Alexithymia is a phenomenon that many autistic people, including myself, struggle with. It refers to having significant challenges in recognizing, expressing, sourcing, and describing one’s emotional states. While about 1 in 10 people in the general population experience alexithymia, it affects 1 in 5 autistic people, making it twice as common in us. But numbers don’t tell the full story of how deeply this condition can impact our lives.

For me, discovering things like alexithymia and sensory processing disorders was a major turning point in realizing I was autistic. These experiences became a gateway into learning more about autism and, ultimately, seeing my own experiences reflected in those of other autistic people.

The only emotion I’m ever really aware of in real-time is anxiety—or, more accurately, agitation—based on the physical sensations it brings. My body becomes tense, my stomach knots, I feel dizzy. This hyper-awareness of physical symptoms makes me sensitive to emotions like anger, fear, and sorrow. Yet, even then, I can’t necessarily tell them apart. I only know that I feel uncomfortable, hyper-vigilant, and too aware of my surroundings.

And, because an absence of anxiety isn’t the same as joy or contentment, I often find that every emotion feels like anxiety. It’s only after I’ve had time to process the situation that I can piece together what I was truly feeling.

Most definitions of alexithymia fail to capture, though, how this emotional fog can extend to other aspects of self-awareness, especially interoception. Interoception is the sense of what’s going on inside your body.

After all, emotions don’t exist in isolation; they manifest physically. If we struggle to identify our feelings, it’s likely because we have trouble sensing and interpreting those physical signals. This was originally something I only ever heard from people in the autism community. Still, the theory seems to be growing in popularity.

I didn’t realize this connection until I heard about it in the autism community. It makes sense to me now—my difficulties with alexithymia and interoception are deeply intertwined.

Since I usually only recognize anxiety when it hits me physically, I’m often unaware of how anxious I am until it’s too late. By the time I notice, I’m already dealing with tension headaches from my clenched jaw or an upset stomach. My attempts at coping are often more about damage control than prevention. And when I do manage to catch it early, it’s because I’m hyper-focused on scanning for subtle signs of anxiety, which ironically leaves me just as exhausted.

Either way, it can feel like a losing game.

This struggle also extends to overstimulation, particularly in social settings. Autism comes with cognitive processing difficulties that slow my awareness in social situations. Add alexithymia to that, and the processing difficulties are two-fold. I rely on being in tune with what my body is telling me to interpret what I’m feeling, but when I’m overstimulated (such as in social situations), it takes me longer to process those physical signals. I don’t notice I’m anxious or overwhelmed until alarm bells are going off in my head. By then, my jaw is tight, my head throbbing, and my neck immobilized from the strain–physical symptoms that take days to recover from.

And then there’s appetite. You might not associate alexithymia with eating, but it’s a massive contributor to my disordered eating habits. Like many autistic people, I have sensory sensitivities around food—textures, tastes, smells. Add to that a lack of hunger awareness and medications that suppress appetite (like Adderall), and eating becomes less about hunger and more about convenience. I often eat because food is there or I know I should, not because I feel hungry. Only when the physical signs of hunger hit—like dizziness, nausea, or headaches—do I realize I’ve gone too long without eating.

Once I do start eating, the same problem arises with knowing when to stop. I don’t feel “full” until I’m uncomfortably stuffed, which takes the joy out of meals. I try to stick to the same eating schedule and meals daily to avoid these pitfalls, but even that strategy is unpredictable. I can eat the same thing for months on end with no problem, and then suddenly, one day, I can’t stomach the thought of it.

Living with alexithymia often feels like navigating through a fog—you can’t always see where you are. By the time you realize something’s wrong, you’ve already stumbled off the path. It’s isolating and frustrating, but it’s also a puzzle I’m still learning to solve.

For anyone else facing similar challenges, it’s important to remember that understanding your emotions—and yourself—is a lifelong process. There’s no single “right” way to do it. We’re all learning in our own time.

Alexithymia is just one of many aspects of being autistic that underscores how complex and varied our experiences are. It’s a reminder that our perceptions and ways of processing the world are different, and those differences deserve to be understood—not dismissed. We must recognize and appreciate these nuances as we push for greater awareness and inclusivity. Autism isn’t a one-size-fits-all experience, and the more we learn about its many layers, the better we can support each other in a world that’s not always built with us in mind.