Background

When you start a new job, you will encounter many new experiences. Some you will enjoy, others you may not. Adapting to a new environment can be challenging to some people on the Autism Spectrum. This article focuses on how to build the foundations of emotional balance and mental wellbeing. It will guide you through making a plan to make small changes that can increase your emotional resilience (ability to adapt to stressful situations) and mental wellbeing.

It is common to feel stressed at work, in fact, the Health and Safety Executive report that over 11 million days a year are lost due to employees feeling stressed. However, as people on the Autism Spectrum tend to have higher levels of anxiety than other adults, it’s important to know how to deal with these feelings (alongside other forms of support like therapy, counselling and medication where appropriate) so that they don’t become overwhelming.

Why is this relevant?

You may be looking forward to your new job and learning new skills or it may feel like quite daunting, or a mix of both. These is normal and understandable. It may be that you are looking forward to learning in depth about your job and hoping that you may find some like-minded people at work.

Whatever it is that you are experiencing these are the most common challenges people experience:

Practical tips

To meet the challenges we face in life, we need to keep our bodies and minds healthy. A simple model for this, based on Marsha Linehan's research, is the PLEASE model: treat Physical illness, baLance Eating, use Alcohol responsibly, balance Sleep, and get Exercise.

Physical Illness

When we are ill, it becomes harder for us to think clearly and we may find ourselves getting upset or angry. It is important that you see a GP straight away if you feel ill. However, it can be daunting to phone the GP surgery and talk to the receptionist.

There are a few things you can do to make GP appointments work better for you:

• You could visit the GP surgery before you are ill so that you are familiar with the layout. If you feel you could do with some extra support, take a family member or friend with you.
• Find out if you can book appointments online.
• Write down what you need to say to the receptionist or GP before you go.
• Complete a hospital passport, which explains your communication preferences, how you express pain and what people can do to reduce your distress. This can be useful for both the GP and hospital staff.

It may be possible to ask for the following reasonable adjustments:

• Early/late or longer appointments
• Somewhere quiet to wait, or waiting outside and being called in from there
• Seeing the same clinician if at all possible (recognising that in an emergency this may not be possible)
• Accessible information in a format you understand about how and when appointments are available and how to get prescriptions or access services like cancer-screening tests.

Balanced eating

Our energy levels and emotions are directly affected by the food we eat and what we drink. When starting a new job, it may be more difficult to find the time to cook and people may be tempted to turn to fast food, chocolate and crisps as these foods are often cheap and easy to get hold of. These types of food can also initially provide some comfort of their own. However, if they are our main food source, they can lead to us feel run down and exhausted.

It is a good idea to plan ahead for how you will ensure you have a balanced diet. Learn about what nutrients you need to keep your energy levels up, so that you can make the most of your job. Below, we provide some useful links to easy recipes.

Responsible alcohol use

Many people can use alcohol to try and reduce the feelings of anxiety, especially when socialising. In the short term, these can appear to reduce the anxiety/distress, which is why some people use them. However, in the longer term it creates increased distress and anxiety, so does the opposite of what is intended.

If you think you may be over drinking, you may want to start reflecting on how you can manage uncomfortable situations in which you may feel tempted or pressured to drink. Think about what you are comfortable drinking and learn the signs that you need to stop drinking on that evening. It can also help to think about what you enjoy and what helps you to feel calm and relaxed.

Balanced sleep

Autism can make getting a good night’s sleep more difficult. Research has shown that many different factors contribute to this, including irregular sleep-wake cycles (circadian rhythms), physical health issues such as gastrointestinal problems and epilepsy, or anxiety and depression (which affect sleep because the brain is constantly trying to sort through the day's events or other worries). All of these factors can mean that it takes longer to fall asleep, it is harder to stay asleep and the depth and quality of sleep is lower than average. Being constantly tired can, of course, make your daily activities much more difficult.

Thankfully, there are many things that can help you to get a good night’s sleep. These include some of the other things on this list, like a balanced diet, and regular exercise. It also helps to have a clear daily structure, with consistent times for going to sleep and getting up. This can be difficult to establish when in shift work so you may want to request regular shift patterns.

If you have started work and you are having difficulty getting a good night's sleep, it may also help to talk to your GP about how to get a good night's sleep.

Exercise

We all know that we should exercise regularly but sometimes it can be very hard to do, especially if you are feeling low or anxious about what others may think. It may help to remind yourself about the many benefits exercise can bring you, such as:

• using up adrenaline (produced by anxiety)
• releasing endorphins and other chemicals which are good for the body and mind
• helping the body to repair itself better, with quicker recovery from infection
• reduced anxiety and improved mood
• helping to clear the head and think more clearly

If you unsure which exercise to do, you could try talking to a trainer at the sports centre and discuss what would best suit you.

Questions to think about

Physical illness

Before you get ill you may want to consider the following questions:

• Do you think you need any adjustments regarding timing of appointments?
• How you would like the GP surgery to communicate with you?
• Would you need to see the same clinician every time?
• Are you comfortable making appointments on the phone or would you rather make them online?

Once you have the answers to these questions, contact the GP surgery and ask them to make any necessary adjustments. You can ask for a key named contact person who will navigate the system for you.

Balanced eating

A balanced diet requires planning as you need to allow time both for shopping and cooking, so you need to allow time for this in your timetable. Here are some questions you may want to think about regarding your preferences:

• Do you think it would work better for you to devote one day (e.g. Sunday) to shop and cook for the week or do you think it would be better for you to introduce cooking as a daily routine at the end of each day?
• Which vegetables and fruit do you most like? Can you find recipes that include them? In what other ways can you include them in your diet?
• If you share accommodation, have you consider sharing cooking with your housemates? It can be cheaper and also a good way to share the load.

Responsible alcohol use

Think about the situations in which you may find yourself tempted to drink more than you would like to:

• Do you find it more comfortable to go out in small groups or larger groups ?
• What sort of places you find easier to go to?
• Do you like loud places or quiet places, bright lights or gentle lighting?

Once you know what makes things more comfortable for you, think about how you can explain this to your friends and, where appropriate, work colleagues. It may feel hard to explain this to others, but most people want the people they are with to feel happy and have a good time.

Balanced sleep

Before you start work, it may be helpful to think about your bedtime routine and what helps you to sleep well. Once you have a clear idea of what works for you, then the next stage is to think how you can replicate with your new work routine.

Exercise

It is sometimes hard to get into a routine to exercise regularly. Here are some things you may want to think about to get you started:

• Do you like team sports or group classes or do you prefer to exercise on your own?
• Do you enjoy outdoors or prefer a gym?
• If you are not one for active sports, have you considered merely walking? Try walking to work a longer way, or setting a routine to walk at east 3 times a week.
• Looking at your weekly timetable, are there any slots you could use to exercise, even if for short periods?

Additional information and links

• Managing stress in autism factsheet
• The National Autistic Society workbook offers guidance on how to manage anxiety at work (pages 190-203).

Physical illness

• Making the most of your visit to the GP: A guide for those on the autistic spectrum
• National Autistic Society - Hospital passport and guidance

Balanced eating

• Find information here about the link between diet and mental health, and what you need to watch out for here.
• There are many websites where you can find healthy and easy recipes: Brain boosting recipes and a helpful app from the NHS called Easy Meals.

Alcohol abuse

• If you are worried about your own, or others' drinking habits, you can find advice and support here.

Sleep

• This link gives advice on how to set up a good bedtime routine.
• Smiling Mind is a free mindfulness meditation resource and once you have registered, you can use all the resources. There is a module on sleep. You can find it here.
• This app gives relaxing melodies to aid sleep: Relaxing melodies app (for iPhone only)

Exercise

• The Mental Health Foundation has an article outlining the benefits of exercise and gives some ideas about how to start it. You can find it here.

About the author

This article was adapted from an article written by a clinical psychologist, Abigail Tolland, who works as a mental health adviser at the Student Wellbeing Service at the University of Portsmouth.

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