alter the treatment to suit the needs of an individual with ID.
Medication for Anxiety
Medication is an excellent choice if an individual's anxious symptoms are severe and highly debilitating. While medication may alleviate the symptoms associated with anxiety, it will not provide a 'cure.'
It's also important to note that medication isn't recommended as a stand-alone treatment - it is supposedly much more effective when used in conjunction with a form of psychological therapy like CBT or counseling.
The medications usually prescribed for those with anxiety and ID are antidepressants, stimulants, and antipsychotics. These medications have side effects, so this is worth bearing in mind.
Stress-Relieving Activities for Anxiety
Stress-relieving activities are recommended for intellectually disabled people suffering from anxiety as they can help cope with everyday difficulties that may cause elevated stress levels.
Deep breathing and progressive muscle relaxation techniques are excellent options to incorporate into your everyday routine. Other activities to try are visualization, meditation, and yoga.
The Bottom Line
Anxiety and intellectual disability often co-exist, but they're widely viewed as separate developmental disabilities. Research examining the relationship between the two supports this, as anxiety disorder is often commonly associated with high intelligence, and anxiety only occurs in up to 22% of individuals with intellectual disabilities.
Nonetheless, anxiety disorders can be hugely debilitating for those with intellectual disabilities and are often difficult to spot. If you're worried an intellectually disabled loved one is struggling with anxiety, get them the support they need through talk therapy, medication, or daily stress-relieving activities.