Alexithymia in Neurodivergent Adults: When Feelings Are Hard to Name

Many autistic, ADHD and AuDHD adults say some version of:

🗣 “I know something is wrong, but I don’t know what I’m feeling.”
🗣 “I can tell other people are upset, but I can’t always tell what’s happening inside me.”
🗣 “I only realise I was stressed once I crash or get sick.”

This difficulty noticing, understanding or describing emotions has a name: alexithymia.

Alexithymia in neurodivergent adults is not a diagnosis on its own. It is a trait or pattern that can appear in many conditions, and it is especially common in autistic and otherwise neurodivergent adults. Understanding it can make sense of a lot of confusion around “emotional awareness”.

🧾 What this article explains

💡 What alexithymia is (and what it is not)
🧠 How it shows up in neurodivergent adults
🧩 How it interacts with autism, ADHD and AuDHD
🔍 Why it complicates anxiety, depression and burnout
🧰 Practical strategies to work with alexithymia rather than against it

The aim is educational: to give you language and a framework, not to diagnose or label you.

💡 What is alexithymia?

Alexithymia literally means “no words for feelings”. In practice, it refers to difficulty recognising, interpreting or describing emotions.

People with alexithymic traits might notice:

🧩 Vague internal sensations (tight chest, knot in stomach, tiredness)
❓ Uncertainty about whether they are sad, angry, anxious, bored, or something else
🗣 Struggle to explain feelings beyond very general labels like “fine”, “stressed” or “bad”

Alexithymia includes several related difficulties:

🧠 Identifying emotions
🧠 Distinguishing emotions from bodily sensations (for example, “Am I anxious or just hungry/tired?”)
🧠 Finding words to describe emotional states to others

It is not about not having feelings. It is about reduced access to clear information about those feelings.

🧩 Alexithymia vs “not being emotional”

A common misconception is that alexithymia means “emotionless” or “cold”. In reality, many people with alexithymia:

💥 Feel emotions strongly but cannot easily identify or explain them
🧊 May appear calm, flat or detached from the outside
🧱 Have learned to mask or suppress expression because they don’t know what to say

Important distinctions:

❌ Alexithymia does not mean you lack empathy
❌ It does not mean you don’t care
❌ It does not mean you never feel anything

✅ It does mean that the information channel from body/brain to conscious understanding is limited or noisy.

🧠 How alexithymia shows up in neurodivergent adults

In autistic, ADHD and AuDHD adults, alexithymia often shows in specific ways.

Internal experience

🧩 Difficulty answering “How are you feeling?” with any detail
🧩 Realising emotions only in hindsight (for example, “I guess I was anxious all week”)
🧩 Confusion between different emotions, especially those that feel similar in the body (anxiety vs excitement, anger vs overwhelm)

Behaviour and coping

🧍‍♀️ Using actions instead of words to communicate distress (withdrawing, cancelling, snapping)
🔁 Repeating the same behaviour in stressful situations because emotional signals aren’t clear enough to guide change
🧺 Missing early warning signs and only reacting once things are unbearable

Relationships and communication

🗣 Giving very cognitive explanations when asked about feelings (facts, logic, timelines)
🔍 Finding it easier to analyse other people’s emotions than your own
⚖️ Being told you’re “hard to read” or “hard to connect with emotionally”

Many neurodivergent adults only discover the concept of alexithymia later in life, and it often explains longstanding confusion around emotions.

🧭 How alexithymia interacts with autism, ADHD and AuDHD

Alexithymia can occur in many groups, but it is particularly common in autistic adults and also appears in ADHD and AuDHD populations. It interacts with each neurotype a bit differently.

In autistic adults

🧠 High rates of alexithymia are reported in autistic populations
🧩 Combining sensory overload, social decoding load and alexithymia makes it harder to distinguish “I am overwhelmed” from “I am angry/sad/anxious”
🧱 Shutdowns or meltdowns may appear “out of nowhere” because internal emotional build‑up is not consciously registered earlier

In ADHD adults

⏳ Fast-moving situations and attention shifts make it harder to pause and label internal states
🔁 People may act on impulses or urges (for example, quitting a job, starting an argument, bingeing on stimulation) before realising which feelings were driving those actions
📦 Emotional awareness is often delayed until after the behavioural consequence or crash

In AuDHD adults

🎢 Combined autistic and ADHD traits add layers: sensory overload, social masking, time blindness and fast internal shifts
🧩 Alexithymia here may look like rapid swings in behaviour with unclear emotional narrative (“I don’t know why I suddenly couldn’t handle it”)
🧱 This can increase confusion in both self‑understanding and relationships

In all three groups, alexithymia can make it harder to use typical “check in with your feelings” strategies that therapy or self‑help often recommend.

🔍 Why alexithymia complicates anxiety, depression and burnout

When feelings are hard to recognise, emotional states can escalate without being named or addressed.

Anxiety

😰 Anxiety may show up mainly as physical symptoms (racing heart, nausea, tension)
❓ Without clear emotional labelling, it may be misattributed to physical illness, “random panic”, or nothing at all
📈 This can delay seeking support and make anxiety feel unpredictable and unmanageable

Depression

🌧 Low mood may be experienced more as heaviness, tiredness and lack of motivation than as clearly felt “sadness”
🧊 People may say “I don’t feel sad, I just feel nothing”
📉 This can lead to self‑criticism for “not having a reason” to struggle, despite significant impairment

Burnout

🔥 Emotional and physical exhaustion may build for weeks or months without being consciously noticed
🧱 The person may only recognise burnout when they can no longer function in daily tasks
📆 Without emotional feedback, it is harder to adjust workload early, leading to deeper burnout cycles

In all of these, alexithymia isn’t the cause of the condition, but it reduces early warning information, making conditions harder to detect and manage.

🧪 Alexithymia and body signals: interoception

Alexithymia is closely connected to interoception — the ability to notice internal body signals such as hunger, thirst, heartbeat, temperature, or tension.

Many neurodivergent adults report:

🍽 Forgetting to eat or drink until they feel unwell
😴 Not noticing fatigue until they “hit a wall”
💓 Feeling physical discomfort without knowing whether it is emotion, illness or both

When interoceptive awareness is low or inconsistent:

🧩 Emotional states may be experienced more as vague bodily discomfort
❓ It becomes harder to answer questions like “Am I stressed, or just tired and hungry?”
📉 Emotion regulation strategies that rely on naming feelings (“Notice you are anxious, then…”) may be less accessible

Improving interoceptive awareness can, over time, support better emotional understanding—but it tends to be a gradual process.

🧰 Working with alexithymia: practical strategies

Alexithymia is not something you simply “fix”. Instead, you can build tools and structures around it.

Externalising emotion tracking

📓 Use a simple daily check‑in system, such as a feelings chart or 0–10 scales for key states (energy, tension, anxiety)
🎨 Consider visual tools (colour codes, emoji scales) instead of only words
📱 Use reminders to pause briefly and notice body sensations at pre‑set times

Broad categories instead of perfect labels

🔹 Start with a small set of categories such as “okay”, “not okay”, “overwhelmed”, “shut down”
🧠 Treat these as rough indicators rather than precise labels
📈 Over time, add more nuance if it becomes natural, but do not force complexity early

Connecting body cues to states

🧍‍♀️ Notice patterns such as: “When my jaw and shoulders are tense, I am often in early stress”
💓 Map specific body sensations to possible states (fast heart + tight chest = “might be anxious or overstimulated”)
📌 Write down a short list of your common body–emotion links and refer to it when unsure

Using behaviour as information

🧺 Observe what you do when under strain (for example, withdraw, overtalk, scroll, overwork)
🔍 Treat these behaviours as “flags” pointing to underlying states you may not yet feel clearly
📆 Adjust environment or demands when you notice those flags, even if you can’t name the exact emotion

The aim is not to become perfectly emotionally articulate, but to build enough cues to guide decisions and self‑care.

👥 Alexithymia and relationships

Alexithymia can create recurring misunderstandings in relationships, both personal and professional.

Common patterns include:

🎭 Others perceiving you as distant, unemotional or uncaring when you are actually unsure how to express what is happening internally
❓ Difficulty answering partners’ questions like “What’s wrong?” or “What do you need?”
🔁 Conflict around repeated patterns (“You suddenly withdraw”, “You don’t tell me when something is wrong”)

Some ways to reduce friction:

🗣 Share the concept of alexithymia with trusted people so they understand this as a pattern, not rejection
📋 Use prepared phrases such as “I can tell something is off, but I don’t know what it is yet. I need time to process.”
🧭 Agree that sometimes you will signal “not okay” without full explanation, and that more detail may come later

For partners or friends, it can help to shift from:

❓ “Tell me exactly what you feel now”
to
✅ “Do you feel roughly okay or not okay?” / “Do you need more contact or more space?”

This keeps communication functional without requiring precise emotional language on demand.

🧱 How alexithymia affects therapy and self‑help

Many standard therapy and self‑help approaches start from assumptions like:

🧠 “Notice what you feel in your body.”
🧠 “Name your emotion and then choose a coping skill.”

For people with alexithymia, these steps can be very difficult and sometimes frustrating.

Possible adaptations include:

📋 Focusing first on observable situations and behaviours, then gradually exploring possible feelings
📊 Using rating scales (“0–10 intensity”) instead of detailed labels
🧠 Working with cognitive patterns (thoughts, beliefs) alongside slow development of emotional vocabulary
📦 Practising with real-life examples rather than abstract “how do you feel” questions

If a therapist or coach understands alexithymia, they can adjust expectations and methods, which often makes the process more effective.

🆘 When to seek additional support

It may be helpful to seek professional or peer support if:

🚩 Emotional confusion is contributing to frequent conflict or misunderstandings
🚩 You often reach crisis (meltdowns, shutdowns, burnout, quitting jobs) “without warning”
🚩 You suspect there may be anxiety, depression or trauma but find it hard to describe what is happening internally

Useful support options can include:

🧑‍⚕️ Therapists experienced with autism, ADHD or AuDHD, who understand alexithymia and interoception
🤝 Peer groups where people discuss similar patterns and share tools
📚 Psychoeducation resources on emotion regulation tailored for neurodivergent adults

The goal is not to become a different person emotionally, but to gain enough understanding to navigate life with fewer surprises and crises.

📘 Summary

Alexithymia in neurodivergent adults is best understood as:

🧠 A difficulty recognising, distinguishing and describing emotions
🧩 A common companion of autism, ADHD and AuDHD
⚙️ A factor that complicates anxiety, depression, burnout and relationships

Key points:

💡 Alexithymia does not mean “no feelings”; it means reduced access to emotional information
🔍 It often shows up as delayed recognition of stress, vague bodily discomfort and difficulty answering “how are you?”
🧰 Working with alexithymia involves external tools, broad categories, body cue mapping and behaviour‑based “flags”
👥 Sharing the concept with others can reduce misinterpretation and support more practical communication

Instead of assuming “I should know exactly what I feel at all times”, this framework allows a more realistic approach:

🧠 “Given that my access to emotions is limited or delayed, what systems can I build so I still get the information I need to take care of myself?”