Autistic women experience exhaustion in ways that go far beyond feeling tired—learn to identify the hidden signs of burnout that often go unnoticed by healthcare professionals.

Exhaustion in autistic women often looks and feels different from the tiredness experienced by others. It’s not just about being physically drained—it can manifest in subtle, sometimes hidden ways that are easily overlooked, even by healthcare professionals. For those who work in mental health and frontline healthcare—especially GPs, nurse practitioners, and physician assistants—recognizing these signs early can make a significant difference in providing the right support and intervention.

Autistic women are often underdiagnosed or misunderstood in their exhaustion, as it doesn't always follow the typical patterns of fatigue or depression seen in the general population. This article aims to help you spot the signs of burnout and exhaustion in autistic women, so you can better guide and support their well-being.

Exhaustion Beyond Fatigue

For many autistic women, exhaustion is more than just being tired. It involves a complex interplay of physical, emotional, and sensory overloads that leave them feeling disconnected, overwhelmed, and sometimes physically unwell. Unlike typical burnout or fatigue that might improve with rest, this form of exhaustion tends to be more persistent and deeply ingrained. It doesn’t always align with what we traditionally think of as depression, either.

Here are some of the more subtle ways exhaustion can manifest in autistic women:

1. Physical Symptoms as an Early Warning Sign

Exhaustion in autistic women often presents itself physically before it manifests emotionally or mentally. These signs can include:

• Recurring Infections: Chronic UTIs, sinus infections, or gastrointestinal issues like constipation or diarrhea can be a sign of burnout. The body becomes more susceptible to illness due to constant overstimulation and a lack of restorative rest.
• Frequent Headaches or Migraines: These can be triggered by sensory overload or mental strain, both of which autistic women often face in environments that aren’t accommodating to their needs.
• Sleep Disruptions: Restless sleep, difficulty falling asleep, or staying asleep can signal an exhausted nervous system. Sleep disturbances are common in autistic women, especially when they’re unable to unwind due to overstimulation.

2. Emotional Overload and the Need to Disconnect

Autistic women may experience emotional exhaustion differently than the general population. The frustration, confusion, and overwhelm that come with managing social expectations and daily demands can accumulate in ways that lead to:

• Suicidal Ideation: This may not always manifest as a desire to end life but rather as a way to escape the constant demands. It’s often a plea for peace and quiet—a break from the world and its pressures.
• Anxiety with a Twist: Anxiety in autistic women is often more intense and manifests in two distinct ways:
• Activated Anxiety: This is experienced as a rush of thoughts, like having 20 tabs open in your brain or multiple tracks of music playing simultaneously. The mind races, and the body feels like it's vibrating from the inside out. It’s a feeling of being on high alert without being able to focus or slow down.
• Low Experience Anxiety: This is the feeling of walking through thick mud or wet sand. The body feels heavy and sluggish, while the mind is foggy, scattered, and slow. It's as if every task becomes an uphill battle.

3. Social Withdrawal and Emotional Detachment

Autistic women may appear emotionally distant or aloof when they’re exhausted. This emotional withdrawal is often a coping mechanism—one that protects them from overstimulation and the demands of social interaction. However, this behavior can be mistaken for depression or indifference. In reality, it’s a sign of emotional and mental overload along with self preservation.

4. Hyperactivity and Sensory Overload

At times, exhaustion might not seem like exhaustion at all. Instead, autistic women may experience hyperactivity as their minds and bodies try to manage overwhelming inputs. They might appear constantly "on," with difficulty switching off or slowing down.  There is often an underlying feeling that they aren’t safe to stop or pause.

5. Scattered Thoughts and Sensory Sensitivity

One hallmark of exhaustion in autistic women is difficulty concentrating, which is often accompanied by sensory overload. Whether it’s the sound of a buzzing light, the feel of tight clothing, or the pressure of too many tasks at once, the body and mind become overwhelmed. This leads to cognitive exhaustion, making even the simplest tasks feel like monumental challenges.

Practical Tips for Helping Professionals

As a helping professional, understanding these nuances can help you better support autistic women in managing their burnout. Here are some strategies to consider:

• Focus on Holistic Care: When assessing exhaustion, be sure to ask about both physical and emotional symptoms. Autistic women may be more likely to internalize symptoms of stress, presenting them in ways that don’t match traditional definitions of burnout or depression.
• Avoid Over-Simplification: Fatigue in autistic women isn’t simply a lack of sleep or an emotional slump. It’s a complex experience that might require a multifaceted approach, including physical health management, emotional support, and sensory accommodations.
• Encourage Self-Awareness: Encourage your patients to keep track of their energy levels and identify when they feel their symptoms intensify. This could help pinpoint potential triggers and develop more personalized strategies for managing energy. 

(Download the Whittington Well-Being Daily Stress Relief Tracker)

• Offer Sensory Accommodations: For autistic women, sensory sensitivity in one main area has been reported by 100% of research respondents in our Autistic Burnout study.  Encouraging a quieter, more controlled environment during appointments, and providing communication options beyond the use of phone calls for scheduling, can help reduce overstimulation.
• Normalize Rest and Recovery: Rest is crucial, but for autistic women, it may not always look like typical self-care practices. Gentle movement, sensory breaks, or even short breath work sessions might be more effective than traditional "rest" practices. Guide your patients toward discovering what helps them recharge.

By recognizing the subtle signs of exhaustion in autistic women and understanding how it presents differently from the general population, you can play a key role in helping them recover and thrive. Early identification of burnout warning signs can drastically reduce the risk of long-term physical and emotional damage.

For more insights on supporting autistic women through burnout recovery, download our Exhaustion Decoder for Autistic Women and learn practical strategies to help them replenish their energy and restore balance.

Download the Exhaustion Decoder for Autistic Women here

By paying close attention to these signs, you can be the supportive guide that makes all the difference in their burnout recovery journey.

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Carole Jean Whittington: Transforming Exhaustion to Sustainable Energy for Autistic Women and Their Support Team

Meet Carole Jean Whittington, a multi-award winning disability inclusion leader advocating for equitable healthcare policy and practice for autistic women.  

Carole Jean is the author of "Unleashing Sustainable Energy" a groundbreaking book setting new accessibility standards in the publishing world, along with her upcoming book, “Finding Her Autistic Self: A Guide to Self Discovery”  publishing on May 2, 2025.

Her work is reshaping the landscape of support for autistic women and their support team, fostering equitable access to healthcare and guiding autistic women to an intimate and authentic relationship with themselves. 

Carole Jean hosts the popular talk show, "Beyond Chronic Burnout," a global sensation that captivates audiences in over 100 countries. Spotify has honored "Beyond Chronic Burnout" as a top 10% podcast in the Self-Help category for 2022 & 2024 recognizing its profound impact on the Autistic community.

As Chef Well-Being Officer and Lead Researcher at Whittington Well-Being, she’s developed proprietary and groundbreaking solutions to burnout recovery for autistic women, including The UnVeiling Method, Rapid Recharge Lab, and The Inclusive Communication Ecosystem.

Through her current pursuit of a Master's in Public Health, and with over a decade of research and application, lives are transformed, and a more inclusive and supportive world is being built.

Connect with Carole Jean Today!