Interoception and Neurodivergence: Why Body Signals Are Hard to Read

Many autistic, ADHD and AuDHD adults describe things like:

🗣 “I forget to eat until I feel sick.”
🗣 “I can’t tell if I’m anxious, tired, or coming down with something.”
🗣 “I only realise I needed a break after I crash.”

These are all related to interoception — the way the brain senses and interprets signals from inside the body.

Interoception and neurodivergence is an important piece of the puzzle for understanding energy, emotions, burnout and self‑care in neurodivergent adults.

🧾 What this article explains

🩺 What interoception is and how it works
🧩 How interoception often differs in autistic, ADHD and AuDHD adults
🔍 How interoception links to emotions, alexithymia and shutdowns
📉 How interoceptive differences affect daily life, health and energy
🧰 Practical ways to work with your interoception rather than against it

The focus is educational. The aim is to give you language and structure for patterns you may already have noticed.

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🩺 What is interoception?

Interoception is the sense that tracks what is happening inside your body.

It includes signals such as:

💓 Heartbeat and pulse
🌡 Temperature (too hot, too cold)
🍽 Hunger and fullness
🥤 Thirst
😴 Sleepiness and fatigue
🚽 Need to use the bathroom
😣 Pain and discomfort
😮‍💨 Breathlessness or tightness in the chest

The brain constantly receives and interprets these signals, usually outside of conscious awareness. Based on that, it helps you:

🧭 Notice when something needs attention
🧱 Adjust behaviour (eat, drink, rest, take off a jumper, seek medical help)
💬 Form the basis of emotional experiences (“I feel calm / tense / sick / anxious”)

When interoception is working smoothly, you don’t have to think about it much. You simply “know” you’re hungry, tired, stressed or unwell.

When interoception is different or inconsistent, that internal knowing becomes less reliable.

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🧩 How interoception works in everyday life

Even without thinking about it, interoception shapes a lot of daily decisions.

🧍‍♀️ Monitoring internal status

Your brain is constantly checking:

💓 “Is my heart rate roughly where it should be?”
🍽 “Do I need fuel?”
🥤 “Do I need fluids?”
🌡 “Is my temperature ok?”
😴 “Is it time to sleep?”

If signals cross certain thresholds, you consciously notice:

🍽 “I’m hungry.”
🥤 “I’m thirsty.”
😴 “I’m exhausted.”

Those conscious experiences then feed into actions.

🧭 From signal to action

Ideally, the chain looks like:

🧠 Body sends a clear enough signal
💡 Brain recognises it (“this is hunger / thirst / fatigue / pain”)
🧭 You decide “I should eat / drink / rest / get this checked”
🚶‍♀️ You act on that decision

When interoception is harder to read, any of these links can break. You might:

😕 Notice vague discomfort but not know what it means
⏳ Notice the signal very late (only when it’s extreme)
🔁 Misinterpret signals (for example, treating anxiety as a purely physical problem)
📉 Ignore or override signals until they become urgent

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🧠 Interoception in autistic, ADHD and AuDHD adults

Research and lived experience both suggest that interoception works differently for many neurodivergent people. That doesn’t mean it is always worse; it can be reduced, heightened, or inconsistent.

🧩 Interoception in autistic adults

Common patterns reported include:

🍽 Forgetting to eat or drink until feeling faint, shaky or nauseous
🚽 Ignoring or not noticing bathroom needs until they are very urgent
🌡 Being unsure whether physical discomfort is “normal” or requires help
💓 Difficulty distinguishing emotional arousal (anxiety, anger) from physical problems

For some autistic adults, interoception is under‑responsive (signals feel faint or delayed). For others, it can be over‑responsive (internal sensations feel intense or overwhelming).

Both patterns can make it harder to match internal signals to useful action.

⚡ Interoception in ADHD adults

In ADHD, attention and time perception also interact with interoception.

Common experiences include:

⏳ Hyperfocus leading to long periods without noticing hunger, thirst or fatigue
📺 Realising you are exhausted only after you stop an activity
❓ Difficulty distinguishing between being “bored”, “tired”, or “low”
🙃 Using external stimulation (caffeine, sugar, screens) to override or ignore body signals

Here, signals may be present, but they are:

📉 Competing with high external stimulation
📆 Not checked regularly because attention is focused outward or on urgent tasks

🎢 Interoception in AuDHD adults

AuDHD combines autistic and ADHD traits, so interoception can be influenced by both:

🎧 Sensory overload and masking can drown out subtle body signals
🚀 Fast shifts in activity and focus can make it harder to notice gradual changes
🧩 Emotional states may flip quickly without clear internal explanation

Many AuDHD adults describe:

🧱 Sudden crashes (physical or emotional) that seem to arrive “out of nowhere”
🧊 Difficulty explaining to others whether they are unwell, tired, or emotionally overloaded

In reality, there are often many early signals — but they are either too faint, too intense, or overshadowed by other demands.

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🔍 Interoception, alexithymia and emotion recognition

Interoception and alexithymia (difficulty identifying and describing feelings) are closely connected.

Emotions are not just thoughts; they are built from:

💓 Body signals (heartbeat, tension, temperature, breathing)
🧠 Brain interpretations of those signals
📜 Context and meaning (what is happening around you)

When interoceptive signals are unclear or inconsistent:

❓ It becomes harder to say which emotion you are experiencing
🧩 Emotions may be experienced as vague discomfort, heaviness or agitation
📆 Emotional patterns may only be recognised in hindsight (“I guess I was anxious all week”)

This can lead to:

🧱 Underestimating stress, because it does not feel like stress
📉 Delayed recognition of anxiety, depression or burnout
🔁 Reliance on behaviour (withdrawal, overworking, irritability) as the main signal that something is wrong

Understanding interoception can therefore clarify why “checking in with your feelings” is harder than it sounds.

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📉 How interoceptive differences affect daily life

Interoceptive differences can have wide‑ranging effects, even when they are subtle.

🍽 Basic needs and self‑care

People often report:

🥤 Long periods without drinking, followed by headaches or fatigue
🍽 Forgetting meals or eating irregularly, then feeling unwell or shaky
🚽 Ignoring bathroom needs because the signal did not register strongly enough
😴 Not noticing tiredness until they suddenly cannot function

This can create cycles such as:

🍽 “I skip meals, then overeat quickly when I finally notice hunger.”
😴 “I push through tiredness until I crash and then sleep for a very long time.”

🩺 Health and medical care

If interoceptive signals are hard to interpret, it can be challenging to:

❓ Know when a symptom is serious enough to need medical attention
🗣 Describe pain or discomfort clearly to health professionals
📆 Notice gradual changes (for example, ongoing fatigue or low‑grade pain) before they accumulate

This can delay diagnosis or management of physical conditions.

🔋 Energy, overload and burnout

Interoception also plays a role in energy management:

🧱 If early signs of overload or fatigue are not noticed, you may continue in demanding situations too long
🔥 This raises the risk of shutdowns, meltdowns or neurodivergent burnout
📉 Recovery may start only when the system is already in a deep crash

Without reliable internal signals, it becomes harder to pace yourself. You may oscillate between overdoing and stopping completely.

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🧰 Working with interoceptive differences

Interoception is not something you can simply “fix” on command, but you can build supports around it.

📅 External structure for body needs

Instead of waiting to feel hunger, thirst or fatigue clearly, you can use external prompts:

⏰ Regular reminders for meals, drinks and short breaks
📋 Pre‑planned routines (for example, “glass of water every time I sit down to work”)
🍽 Simple, predictable food options to reduce decision effort when signals are unclear

This shifts from “respond when I notice” to “assume I have needs and support them regularly.”

🧭 Building a personal signal map

You can gradually build your own “dictionary” of how body signals tend to show up:

📓 Keep brief notes: “When I have tension here, it often means X”
💓 Notice heart rate, breathing, muscle tension and link them to activities and contexts
📌 Over time, identify patterns such as: “Tightness in my shoulders + fast thoughts often precedes overload”

The goal is not perfect accuracy, but enough recognition to adjust earlier.

🧿 Using the environment as feedback

If interoceptive signals are subtle, external signs can act as proxies:

📦 Messier environment than usual can signal reduced capacity
📧 Growing backlog of messages may indicate rising cognitive load
🗓 Frequent cancellations or avoidance can be a sign of accumulating social or sensory strain

These are not moral judgments; they are data points. They can remind you to rest or adjust expectations even if your body does not feel obviously “tired”.

🗣 Communication strategies

When describing how you feel, it might help to:

🧾 Talk in terms of energy and capacity (“I have low energy”, “I’m overloaded”) rather than precise emotions
📋 Use simple scales (“My energy is 3/10 today”)
🔍 Mention uncertainties (“I’m not sure if this is illness or stress, but my body feels off”)

This lets you communicate useful information without needing perfect emotional or physical clarity.

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🧪 Interoception and therapy/self‑help

Many therapy and self‑help approaches assume that people can:

🧠 Easily notice body sensations on command
🧠 Quickly connect them to specific emotions

For people with interoceptive differences, these steps can be slow and effortful. Some adjustments that may help:

📋 Starting with concrete, observable situations and behaviours before focusing on internal states
📊 Using structured scales or charts rather than open‑ended “how do you feel?” questions
🧱 Allowing more time to notice and explore body sensations without pressure to label them perfectly
🔁 Practising small, repeated check‑ins instead of expecting immediate insight

If a clinician understands interoception in a neurodivergent context, they can adapt techniques accordingly.

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🆘 When to seek additional support

It may be useful to seek professional input when:

🚩 Interoceptive confusion leads to repeated health crises or near‑misses
🚩 You frequently reach collapse (burnout, shutdown, severe anxiety) without seeing it coming
🚩 You suspect underlying conditions (physical or mental health) but struggle to describe your experience

Helpful sources can include:

🧑‍⚕️ ND‑informed clinicians (GPs, psychiatrists, psychologists, occupational therapists)
🤝 Peer groups where interoception, alexithymia and ND self‑care are discussed in practical terms
📚 Psychoeducation resources about interoception and emotion regulation tailored to neurodivergence

Support is not about making your body “typical”. It is about improving your maps and tools so you can navigate more safely.

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📘 Summary

Interoception is the internal sense that tells your brain what is happening in your body. In many autistic, ADHD and AuDHD adults, interoception is:

📉 Less reliable, delayed, or overly intense
🧩 Harder to interpret and connect to clear emotional or practical conclusions
📆 Strongly affected by sensory load, masking, attention and routine

Key points:

🧠 Interoceptive differences can explain why hunger, thirst, pain, fatigue and emotion are easy to miss or misinterpret
🔍 They are closely linked with alexithymia and can complicate anxiety, depression and burnout
🧰 Working with interoception involves external routines, personal signal maps, environmental cues and adapted communication
📈 The goal is not perfection, but enough information to make better decisions about rest, food, activity and support

Instead of expecting your body to “speak clearly” like a textbook, this perspective asks:

🧭 “Given how my body signals actually behave, what systems can I put in place so I still know when I need to eat, rest, slow down or seek help?”