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Health and wellbeing

Health and wellbeing

An overview of autistic health and wellbeing: autistic burnout, spoon theory and energy, mental health, anxiety, physical health and lifespan, getting health care, suicide and self-harm, and periods, pregnancy care and menopause. Each section links to a full entry.

A short tour of health for autistic people, from burnout and energy to mental and physical health, getting health care, suicide and self-harm, and periods, pregnancy and menopause. Each part links to a longer page.

Last reviewed 5 October 2026 · one person's reading of the research · 30 research and 1 community sources

Autistic burnout Established

The first research study of autistic burnout, in the US, drew on 19 interviews with autistic adults and 19 public online sources, and identified three core features: chronic exhaustion, loss of skills, and reduced tolerance of stimulation.1 Participants described burnout building from everyday stresses, masking the most prominent among them, that added up over time, along with barriers that kept them from getting relief, until what was expected of them outweighed what they could do.1 A 2025 systematic review of 48 studies, most of them qualitative, described burnout as debilitating exhaustion and increased disability that could be chronic with intermittent crises.2 Its length varies a great deal: in an Australian survey of 141 autistic adults, people's typical episodes ranged from hours to more than a year, and 20% said a typical episode lasted three months or more.3

Full entryAutistic burnout A long stretch of exhaustion, lost skills and lower tolerance of noise and people that many autistic adults describe. How the community uses the term, where it came from, what research since 2020 has found, and the arguments over whether it differs from depression.

The first study of autistic burnout talked with 19 autistic adults in the US. It found three main signs. People were very tired for a long time. They lost skills they used to have. And noise, light and other input got harder to bear.1 People said burnout built up from everyday stress. The biggest part was masking, which means hiding autistic ways to fit in. In time, what others expected of them was more than they could do.1 A big review of 48 studies found that burnout can last a long time, with bad spells along the way.2 It lasts a different time for each person. In one survey, it lasted from hours to more than a year.3

Full entryAutistic burnout Autistic burnout is a long time of deep tiredness, losing skills and finding noise and people harder to handle. Here is how autistic people use the words, where they came from, and what studies show so far.
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Established

Summarizes Autistic burnout. A 2025 systematic review and studies by separate groups in the US and Australia agree on the description of exhaustion and lost skills, as reported by the adults studied. Most of the studies are qualitative, and their participants were mostly white, mostly women and mostly diagnosed late. The length of episodes comes from one survey.

Established

Many studies agree on what burnout feels like, as the adults in them describe it. Most of those adults were white women who found out late that they were autistic.

Spoon theory and energy Emerging

Spoon theory began with a 2003 essay by Christine Miserandino, who has lupus, in which spoons stand for units of energy: "when your 'spoons' are gone, they are gone", and borrowing against tomorrow's spoons makes tomorrow harder.c1 She wrote that the idea "isn't just good for understanding Lupus, but anyone dealing with any disability or illness."c1 In Norway, 14 autistic young adults aged 21 to 29 talked about a "social battery being emptied", and the authors report this was "evident for many of the interviewees".4 In a Dutch population study of 35,048 adults, people who reported more autistic traits also reported more fatigue, though the study measured everything at one time, so it cannot say which comes first.5

Full entrySpoon theory and energy Spoon theory and the other energy metaphors autistic people use to explain what an ordinary day costs. Where they came from, why they resonate, what research shows about fatigue, and how little the models themselves have been tested.

Spoon theory is a way to talk about energy. Christine Miserandino made it up in 2003. She has an illness called lupus. In her story, each spoon stands for a bit of energy. When the spoons are gone, they are gone.c1 She wrote that the idea can help anyone with a disability or illness.c1 In Norway, many young autistic adults talked about a "social battery" that gets used up.4 In one big Dutch study, people with more autistic traits also said they felt more tired. The study checked only once, so it cannot tell which came first.5

Full entrySpoon theory and energy Spoon theory and other ways autistic people explain how much energy a normal day takes. Where the ideas came from, why people like them, what scientists know about tiredness, and how little the ideas have been tested.
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Emerging

Summarizes Spoon theory and energy. The origin rests on a dated essay, and interview studies find autistic adults using the same energy language. The fatigue finding comes from one population study that measured traits and fatigue by questionnaire at one time. In the studies the full entry reviews, no one has tested spoon theory or energy accounting directly.

Emerging

We know where the idea came from, and many autistic adults use it. But nobody has tested whether energy really works this way.

Mental health Established

Among autistic adults, a meta-analysis of 35 studies found about 27% with an anxiety disorder at the time of study and 42% at some point in life; for depression the figures were 23% and 37%, though the studies leaned heavily on clinic samples.6 Autistic people die by suicide more often than other people: a 2024 meta-analysis of 10 studies, covering about 10.4 million people, put the risk at about 2.85 times that of non-autistic people, and its authors note the studies were few and covered few countries.7 Pooling 36 studies of autistic and possibly autistic people without intellectual disability, 34.2% had had suicidal thoughts, 21.9% had made plans and 24.3% had made an attempt or other suicidal act.8 Reviews pooling dozens of studies find that the most common barrier to psychological treatment is that therapists lack knowledge of autism or cannot or will not adapt their approach.9

Full entryMental health How often autistic adults have anxiety, depression and other mental-health diagnoses, what is known about suicide risk, and why services and talking therapies often fit poorly. The high rates are well established; most of what explains them, and most of what helps, rests on small or early studies.

Anxiety means strong worry. Depression means feeling very low for a long time. Both are much more common in autistic adults. In one big review, about 4 in 10 had anxiety at some point, and almost as many had depression.6 Suicide means ending your own life. Autistic people die by suicide about 3 times as often as other people.7 In one pooled study, about 1 in 3 autistic adults had had thoughts of suicide.8 Help is often hard to get. Many therapists do not know about autism or do not change how they work.9

Full entryMental health How often autistic adults feel very worried or very low, what is known about suicide, and why help often does not fit. Scientists are sure the rates are high. Most of what helps has only been tested in small studies.
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Established

Summarizes Mental health. Several meta-analyses and national registers agree that anxiety, depression, suicide and suicidal thoughts are more common, though the exact figures vary widely. The account of services comes from several independent reviews of autistic people's own reports.

If you are thinking about suicide

Please talk to someone now: a doctor, a person you trust, emergency services, or a crisis line where you live. International directories of crisis lines list free services by country.

Established

Many big studies from different places agree on these numbers. The exact numbers change from study to study.

If you are thinking about suicide

Please talk to someone now. You can call a doctor, a person you trust, emergency services, or a crisis line where you live.

Anxiety Established

At the time of study, social anxiety disorder was the most common kind of anxiety disorder in autistic adults, at about 29%, followed by obsessive-compulsive disorder at 24% and generalized anxiety disorder at 18%.6 A 2019 meta-analysis across all ages, counting only confirmed diagnoses, put anxiety disorders at about 20%, against about 7% in published general-population figures; studies of whole populations or registers gave about 15%.25 In autistic children and young people, a 2021 meta-analysis of 19 trials with 833 participants found the effects of cognitive behavioral therapy on anxiety largest on clinician ratings and smallest on the young people's own reports, and found no evidence that the benefits lasted at follow-up, though few trials measured it.26

Full entryAnxiety How common anxiety is in autistic adults, how it can differ from anxiety in other people, how well the usual questionnaires work, and what is known about adapted therapies and medication.

Anxiety means strong worry or fear that is hard to control. In autistic adults, the most common kind was social anxiety, a strong fear of being judged by others. About 29% had it at the time of the studies.6 Across all ages, about 20% of autistic people had an anxiety disorder. In the general population, the figure is about 7%.25 A talking therapy called CBT lowers anxiety in autistic children for a while. Therapists saw the biggest change, and children saw the smallest. No one has shown that it lasts.26

Full entryAnxiety How common anxiety is in autistic adults, how it can be different, how well the usual questionnaires work, and what is known about therapy and medicine.
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Established

Summarizes Anxiety. Several meta-analyses agree that anxiety disorders are more common in autistic people, though they pool many of the same mostly clinic-based studies and the figures vary widely. The therapy finding comes from meta-analyses of overlapping trials in children, measured over the short term.

Established

Several big reviews agree that anxiety is more common in autistic people. The numbers vary a lot. The therapy finding is about children, over a short time.

Physical health and lifespan Emerging

In the health records of one large US insurer, nearly all medical conditions were more common in 1,507 autistic adults than in 15,070 adults of the same age and sex, including immune conditions, gut and sleep disorders, seizures, obesity, high cholesterol, high blood pressure and diabetes.10 People diagnosed autistic die at higher rates than other people of the same age and sex: a 2022 meta-analysis of 12 studies found a risk about 2.4 times that of the general population, with wide differences between studies.11 The figures often quoted, that autistic people live to 36 or to 54, are average ages at death among the minority who died during short studies, not life expectancy.12,13 The one life-table study, from UK primary-care records, found a gap of about 6 years for autistic adults without an intellectual disability, and its authors think even that may be too high.14

Full entryPhysical health and lifespan Which physical conditions are more common in autistic adults and which appear earlier, how much higher death rates are and why the life expectancy figures often quoted are wrong, and what the evidence says about the idea that the immune system plays a part in autism. A research summary, not medical advice.

In one large set of US health records, autistic adults had more of almost every illness. These included sleep and stomach problems, seizures and diabetes.10 Autistic people also die at more than twice the rate of other people their age.11 You may hear that autistic people live only to 36 or 54. Those numbers are not how long autistic people live. They are the average age of the few people who died during short studies.12,13 One UK study worked out how long autistic adults can expect to live. For those without an intellectual disability, it found about 6 years less than others. Its writers think even that may be too high.14

Full entryPhysical health and lifespan Some health problems of the body are more common in autistic adults. This page covers which ones, how long autistic people live, and an idea about the immune system that has not been proven.
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Emerging

Summarizes Physical health and lifespan. Large health-record studies and a meta-analysis agree that physical conditions and death rates are higher. The life-expectancy estimate comes from one UK study of people with a recorded diagnosis, and its authors think it may overstate the gap, so the section as a whole is emerging.

Word
Life table

A method that uses death rates at each age to estimate how long a group of people can expect to live.

Emerging

Big studies agree that health problems are more common. How much shorter lives are comes from only one study, and its writers think it may be too high.

Getting health care Established

Autistic adults use emergency departments more than other adults.28,29 A systematic review of 11 studies found communication difficulties, sensory overload, long waits and staff who were not prepared the most frequent problems.27 Screening is missed more often: in two independent studies autistic adults were less likely to have had cervical screening,28,29 and in England a free annual health check goes to people on their doctor's learning disability register, which a diagnosis of autism alone does not put someone on, as of July 2026.30 Autistic people also die at higher rates than others of the same age and sex,11 and in the July 2026 LeDeR review 39% of deaths of people with a learning disability were from an avoidable cause, nearly double the general population.30

Full entryGetting health care What autistic people face in emergency departments, surgery, scans, dental and eye care and cancer screening, how often care goes wrong or is delayed, and what the evidence says helps. A research summary, not medical advice.

Autistic adults go to the emergency department more often than other adults.28,29 A review of 11 studies looked at what gets in the way. The biggest problem was hard communication. Others were too much noise and light, long waits, and staff who were not ready.27 Autistic adults are also less likely to have cervical screening, a test that checks for cancer of the cervix.28,29 In England, a free yearly health check goes to people on their doctor's learning disability register. Being autistic on its own does not put someone on it.30 Autistic people also die at higher rates than other people of the same age.11

Full entryGetting health care What happens when autistic people go to the doctor, the hospital or the dentist. Some problems are well known. What helps is less certain.
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Established

Summarizes Getting health care. The barrier findings come from systematic and scoping reviews, and the death-rate finding from a meta-analysis and national registers. The full entry also covers what helps, where the evidence is much thinner.

Established

Many studies agree that autistic people face more barriers to health care. What helps is much less certain.

Suicide and self-harm Established

Autistic people die by suicide more often than other people: a 2024 meta-analysis of 10 studies, covering about 10.4 million people, put the risk at about 2.85 times that of non-autistic people.31 Thoughts of suicide are common: pooling 36 studies of autistic and possibly autistic people without intellectual disability, 34.2% had had suicidal thoughts, 21.9% had made plans and 24.3% had made an attempt or other suicidal act.32 Autistic people also self-harm more often, at about three times the odds in a meta-analysis of 31 studies.33 Standard questionnaires often misread autistic people, and as of October 2026 no measure of self-harm had been validated for autistic people.34 Adapted safety plans were acceptable in a small pilot trial of 49 adults, but no trial powered to show whether they work was found as of October 2026.35

Full entrySuicide and self-harm How often autistic people die by suicide or have suicidal thoughts, what is known about self-harm, why standard questions and safety plans often fit poorly, and what autistic writers say. The raised risk is well established; most of what helps rests on small, early studies.

Autistic people die by suicide more often than other people. A review of 10 studies, covering about 10.4 million people, found the risk was about 2.85 times higher.31 Many autistic adults have thought about suicide. In a review of 36 studies, about 34 in 100 had had these thoughts. About 22 in 100 had made a plan. About 24 in 100 had made an attempt or another suicidal act.32 Autistic people also self-harm more often. A review of 31 studies found the chance was about three times higher.33 Many standard questionnaires do not fit autistic people. As of October 2026, no self-harm questionnaire had been checked for use with autistic people.34 A small pilot study found an adapted safety plan was acceptable, but no larger trial has tested whether it works.35

Full entrySuicide and self-harm Some autistic people think about suicide, or hurt themselves. This is much more common than in other people. A few kinds of help may work, but scientists are still learning what helps most.
Suggest a correction
Established

Summarizes Suicide and self-harm. National registers and meta-analyses agree that suicide, suicidal thoughts and self-harm are more common. The self-harm patterns and the safety-plan findings in the full entry rest on small, mostly cross-sectional studies.

If you are thinking about suicide

Please talk to someone now: a doctor, a person you trust, emergency services, or a crisis line where you live. International directories of crisis lines list free services by country.

Established

Big studies from several countries agree that suicide, thoughts of suicide and self-harm are more common in autistic people. What helps is much less certain.

If you are thinking about suicide

Please talk to someone now. You can call a doctor, a person you trust, emergency services, or a crisis line where you live.

Periods, pregnancy care and menopause Established

Autistic people report that periods are harder: a systematic review of twelve sources found more sensory sensitivity, burnout and anxiety around them, and that the people supporting them often do not see it.36 In a United Kingdom survey of 136 autistic adults, respondents said they were uncomfortable discussing periods with clinicians and that clinicians rarely adjusted for their sensory or communication needs.37 Maternity care repeats the pattern: a mapping review of 25 papers found sensory overload, communication barriers and a poor fit with routine care again and again,38 and among autistic people giving birth on United States Medicaid, postpartum anxiety (adjusted hazard ratio 3.2) and postpartum depression (2.4) were more common than among other birthing people.39 Menopause is described the same way: a mixed-methods review of eight studies and seven first-hand accounts found low knowledge, a wide range of negative symptoms, and treatment experiences that were mostly negative.40 No HRT trial in autistic people was found as of October 2026.

Full entryPeriods, pregnancy care and menopause How autistic adults experience periods, premenstrual symptoms, pregnancy and menopause, and what the research says about the barriers they meet in care. A research summary, not medical advice.

Autistic people say periods are harder. A review of 12 studies found more sensory sensitivity, burnout and worry around them, and that the people helping often did not notice.36 In one UK survey, autistic adults said talking about periods with a doctor felt uncomfortable and that doctors rarely changed anything for their senses or the way they communicate.37 Birth and maternity care follow the same pattern. A review of 25 studies found too much noise and light, hard communication, and care that did not fit.38 Among autistic people giving birth on US Medicaid, anxiety and depression after the birth were more common than among other people.39 Menopause is described the same way. A review of 8 studies and 7 first-hand accounts found people knew little about it, had many hard symptoms, and mostly found that treatment did not go well.40 No HRT trial in autistic people was found as of October 2026.

Full entryPeriods, pregnancy care and menopause How autistic people experience periods, pregnancy and menopause, and why care can be harder to get.
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Established

Summarizes Periods, pregnancy care and menopause. A systematic review and independent surveys agree that autistic people report periods, pregnancy and menopause as harder, and reviews of maternity care find the same barriers. The samples are small, mostly recruited online and mostly late-diagnosed women, and the symptom-severity figures are early evidence.

Established

Many studies agree that autistic people find periods, pregnancy and menopause harder, and that care often does not fit. The studies are small.

Sources

Research

  1. 1Raymaker DM, Teo AR, Steckler NA, et al. "Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew": Defining Autistic Burnout. Autism in Adulthood, 2020. https://doi.org/10.1089/aut.2019.0079 ; https://pmc.ncbi.nlm.nih.gov/articles/PMC7313636/
  2. 2Ali D, Bougoure M, Cooper B, et al. Burnout as experienced by autistic people: A systematic review. Clinical Psychology Review, 2025. https://doi.org/10.1016/j.cpr.2025.102669
  3. 3Arnold SRC, Higgins JM, Weise J, et al. Confirming the nature of autistic burnout. Autism, 2023. https://doi.org/10.1177/13623613221147410
  4. 4Øverland E, Hauge ÅL, Orm S, et al. "I have to charge my social battery": Perspectives from autistic young adults on Quality of Life. Autism, 2024. https://doi.org/10.1177/13623613241245578
  5. 5Li Y, Xie T, Snieder H, et al. Associations between autistic and comorbid somatic problems of gastrointestinal disorders, food allergy, pain, and fatigue in adults. Autism, 2024. https://doi.org/10.1177/13623613241254619
  6. 6Hollocks MJ, Lerh JW, Magiati I, et al. Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis. Psychological Medicine, 2019. https://doi.org/10.1017/S0033291718002283 ; https://pubmed.ncbi.nlm.nih.gov/30178724/
  7. 7Santomauro DF, Hedley D, Sahin E, et al. The global burden of suicide mortality among people on the autism spectrum: A systematic review, meta-analysis, and extension of estimates from the Global Burden of Disease Study 2021. Psychiatry Research, 2024. https://doi.org/10.1016/j.psychres.2024.116150 ; https://pubmed.ncbi.nlm.nih.gov/39197224/
  8. 8Newell V, Phillips L, Jones C, et al. A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability. Molecular Autism, 2023. https://doi.org/10.1186/s13229-023-00544-7 ; https://pubmed.ncbi.nlm.nih.gov/36922899/
  9. 9Adams D, Young K. A Systematic Review of the Perceived Barriers and Facilitators to Accessing Psychological Treatment for Mental Health Problems in Individuals on the Autism Spectrum. Review Journal of Autism and Developmental Disorders, 2021. https://doi.org/10.1007/s40489-020-00226-7
  10. 10Croen LA, Zerbo O, Qian Y, et al. The health status of adults on the autism spectrum. Autism, 2015. https://doi.org/10.1177/1362361315577517
  11. 11Catalá-López F, Hutton B, Page MJ, et al. Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder. JAMA Pediatrics, 2022. https://doi.org/10.1001/jamapediatrics.2021.6401
  12. 12Guan J, Li G. Injury Mortality in Individuals With Autism. American Journal of Public Health, 2017. https://doi.org/10.2105/AJPH.2017.303696
  13. 13Hirvikoski T, Mittendorfer-Rutz E, Boman M, et al. Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 2016. https://doi.org/10.1192/bjp.bp.114.160192
  14. 14O'Nions E, Lewer D, Petersen I, et al. Estimating life expectancy and years of life lost for autistic people in the UK: a matched cohort study. The Lancet Regional Health - Europe, 2024. https://doi.org/10.1016/j.lanepe.2023.100776
  15. 25Lai MC, Kassee C, Besney R, et al. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. The Lancet Psychiatry, 2019. https://doi.org/10.1016/S2215-0366(19)30289-5
  16. 26Sharma S, Hucker A, Matthews T, et al. Cognitive behavioural therapy for anxiety in children and young people on the autism spectrum: a systematic review and meta-analysis. BMC Psychology, 2021. https://doi.org/10.1186/s40359-021-00658-8
  17. 27Hamad O, Klára S, Elmadani M, et al. Enhancing emergency department care for individuals with autism spectrum disorder across the lifespan: a systematic review. Frontiers in Health Services, 2026. https://doi.org/10.3389/frhs.2026.1835710
  18. 28Nicolaidis C, Raymaker D, McDonald K, et al. Comparison of healthcare experiences in autistic and non-autistic adults: a cross-sectional online survey facilitated by an academic-community partnership. Journal of General Internal Medicine, 2013. https://doi.org/10.1007/s11606-012-2262-7
  19. 29Schuering KM, Sewell K, Hua J, et al. Health Care Utilization and Cancer Screening Among Patients with Neurodivergence in a Safety-Net Adult Primary Care Clinic. Journal of General Internal Medicine, 2026. https://doi.org/10.1007/s11606-026-10272-2
  20. 30Gibson J, Coppinger L, Handley-Cole E. Avoidable mortality: learning from the lives and deaths of people with a learning disability and autistic people. British Journal of General Practice, 2026. https://doi.org/10.3399/bjgp.2026.0415
  21. 31Santomauro DF, Hedley D, Sahin E, et al. The global burden of suicide mortality among people on the autism spectrum: A systematic review, meta-analysis, and extension of estimates from the Global Burden of Disease Study 2021. Psychiatry Research, 2024. https://doi.org/10.1016/j.psychres.2024.116150
  22. 32Newell V, Phillips L, Jones C, et al. A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability. Molecular Autism, 2023. https://doi.org/10.1186/s13229-023-00544-7
  23. 33Blanchard A, Chihuri S, DiGuiseppi CG, Li G. Risk of Self-harm in Children and Adults With Autism Spectrum Disorder. JAMA Network Open, 2021. https://doi.org/10.1001/jamanetworkopen.2021.30272
  24. 34Gordon I, Pelton M, Goodwin J, et al. 'My Answers Don't Fit Your Options': Measuring Self-Harm With Autistic People Using the Self-Injurious Thoughts and Behaviours Interview (SITBI). Autism, 2026. https://doi.org/10.1177/13623613261435249
  25. 35Rodgers J, Bhattarai N, Goodwin J, et al. Adapted Safety Plans to Address Self-Harm and Suicide Behaviours in Autistic Adults: single arm feasibility trial and external pilot RCT. Public Health Research, 2025. https://doi.org/10.3310/CGDF8525
  26. 36Ellis R, Williams G, Caemawr S, et al. Menstruation and Autism: A Qualitative Systematic Review. Autism in Adulthood, 2026. https://doi.org/10.1089/aut.2024.0307
  27. 37de Visser RO, Mosely R, Gamble-Turner J, et al. Unmet need for autism-aware care for gynaecological, menstrual and sexual wellbeing. Autism, 2025. https://doi.org/10.1177/13623613241290628
  28. 38Steinbrück PC, Byrne S, Tollenaere E. Autistic persons in the perinatal context: A mapping review of midwifery care, experiences, needs, and evidence. Midwifery, 2026. https://doi.org/10.1016/j.midw.2026.104936
  29. 39Shea L, Sadowsky M, Tao S, et al. Perinatal and Postpartum Health Among People With Intellectual and Developmental Disabilities. JAMA Network Open, 2024. https://doi.org/10.1001/jamanetworkopen.2024.28067
  30. 40Grant A, Axbey H, Holloway W, et al. Autism and the Menopause Transition: A Mixed-Methods Systematic Review. Autism in Adulthood, 2026. https://doi.org/10.1177/25739581251369452

Community sources

  1. c1Miserandino C. The Spoon Theory. ButYouDontLookSick.com, 2003 (earliest archived copy, posted 18 November 2004). https://web.archive.org/web/20051125045420/http://www.butyoudontlooksick.com:80/2004/11/the_spoon_theory.php