In general, anxiety features significantly in the lives of those with Asperger Syndrome. Living in a continually confusing and predictable social world is stressful. Routine-based and ritualistic behaviour is often used as a way of coping and alleviating anxiety.

Awareness of not 'fitting in', being socially vulnerable and negative social experiences can affect self-esteem and increase anxiety. Low mood can also be a consequence of knowingly living with a socially disabling condition and people with Asperger Syndrome can be more at risk of mental health problems.

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